Published ahead of print on December 18, 2003, doi:10.1164/rccm.200305-692OC Am. J. Respir. Crit. Care Med., Volume 169, Number 6, March 2004, 733-738 A more recent version of this article appeared on March 15, 2004
Submitted on May 28, 2003 THE EFFECT OF MATERNAL SMOKING ON RESPIRATORY AND AROUSAL PATTERNS IN PRETERM INFANTS DURING SLEEPHemant Sawnani1,1 Pediatrics, Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Tulane University School of Medicine, New Orleans, LA, USA, 2 Pediatrics, Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Tulane University School of Medicine, New Orleans, LA, USA; Comprehensive Sleep Medicine Center, Tulane University Hospital and Clinics, New Orleans, LA, USA * To whom correspondence should be addressed. E-mail: nsimaka{at}tulane.edu.
Prenatal exposure to cigarette smoke is associated with an increased risk of sudden infant death syndrome. The effect of maternal smoking on apnea and arousal patterns in preterm infants is currently unknown. Multichannel polysomnographic studies were performed in preterm infants. Thirty infants were enrolled into the study; 16 exposed prenatally to cigarette smoke[S] and 14 controls[C]. There was no difference in the gestational and post-conceptional ages at the time of study. Maternal smoking was associated with a significant increase in apneic index in these infants (28.6 + 6.4/hr [S] vs 13.2 + 3.9 [C]; P <0.05), and the difference was noted for obstructive events and only during active sleep. The arousal index was significantly decreased in maternal smoking group (34.5 + 2.3/hr[S] vs 46.3 + 5.6/hr[C]; P<0.05) with a specific decrease in percentage of arousal following respiratory events (10.7 + 2.1%[S] vs 29.4 + 5.4%[C]; P <0.05). In conclusion, preterm infants exposed prenatally to cigarette smoke have increased respiratory events during active sleep, predominantly due to obstructive apnea, and possibly a higher arousal threshold during apneic events. These alterations in respiratory and arousal patterns in preterm infants born to smoking mothers may lead to significant vulnerability in this population. Key words: maternal smoking, preterm infants, apnea of prematurity, infant apnea, infant arousal
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