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Antenatal smoking and substance‐misuse, infant and newborn response to hypoxia
Author(s) -
Ali Kamal,
Rosser Thomas,
Bhat Ravindra,
Wolff Kim,
Hannam Simon,
Rafferty Gerrard F.,
Greenough Anne
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23620
Subject(s) - medicine , hypoxia (environmental) , pediatrics , intensive care medicine , oxygen , organic chemistry , chemistry
Summary Objectives To determine at the peak age for sudden infant death syndrome (SIDS) the ventilatory response to hypoxia of infants whose mothers substance misused in pregnancy (SM infants), or smoked during pregnancy (S mothers) and controls whose mothers neither substance misused or smoked. In addition, we compared the ventilatory response to hypoxia during the neonatal period and peak age of SIDS. Working hypothesis Infants of S or SM mothers compared to control infants would have a poorer ventilatory response to hypoxia at the peak age of SIDS. Study Design Prospective, observational study. Patient‐subject selection Twelve S; 12 SM and 11 control infants were assessed at 6–12 weeks of age and in the neonatal period. Methodology Changes in minute volume, oxygen saturation, heart rate, and end tidal carbon dioxide levels on switching from breathing room air to 15% oxygen were assessed. Maternal and infant urine samples were tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine, and benzodiazepines. Results The S and SM infants had a greater decline in minute volume ( P = 0.037, P = 0.016, respectively) and oxygen saturation ( P = 0.031) compared to controls. In all groups, the magnitude of decline in minute volume in response to hypoxia was higher in the neonatal period compared to at 6–12 weeks ( P < 0.001). Conclusions Both maternal substance misuse and smoking were associated with an impaired response to a hypoxic challenge at the peak age for SIDS. The hypoxic ventilatory decline was more marked in the neonatal period compared to the peak age for SIDS indicating a maturational effect. Pediatr Pulmonol. 2017;52:650–655. © 2016 Wiley Periodicals, Inc.