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Maternal smoking in pregnancy, fetal activity & newborn behavioral state: An observational ultrasound study.
Neurotoxicology and Teratology ( IF 2.9 ) Pub Date : 2020-05-11 , DOI: 10.1016/j.ntt.2020.106894
Laura R Stroud 1 , Margaret H Bublitz 2 , Frank A Crespo 3 , Barry Lester 4 , Amy L Salisbury 4
Affiliation  

Maternal smoking during pregnancy (MSDP) remains one of the most common prenatal drug exposures in the US and worldwide. MSDP is associated with medical risk for the fetus and altered behavioral development in infants; however, fewer studies have examined the impact of MSDP on fetal behavior or newborn behavioral state. We investigated associations between MSDP and (a) fetal motor activity and (b) newborn behavioral state following handling. Participants were 79 healthy mother-fetus/newborn pairs (57% MSDP-exposed). MSDP was measured by maternal interview and verified by saliva biomarkers. Mothers completed an observational fetal ultrasound assessment between 24 and 37 weeks gestation (M = 28 weeks), including baseline, vibro-acoustic stimulus and recovery periods. Total fetal motor activity and complex body movements were coded from ultrasound videos. Following delivery, newborn post-handling behavioral state was assessed by direct observational coding. MSDP exposure was associated with higher baseline fetal motor activity, particularly at younger gestational ages. Further, motor reactivity to stimulation emerged at later gestational ages in MSDP-exposed fetuses, while motor reactivity was consistent across gestational ages in unexposed fetuses. Finally, heavy MSDP exposure was associated with more arousal following handling and greater need for soothing interventions in the newborn period. Monitoring of fetal behavior via ultrasound may offer a unique opportunity to identify at-risk infants and provides data for stronger public health messaging regarding risks of MSDP. Associations between MSDP and increased newborn fussiness highlight opportunities for education and anticipatory guidance in the postpartum period.

中文翻译:

孕期母亲吸烟、胎儿活动和新生儿行为状态:一项观察性超声研究。

孕期母亲吸烟 (MSDP) 仍然是美国和全世界最常见的产前药物暴露之一。MSDP 与胎儿的医疗风险和婴儿的行为发育改变有关;然而,很少有研究检查 MSDP 对胎儿行为或新生儿行为状态的影响。我们调查了 MSDP 与(a)胎儿运动活动和(b)处理后新生儿行为状态之间的关联。参与者是 79 对健康的母胎/新生儿对(57% 暴露于 MSDP)。MSDP 通过产妇访谈测量并通过唾液生物标志物验证。母亲在妊娠 24 至 37 周(M = 28 周)期间完成了观察性胎儿超声评估,包括基线、振动声刺激和恢复期。总的胎儿运动活动和复杂的身体运动是从超声视频中编码的。分娩后,通过直接观察编码评估新生儿处理后的行为状态。MSDP 暴露与较高的基线胎儿运动活动相关,尤其是在较年轻的胎龄时。此外,在暴露于 MSDP 的胎儿中,对刺激的运动反应出现在较晚的胎龄,而未暴露胎儿的运动反应在整个孕龄中是一致的。最后,重度 MSDP 暴露与处理后更多的唤醒和新生儿期对舒缓干预的更大需求有关。通过超声监测胎儿行为可能提供一个独特的机会来识别有风险的婴儿,并为有关 MSDP 风险的更强有力的公共卫生信息提供数据。
更新日期:2020-05-11
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