Secondhand smoke exposure during pregnancy reduces gross motor development

Maternal exposure to secondhand smoke (SHS) during pregnancy, even at low levels, is associated with a decrease in gross motor function among young children, a study in 175 nonsmoking mothers and their infants showed. The study, which was conducted in Greece where per capita consumption of cigarettes is high, relied on urine cotinine measurements during pregnancy; maternal reporting of passive smoke exposure at home, public places, and work; and neurodevelopmental assessments of the infants when they were aged 18 months, using the Bayley scales.

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Mothers’ SHS exposure during pregnancy was positively correlated with increased levels of urine cotinine, particularly SHS exposure at home. Yet maternal cotinine levels were low, a mean of 10.3 ng/mL. Neurodevelopmental tests nonetheless showed that, at 18 months of age, infants’ gross motor development decreased 3 points per 10 ng/mL of urine cotinine increase during pregnancy. This link remained even after adjustment for factors associated with neurodevelopment as well as postnatal SHS exposure. Increased maternal cotinine levels also were related to a modest reduction in cognitive development (Evlampidou I, et al. J Pediatr. 2015;167[2]:246-252).

Commentary: For a litany of the effects of smoke exposure on fetuses, infants, and children, see the journal’s accompanying editorial by Drs Duby and Langkamp (J Pediatr. 2015;167[2]:224-225). Now add to the list worsened motor and, perhaps, cognitive development in toddlers exposed prenatally to smoke, even without continued postnatal exposure. Meanwhile, we are waiting to see the impact of e-cigarette tobacco “vapor” on these children.

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.