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PEDIATRICS Vol. 113 No. 3 March 2004, pp. 623-624

Effects of Maternal Smoking During Pregnancy on Newborn Neurobehavior: Neonatal Nicotine Withdrawal Syndrome

Óscar García-Algar, MD^a
Carme Puig, MD^a
Oriol Vall, MD^a
Roberta Pacifici, PhD^b
Simona Pichini, PhD^b
a Pediatrics Unit
Hospital del Mar
Pg Marítim 25-29
08003 Barcelona, Spain
^b Istituto Superiore di Sanità
V.Le Regina Elena 299
00161 Rome, Italy

The first 20% of the full text of this article appears below.

To the Editor.—

We read with great interest the paper of Law et al¹ wherein the effects of maternal smoking on newborn neurobehavior was investigated. The authors compared 29 and 27 newborns unexposed and exposed to maternal smoking, respectively. A mean of 6.7 cigarettes per day was declared by smoking mothers during pregnancy. Mean maternal salivary cotinine, obtained only in 16 cases (3 of which showed a zero value), was 32.9 ng/mL. Newborn neurobehavioral function was measured by the NICU Network Neurobehavioral Scale within 48 hours after birth.¹ The authors disclosed neurotoxic effects of prenatal tobacco exposure, suggesting a likely neonatal withdrawal syndrome. In the studies by our team,^2,3 we already postulated the existence of a neonatal nicotine withdrawal among newborns exposed to cigarette smoke. The Finnegan clinical score⁴ was used in 50 newborns from smoking mothers to evaluate the withdrawal syndrome together with the measure of newborn urinary cotinine as a biomarker of acute exposure to tobacco smoke⁵ and neonatal hair nicotine detection to verify a chronic exposure to cigarette constituents during the entire fetal life.

No definitive positive result for defining a withdrawal syndrome by means of the Finnegan test (2 consecutive scores >8) was registered. However, scores between 0 and 8, especially by irritability and tremor . . . [Full Text of this Article]

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