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Smoking During Pregnancy Ups Birth Defect Risks, May Lead to Fussy Babies

Nov 5, 2008 | Parker Waichman Alonso LLP

A mother's cigarette smoking during pregnancy not only increases the chances that her infant will be born with a cleft lip or palate, but can also have an effect on a baby's behavior, according to two new studies published in "The Journal of Pediatrics".  An accompanying editorial said that the studies' findings indicate that smoking has become a major pediatric health problem.

In the first study, researchers from the March of Dimes and institutes in Norway, Holland, and Texas  studied serum samples collected between 2003 and 2005 from pregnant women enrolled in the California Expanded AFP (alpha fetoprotein) program. The researchers measured the levels of cotinine, a metabolite of nicotine, to determine whether the mothers smoked during pregnancy.

The study found that women who smoked during pregnancy were nearly 2.5 times more likely to have babies with oral clefts. Babies with cleft palate or lip require significant medical care–often four surgeries by age two–and may have speech, hearing, and feeding problems

In the second study, researchers at Brown University studied the effects of cigarette smoke exposure on infant behavior. The researchers studied 56 otherwise healthy infants and used questionnaires and cotinine measurements to determine cigarette smoke exposure.

The study found that 28 babies who had been exposed to cigarette smoke were more irritable and difficult to sooth than the 28 babies who were not exposed. The researchers said their study highlighted the importance of cessation programs for smoking mothers, as well as programs to help new mothers manage a baby who is difficult to soothe.

In an accompanying editorial, Dr. Cynthia Bearer of the University of Maryland and Matthew Stefanak of the Mahoning County District Board of Health in Ohio, wrote that smoking should now be considered a major pediatric health problem.  Citing the fact that 90 percent of smokers start smoking by the age of 18, the editorial advocated  prevention as the best solution, and stressed the need to stop smoking before it starts.

The editorial stated that the graphic portrayal of the damaging effects of tobacco use on health and physical attractiveness may be effective in deterring teens from smoking. Because parents who actively disapprove of smoking can help their children avoid the harmful effects of cigarette smoke exposure, the writers of the editorial encouraged  parents to take an active role in smoking prevention.