Academic journal article Environmental Health Perspectives

Smoking during Pregnancy Affects Speech-Processing Ability in Newborn Infants

Academic journal article Environmental Health Perspectives

Smoking during Pregnancy Affects Speech-Processing Ability in Newborn Infants

Article excerpt

BACKGROUND: Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero-placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests.

OBJECTIVES: In the current study we examined the effects of maternal smoking during pregnancy on newborns' speech processing ability as measured by event-related potentials (ERPs).

METHOD: High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking (n = 8) mothers. Participating infants were matched on sex, gestational age, birth weight, Apgar scores, mother's education, and family income. Smoking during pregnancy was determined by parental self-report and medical records. ERPs were recorded in response to six consonant-vowel syllables presented in random order with equal probability.

RESULTS: Brainwaves of babies of nonsmoking mothers were characterized by typical hemisphere asymmetries, with larger amplitudes over the left hemisphere, especially over temporal regions. Further, infants of nonsmokers discriminated among a greater number of syllables whereas the newborns of smokers began the discrimination process at least 150 msec later and differentiated among fewer stimuli.

CONCLUSIONS: Our findings indicate that prenatal exposure to tobacco smoke in otherwise healthy babies is linked with significant changes in brain physiology associated with basic perceptual skills that could place the infant at risk for later developmental problems.

KEY WORDS: ERP, evoked potentials, newborn, prenatal, smoking, speech. Environ Health Perspect 115:623-629 (2007). doi:10.1289/ehp.9521 available via [Online 28 November 2006]


Cigarettes are among the nonmedicinal drugs used most widely during pregnancy (Fried et al. 1997), especially in Western cultures (Fried et al. 1997; Hardy and Mellits 1972; Makin et al. 1991; Weitzman et al. 2002). Although the general population of smokers is declining, pregnant women show the slowest rate of decline (Fried 2002; McCartney et al. 1994). Recent reports indicate that in the United States alone, 18.5% of all women smoke [Centers for Disease Control and Prevention (CDC) 2005], whereas 11.4% of women smoked during pregnancy (the rates for individual states were as high as 26%; CDC 2004).

Numerous studies report that maternal cigarette smoking during pregnancy may have a harmful effect on fetal development (Hellstrom-Lindahl and Nordberg 2002; Lassen and Oei 1998; McCartney et al. 1994; Oliff and Gallardo 1999). Both carbon monoxide and nicotine reduce the amount of oxygen available to fetal tissue by restricting the utero-placental blood flow (Naeye and Peters 1984). This can have potential negative effects on the central nervous system (Fried 2002) through cell damage and reduced cell number caused by errors in cell development (Roy and Sabherwal 1994) and a premature change from replication to differentiation (Slotkin 1998). These changes often occur at thresholds below those necessary for growth impairment and may not always manifest as intrauterine growth retardation [Slotkin 1998; see also Ernst et al. (2001) for review]. Nevertheless, low birth weight in newborns is the most consistently reported consequence of maternal smoking (Dejin-Karlsson et al. 1998; Fried 2002; Hardy and Mellits 1972; Lassen and Oei 1998).

Prenatal exposure to tobacco smoke is also linked to various health, behavioral, and cognitive impairments (see Weitzman et al. 2002 for review). Neonatal hyperactivity (greater excitability, heightened tremors and startles) is frequently noted among newborns prenatally exposed to tobacco (Fried et al. 1987; Law et al. 2003; Longo 1977). The American Academy of Pediatrics Committee on Environmental Health (1997) noted increased incidents of asthma, respiratory infections, and middle ear effusions. …

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