- Full (HTML) - Related EHP Articles - Purchase This Issue

Cynthia Bearer,¹ Renee K. Emerson,² Mary Ann O'Riordan,¹ Esther Roitman,² and Cedric Shackleton²

¹Case Western Reserve University, Cleveland, OH 44106-6010 USA; ²Children's Hospital Oakland Research Institute, Oakland, CA 94609 USA

Abstract

We propose that in utero exposure to tobacco smoke products places a newborn at risk for persistent pulmonary hypertension of the newborn (PPHN) . To test this hypothesis, infants with PPHN were identified. Healthy newborns of similar ethnicity were identified as a comparison group. Cord blood cotinine concentrations and maternal questionnaires were obtained. The number of women exposed to tobacco smoke in each group ascertained by questionnaire was borderline significantly different (38.7% vs. 20.5% ; p = 0.080) . However, more PPHN infants had detectable cotinine in their cord blood (64.5% vs. 28.2% ; p = 0.002) , and the median cotinine concentrations were significantly higher (5.2 ng/ml vs. 2 ng/ml ; p = 0.051) than the comparison infants. Among infants delivered to nonsmoking women, more PPHN infants had detectable cotinine (50% vs. 19% ; p = 0.015) , and the cotinine concentrations were higher (3.5 ng/ml vs. 1.65 ng/ml ; p = 0.022) than the comparison group. We conclude that active and passive smoking during pregnancy is a risk factor for PPHN. Therefore, we recommend that pregnant women cease smoking and avoid environmental tobacco smoke. Key words: cotinine, newborns, passive, persistent pulmonary hypertension, smoking, tobacco smoke pollution. Environ Health Perspect 105:202-206 (1997)

Address correspondence to C.F. Bearer, Case Western Reserve University, Rainbow Babies and Childrens Hospital, 11100 Euclid Avenue, Cleveland, Ohio 44106-6010 USA.

We wish to thank Cassandra Blythewood for secretarial assistance, Martina Nicholas for library assistance, and Rachel Phillips, Chris Lee, and Mimi Poinsett for technical assistance. We thank Avroy Fanaroff, Michelle Walsh-Sukys, Boyd Goetzman and Kay Kyllonen for editorial comments. Supported by grant 1 KT 125 from the Tobacco-Related Disease Research Program (Cynthia F. Bearer, Principal Investigator) and NIH grant DK34400 (Cedric Shackleton, Principal Investigator) .

Received 20 May 1996 ; accepted 13 November 1996.