Zusammenfassung
-jährigen Kindern, deren Mütter während der Schwangerschaft Nikotin konsumierten, wurde mit den Leistungen einer Gruppe von 100 nach Alter, Geschlecht und sozioökonomischem Status parallelisierten Kindern nicht rauchender Mütter anhand der Ergebnisse aus dem „Kognitiven Entwicklungstest für das Kindergartenalter“ (KET‐KID) verglichen. Zusätzlich wurden anamnestische Daten durch einen elterlichen Fragebogen erhoben. Ergebnisse: In den Bereichen Psychomotorik, Artikulation, auditives Gedächtnis, Sprachverständnis und Rhythmus zeigen die Kinder, deren Mütter während der Schwangerschaft geraucht hatten, signifikant schwächere Leistungen. Nach Unterteilung in die Gruppen von Kindern leichter Raucherinnen (≤ 9/Tag) vs. Kinder starker Raucherinnen (≥ 10/Tag) zeigten sich dosisabhängig Defizite im auditiven Gedächtnis. Schlussfolgerung: Selbst ein geringer täglicher Nikotinkonsum während der Schwangerschaft verursacht kognitive Defizite beim Kind, die sich auch im Kindergartenalter nachweisen lassen. Daraus lässt sich ein deutlicher Appell an werdende Mütter formulieren, mit Beginn einer Schwangerschaft vollständig auf das Rauchen zu verzichten!
Abstract
Purpose: Aim of the study was to examine to what extent children whose mothers smoked during pregnancy show cognitive deficits at preschool age. Material and Methods: The cognitive developmental stage of 100 children aged from three to six and a half-years whose mothers smoked during pregnancy was compared to 100 children matched for age, sex, and socioeconomic state whose mothers did not smoke during pregnancy; all children were assessed using the “Kognitiver Entwicklungstest für das Kindergartenalter” [cognitive developmental test for children of kindergarten age] (KET-KID). Anamnestic data was collected with the help of parental questionnaires. Results: The performance of children whose mothers had smoked during pregnancy was significantly poorer with regard to psychomotor activities, articulation, auditory memory, speech perception, and rhythm. The group of children whose mothers had smoked was differentiated further into two groups: a group of children born to mild (< 9/day) and a group of children born to heavy (≥ 10/day) smokers. Dose-dependent deficits in auditory memory performance were found in the children from the heavy smokers group. Conclusion: Children tested at preschool age whose mothers consumed nicotine during pregnancy show significant cognitive impairments even after small daily doses of nicotine. Pregnant women need to be clearly urged to stop smoking completely at the start of pregnancy and not to smoke throughout the pregnancy.
Schlüsselwörter
Rauchen während der Schwangerschaft - Nikotinkonsum - kognitive Entwicklung - Gedächtnis
Key words
smoking during pregnancy - nicotine exposure - cognitive development - memory
Literatur
-
1
Haustein K-O.
Rauchen, Nikotin und Schwangerschaft.
Geburtsh Frauenheilk.
2000;
60
11-19
-
2
Laucht M, Schmidt M H.
Mütterliches Rauchen in der Schwangerschaft.
Monatsschr Kinderh.
2004;
152
1286-1294
-
3
Jauniaux E, Burton G J.
Morphological and biological effects of maternal exposure to tobacco smoke on the feto-placental unit.
Early Hum Dev.
2007;
83
699-706
-
4
Cnattingius S.
The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes.
Nicotine Tob Res.
2004;
6
125-140
-
5
Carter S, Paterson J, Gao W et al.
Maternal smoking during pregnancy and behaviour problems in a birth cohort of 2-year-old Pacific children in New Zealand.
Early Hum Dev.
2008;
84
59-66
-
6 Kröger C B, Lohmann B. Tabakkonsum und Tabakabhängigkeit. Göttingen; Hogrefe 2007
-
7
Breslau N, Paneth N, Lucia V C et al.
Maternal smoking during pregnancy and offspring IQ.
Int J Epidemiol.
2005;
34
1047-1053
-
8
Batty G D, Der G, Deary I J.
Effect of maternal smoking during pregnancy on offspring's cognitive ability: Empirical evidence for complete confounding in the US national longitudinal survey of youth.
Pediatrics.
2006;
118
943-950
-
9
Ernst M, Moolchan E T, Robinson M L.
Behavioral and neural consequences of prenatal exposure to nicotine.
J Am Acad Child Psy.
2001;
40
630-641
-
10 Martinez A, Partridge J C, Bean X et al. Perinatal substance abuse. Taeusch HW, Ballard RA Avery's diseases of the newborn. Philadelphia; W. B. Saunders 1998: 103-118
-
11
Julvez J, Ribas-Fito N, Torrent M et al.
Maternal smoking habits and cognitive development of children at age 4 years in a population-based birth cohort.
Int J Epidemiol.
2007;
dym107
1-8
-
12
Spohr H L.
Teratogene Effekte von Nikotin, Drogen und Alkohol.
Der Gynäkologe.
2005;
38
25-32
-
13
Carratù M R, Coluccia A, Borracci P et al.
Smoking during pregnancy: A risk factor for peripheral neuropathy?.
Dev Neurosci-Basel.
2008;
30
224-230
-
14
Slotkin T A.
Fetal nicotine or cocaine exposure: Which one is worse?.
J Pharmacol Exp Ther.
1998;
285
931-945
-
15
Levin E D.
Nicotinic receptor subtypes and cognitive function.
J Neurobio.
2002;
53
633-640
-
16
Felix R, Levin E D.
Nicotinic antagonist administration into the ventral hippocampus and spatial working memory in rats.
Neurosci Lett.
1997;
81
1009-1018
-
17
Hellström-Lindahl E, Gorbounova O, Seiger A et al.
Regional distribution of nicotinic receptors during prenatal development of human brain and spinal cord.
Brain Res.
1998;
108
147-160
-
18
Role L W, Berg D K.
Nicotinic receptors in the development and modulation of CNS synapses.
Neuron.
1996;
16
1077-1086
-
19
Slotkin T A.
If nicotine is a developmental neurotoxicant in animal studies, dare we recommend nicotine replacement therapy in pregnant women and adolescents?.
Neurotoxicol Teratol.
2008;
30
1-19
-
20
Abreu-Villaça Y, Seidler F J, Tate C A et al.
Prenatal nicotine exposure alters the response to nicotine administration in adolescence: Effects on cholinergic systems during exposure and withdrawal.
Neuropsychopharmacol.
2004;
29
879-890
-
21
Dwyer J B, Broide R S, Leslie F M.
Nicotine and brain development.
Birth Defects Res C.
2008;
84
30-44
-
22
Garcia-Algar O, Puig C, Vall O et al.
Effects of maternal smoking during pregnancy on newborn neurobehavior: Neonatal nicotine withdrawal syndrome.
Pediatrics.
2004;
113
623-624
-
23
Schellscheidt J, Oyen N, Jorch G.
Interactions between maternal smoking and other prenatal risk factors for sudden infant death syndrome (SIDS).
Acta Paediatr.
1997;
86
857-863
-
24
Kelly Y, Nazroo J Y, McMunn A et al.
Birthweight and behavioural problems in children: A modifiable effect?.
Int J Epidemiol.
2001;
30
88-94
-
25
Daseking M, Lemcke J, Macha T et al.
Perinatal stroke – clinical validity of the ET 6-6.
Z Kinder Jug-Psych.
2007;
35
311-319
-
26
Batstra L, Hadders-Algra M, Neeleman J.
Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood: prospective evidence from a Dutch birth cohort.
Early Hum Dev.
2003;
75
21-33
-
27
Cornelius M D, Ryan C M, Day N L et al.
Prenatal tobacco effects on neuropsychological outcomes among preadolescents.
J Dev Beh Pediatr.
2001;
22
217-225
-
28
Fried P A, O'Connell C M, Watkinson B.
60-and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: Cognitive and language assessment.
J Dev Beh Pediatr.
1992;
13
383-391
-
29
D'Onofrio B M, Van Hulle C A, Waldman I D et al.
Smoking during pregnancy and offspring externalizing problems: An exploration of genetic and environmental confounds.
Dev Psychopathol.
2008;
20
139-164
-
30
Linnet K M, Obel C, Bonde E et al.
Cigarette smoking during pregnancy and hyperactive-distractible preschooler.
Acta Paediatr.
2006;
95
694-700
-
31
Martin R P, Dombrowski S C, Mullis C et al.
Smoking during pregnancy: Association with childhood temperament, behavior, and academic performance.
J Pediatr Psychol.
2006;
31
490-500
-
32
Weinstock M.
Alterations induced by gestational stress in brain morphology and behaviour of the offspring.
Prog Neurobiol.
2001;
65
427-452
-
33 Daseking M, Petermann F. Kognitiver Entwicklungstest für das Kindergartenalter (KET-KID). Göttingen; Hogrefe 2009
-
34
Herrmann M, King K, Weitzman M.
Prenatal tobacco smoke and postnatal secondhand smoke exposure and child neurodevelopment.
Curr Opin Pediatr.
2008;
20
184-190
-
35
Heimann K, Heubrock D, Petermann F.
Diagnostik von Entwicklungsauffälligkeiten im Kindergartenalter.
Monatsschr Kinderh.
2004;
153
871-877
-
36
Jacobs C, Tischler L, Petermann F.
Typische klinische Problemkonstellationen bei Patienten der Psychologischen Kinderambulanz der Universität Bremen.
Verhaltenstherapie.
2009;
19
22-27
-
37
Lepach A, Petermann F.
Klinische Kinderneuropsychologie.
Kindh Entwickl.
2007;
16
1-6
-
38
McBride C M, Curry S J, Lando H A et al.
Prevention of relapse in women who quit smoking during pregnancy.
Am J Public Health.
1999;
89
706-711
-
39 Giersiepern K. Beratung zur Förderung des Nichtrauchens in der Schwangerschaft und nach der Entbindung – Richtlinien und Empfehlungen. 2005. Projektbericht der Projektgruppe EUROpean action on smoking cessation in pregnancy. Zugriff am 20.03.2009 unter:. www.bips.uni-bremen.de/euro-scip/guide_g.pdf
-
40
Nuesslein T G, Struwe A, Maiwald N et al.
Mütterlicher Tabakkonsum lässt sich durch einfache Intervention des Kinderarztes reduzieren.
Klin Padiatr.
2006;
218
283-286
Dipl.-Psych. Julia Danielsson
Zentrum für Klinische Psychologie und Rehabilitation
Grazer Straße 6
28357 Bremen
Email: julia.danielsson@uni-bremen.de
