Influence of Smoking and Alcohol during Pregnancy on Outcome of VLBW Infants

Abstract

Background:

Nicotine and alcohol consumption have been associated with premature delivery and adverse neonatal outcome. We wanted to analyze the influence of self-reported nicotine and alcohol consumption on outcome of VLBW infants.

Material and Methods:

In an ongoing multicenter study 2 475 parents of former very low birth weight (VLBW) infants born between January 2009 and December 2011 answered questionnaires about maternal smoking habits and alcohol consumption during pregnancy. 2 463 (99.5%) completed questions on alcohol consumption and 2 462 (99.5%) on smoking habits. These infants were stratified to reported maternal smoking and alcohol consumption during pregnancy. We compared the reasons for premature delivery, neonatal outcome and parental reports on bronchitis during the first year of life, as well as growth and development at age 2 years to pregnancy exposure.

Results:

In nicotine exposed infants intrauterine growth restriction (31 vs. 21%, p<0.01), a birth weight below the 10^th percentile (26 vs. 17%, p<0.01) and placenta abruption (9.2 vs. 5.8%, p<0.05) was seen more often. Premature rupture of membranes (24 vs. 30%, p<0.05) or HELLP syndrome (6 vs. 11%, p<0.01) was less frequent. A birth weight below the 3^rd percentile was seen more frequently in mothers with reported alcohol consumption (13 vs. 6%, p<0.05). We noted an increased rate of BPD and ROP if mothers reported smoking during pregnancy (p<0.05). Growth parameters and scores on Bayley Sscales of infant development at age 2 years did not differ.

Conclusion:

Smoking during pregnancy results in a high rate of growth restricted VLBW infants. Prenatal exposition to nicotine seems to increase postnatal complications such as BPD und ROP.

Zusammenfassung

Hintergrund und Fragestellung:

Nikotin- und Alkoholkonsum sind mit Frühgeburtlichkeit und neonatalen Komplikationen assoziiert. Wir wollten den Einfluss von selbst-berichtetem mütterlichen Nikotin- und Alkoholkonsum auf das Outcome von Very low birth weight (VLBW)-Frühgeborenen untersuchen.

Material und Methoden:

In einer laufenden multizentrischen Studie beantworteten 2 475 Eltern von VLBW-Frühgeborenen, die zwischen Januar 2009 und Dezember 2011 geboren wurden, einen Fragebogen im Hinblick auf Nikotin- und Alkoholkonsum während der Schwangerschaft. 2 462 (99.5%) Eltern beantworteten die Fragen zu mütterlichen Nikotinkonsum während der Schwangerschaft und 2 463 (99.5%) zu Alkoholkonsum. Wir verglichen die Gründe für die Frühgeburtlichkeit, neonatale Komplikationen und Elternangaben zu Bronchitis im ersten Lebensjahr sowie Länge, Gewicht, Kopfumfang und Ergebnisse der Bayley Scales of infant development im Alter von 2 Jahren in den Gruppen.

Ergebnisse:

Kinder mit einer intrauterinen Nikotinexposition zeigten häufiger eine intrauterine Wachstumsrestriktion (31 vs. 21%, p<0.01), ein Geburtsgewicht unterhalb der zehnten Perzentile (26 vs. 17%, p<0.01) oder eine Plazentalösung (9.2 vs. 5.8%, p<0.05). Ein vorzeitiger Blasensprung (24 vs. 30%, p<0.05) oder HELLP-Syndrom (6 vs. 11%, p<0.01) wurde seltener beobachtet. Ein Geburtsgewicht unterhalb der dritten Perzentile wurde häufiger bei berichtetem Alkoholkonsum gesehen (13 vs. 6%, p<0.05). Wir sahen eine erhöhte Rate an BPD und ROP wenn die Mütter in der Schwangerschaft rauchten (p<0.05). Wachstumsparameter oder Ergebnisse der Bayley Scales of Infant Development im Alter von 2 Jahren zeigten keine signifikanten Unterschiede.

Schlussfolgerung:

Nikotinkonsum während der Schwangerschaft führt bereits bei VLBW-Frühgeborenen zu einer hohen Rate an Wachstumsrestriktionen. Pränatale Nikotinexposition scheint neonatale Komplikationsraten für BPD und ROP zu erhöhen.

Key words

very low birth weight infants - outcome - smoking - alcohol

Schlüsselwörter

Very low birth weight Frühgeborene - Outcome - Rauchen - Alkohol

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