{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:00:27Z","timestamp":1792735227601,"version":"4.5.0"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,6,1]]},"abstract":"<jats:p>Objective. This was a prospective study of the effects of maternal smoking during pregnancy on newborn neurobehavior, including dose-response relationships using self-report and a bioassay of nicotine exposure.<\/jats:p><jats:p>Methods. The sample included 27 nicotine exposed and 29 unexposed full-term newborn infants with no medical problems from comparable social class backgrounds. Mothers were excluded for using illegal drugs during pregnancy, using antidepressant medication, or if they consumed &amp;gt;3 alcoholic drinks per month. Nicotine exposure was determined by maternal self-report and cotinine in maternal saliva. The NICU Network Neurobehavioral Scale (NNNS) was administered by masked examiners in hospital to measure neurobehavioral function. NNNS scores were compared between nicotine-exposed and -unexposed groups including adjustment for covariates. Dose-response relationships with NNNS scores were computed for maternal salivary cotinine and maternal report of number of cigarettes per day during pregnancy.<\/jats:p><jats:p>Results. After adjustment for covariates, the tobacco-exposed infants were more excitable and hypertonic, required more handling and showed more stress\/abstinence signs, specifically in the central nervous system (CNS), gastrointestinal, and visual areas. Dose-response relationships showed higher maternal salivary cotinine values related to more stress\/abstinence signs (r = .530) including CNS (r = .532) and visual stress (r = .688) and higher excitability scores (r = .617). Cigarettes per day during pregnancy was related to more stress\/abstinence signs (r = .582) including CNS (r = .561) and visual stress (r = .640).<\/jats:p><jats:p>Conclusions. These findings suggest neurotoxic effects of prenatal tobacco exposure on newborn neurobehavior. Dose-response relationships could indicate neonatal withdrawal from nicotine. Research directed at understanding the effects of cigarette smoking during pregnancy on infants can lead to improved public health outcome.<\/jats:p>","DOI":"10.1542\/peds.111.6.1318","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"1318-1323","source":"Crossref","is-referenced-by-count":226,"title":["Smoking During Pregnancy and Newborn Neurobehavior"],"prefix":"10.1542","volume":"111","author":[{"given":"Karen L.","family":"Law","sequence":"first","affiliation":[{"name":"Brown Medical School, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R.","family":"Stroud","sequence":"additional","affiliation":[{"name":"Centers for Behavioral and Preventive Medicine, Brown Medical School and the Miriam Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda L.","family":"LaGasse","sequence":"additional","affiliation":[{"name":"Infant Development Center, Brown Medical School, Women and Infants Hospital and Bradley Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Niaura","sequence":"additional","affiliation":[{"name":"Centers for Behavioral and Preventive Medicine, Brown Medical School and the Miriam Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Infant Development Center, Brown Medical School, Women and Infants Hospital and Bradley Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry M.","family":"Lester","sequence":"additional","affiliation":[{"name":"Infant Development Center, Brown Medical School, Women and Infants Hospital and Bradley Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,6,1]]},"reference":[{"key":"2021120821115801300_R1","unstructured":"Centers for Disease Control and Prevention. 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