Adverse circulatory effects of passive smoking during infancy: surprisingly strong, manifest early, easily avoided

作者：Cohen G^*; Vardavas C; Patelarou E; Kogevinas M; Katz Salamon M

来源：Acta Paediatrica, 2014, 103(4): 386-392.

DOI：10.1111/apa.12538

• Baroreflex
• blood pressure
• cotinine
• passive smoking
• U-shaped curve

AimTo compare blood pressure reactions (BPR) of infants to mild stress for evidence of adverse cardiovascular effects of passive exposure to tobacco smoke during pregnancy and early infancy. %26lt;br%26gt;MethodsAn observational field study conducted in Crete. We compared 4- to 6-month olds of lifelong nonsmokers minimally (controls, n=9) or frequently exposed to tobacco smoke (passive smokers; n=10) with those born to habitual smokers (n=6). Smoke exposure was verified biochemically (urine cotinine each trimester and at study). We recorded beat-to-beat blood pressure (BP) during brief repositioning manoeuvres performed during a daytime nap and analysed BPR (% change in BP during head-up tilt) for associations with maternal and infant cotinine. %26lt;br%26gt;ResultsWe observed a 20-fold difference between BPR of infants of controls versus passive smokers - exceptional given number of infants ( error/confidence level %26lt;10% i.e. power %26gt;90%). The BPR declined linearly as the infant%26apos;s (but not mother%26apos;s) cotinine level rose (p=0.04), indicating abnormal BPR was caused mainly by postnatal smoke exposure. Infants of active smokers differed from those of passive smokers. %26lt;br%26gt;ConclusionCardiovascular effects of passive smoking by a newborn infant manifest early on and are exceptionally strong. They can be largely avoided by keeping the home smoke rigorously free.

• 出版日期2014-4