Maternal Cigarette Smoking and the Development of Necrotizing Enterocolitis

The maternal variables that affect fetal development and correlate with necrotizing enterocolitis (NEC), the most common gastrointestinal emergency in premature infants, are not well defined. We hypothesized that maternal risk factors were the primary determinant of future development of NEC. Patien...

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Veröffentlicht in:Pediatrics (Evanston) 2012-07, Vol.130 (1), p.78-82
Hauptverfasser: DOWNARD, Cynthia D, GRANT, Stephanie N, MAKI, Alexandra C, KRUPSKI, Mary C, MATHESON, Paul J, BENDON, Robert W, FALLAT, Mary E, NEAL GARRISON, R
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container_issue 1
container_start_page 78
container_title Pediatrics (Evanston)
container_volume 130
creator DOWNARD, Cynthia D
GRANT, Stephanie N
MAKI, Alexandra C
KRUPSKI, Mary C
MATHESON, Paul J
BENDON, Robert W
FALLAT, Mary E
NEAL GARRISON, R
description The maternal variables that affect fetal development and correlate with necrotizing enterocolitis (NEC), the most common gastrointestinal emergency in premature infants, are not well defined. We hypothesized that maternal risk factors were the primary determinant of future development of NEC. Patients with NEC were identified from an established NICU database and were control-matched with 2 neonates treated at the same institution. The medical records of each patient during the NICU admission as well as the prenatal and delivery record of the patient's mother were reviewed. Perinatal data, including maternal smoking, maternal hypertension, maternal BMI, maternal gestational diabetes, conduct of labor and type of delivery, Apgar scores, types of feedings, and placental pathology, were examined, with P < .05 deemed significant. A total of 73 neonates diagnosed with NEC and 146 matched controls were identified. Medical records for each subject and their mothers were reviewed (438 records total). Maternal cigarette smoking was significantly associated with the future development of NEC (P = .02). Maternal gestational diabetes, maternal hypertension, formula feeding, and pathologic chorioamnionitis or uteroplacental insufficiency did not correlate with NEC. These data identified maternal cigarette smoking as the only risk factor that is associated with the development of NEC in premature infants. Our data imply that smoking delivers toxins and nicotine to the uterine microenvironment that can affect microvascular development and may predispose the fetus to future NEC.
doi_str_mv 10.1542/peds.2011-3808
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We hypothesized that maternal risk factors were the primary determinant of future development of NEC. Patients with NEC were identified from an established NICU database and were control-matched with 2 neonates treated at the same institution. The medical records of each patient during the NICU admission as well as the prenatal and delivery record of the patient's mother were reviewed. Perinatal data, including maternal smoking, maternal hypertension, maternal BMI, maternal gestational diabetes, conduct of labor and type of delivery, Apgar scores, types of feedings, and placental pathology, were examined, with P &lt; .05 deemed significant. A total of 73 neonates diagnosed with NEC and 146 matched controls were identified. Medical records for each subject and their mothers were reviewed (438 records total). Maternal cigarette smoking was significantly associated with the future development of NEC (P = .02). 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Maternal gestational diabetes, maternal hypertension, formula feeding, and pathologic chorioamnionitis or uteroplacental insufficiency did not correlate with NEC. These data identified maternal cigarette smoking as the only risk factor that is associated with the development of NEC in premature infants. Our data imply that smoking delivers toxins and nicotine to the uterine microenvironment that can affect microvascular development and may predispose the fetus to future NEC.</abstract><cop>Elk Grove Village, IL</cop><pub>American Academy of Pediatrics</pub><pmid>22689867</pmid><doi>10.1542/peds.2011-3808</doi><tpages>5</tpages></addata></record>
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subjects Adult
Babies
Biological and medical sciences
Care and treatment
Case-Control Studies
Control
Correlation analysis
Diagnosis
Enterocolitis, Necrotizing - etiology
Enterocolitis, Neonatal necrotizing
Enterocolitis, Pseudomembranous
Female
Gastroenterology. Liver. Pancreas. Abdomen
Gastrointestinal diseases
General aspects
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - etiology
Linear Models
Male
Maternal Behavior
Medical sciences
Mothers
Multivariate Analysis
Necrotizing enterocolitis
Other diseases. Semiology
Pediatrics
Pregnancy
Prenatal Exposure Delayed Effects - etiology
Retrospective Studies
Risk Factors
Smoking
Smoking - adverse effects
Smoking in pregnancy
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tobacco, tobacco smoking
Toxicology
title Maternal Cigarette Smoking and the Development of Necrotizing Enterocolitis
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