Effect of maternal smoking on stress physiology in healthy neonates

Objective: To assess the impact of maternal smoking during pregnancy (MSDP) on the neonatal hypothalamic–pituitary–adrenal axis. Study Design: In a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in healthy neonates whose mothers smoked cigarettes during each stage of pregnancy and compared with controls. Results: Neonates in the control group ( n =70) exhibited a physiologic stress response with a significant increase in cortisol (1.3 to 2.1 ng ml −1 ; P