Prenatal tobacco smoke exposure and risk of brain abnormalities on magnetic resonance imaging at term in infants born very preterm
Prenatal tobacco smoke exposure and preterm birth are associated with abnormal brain and neurodevelopmental outcomes in infants. Studies that can disentangle indirect mediating effects from direct effects of prenatal tobacco smoke exposure on sensitive early brain magnetic resonance imaging biomarke...
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| Veröffentlicht in: | American journal of obstetrics & gynecology MFM 2023-03, Vol.5 (3), p.100856-100856, Article 100856 |
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| container_title | American journal of obstetrics & gynecology MFM |
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| creator | Mahabee-Gittens, E. Melinda Kline-Fath, Beth M. Harun, Nusrat Folger, Alonzo T. He, Lili Parikh, Nehal A. |
| description | Prenatal tobacco smoke exposure and preterm birth are associated with abnormal brain and neurodevelopmental outcomes in infants. Studies that can disentangle indirect mediating effects from direct effects of prenatal tobacco smoke exposure on sensitive early brain magnetic resonance imaging biomarkers in very preterm infants are needed.
This study aimed to determine whether prenatal tobacco smoke exposure in preterm infants posed any direct effects on magnetic resonance imaging–determined global brain abnormality score and secondary measures of brain abnormalities after removing any indirect mediating effects of preterm birth on neurostructural outcomes.
We examined brain magnetic resonance imaging findings collected at 39 to 44 weeks postmenstrual age from a prospective cohort of 395 infants born very preterm (gestational age of ≤32 weeks). The primary outcome was global brain abnormality score, and the secondary outcomes were global efficiency of structural connectome, diffuse white matter abnormality volume, total brain tissue volume, total gray and white matter volumes, and cerebellar volume. Maternal reports of smoking during pregnancy were obtained. We performed multivariable linear regression analyses to examine the association between prenatal tobacco smoke exposure and our magnetic resonance imaging outcomes, controlling for prospectively collected confounders. Moreover, we performed a mediation analysis to estimate the direct effects of prenatal tobacco smoke exposure on brain abnormalities and any indirect effects through preterm birth.
Overall, 12.6% of infants had prenatal tobacco smoke exposure. Infants with prenatal tobacco smoke exposure had a higher median global brain abnormality score than nonexposed infants (7 [interquartile range, 0–41] vs 5 [interquartile range, 0–34]; P≤.001); the findings remained significant (P |
| doi_str_mv | 10.1016/j.ajogmf.2022.100856 |
| format | Article |
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This study aimed to determine whether prenatal tobacco smoke exposure in preterm infants posed any direct effects on magnetic resonance imaging–determined global brain abnormality score and secondary measures of brain abnormalities after removing any indirect mediating effects of preterm birth on neurostructural outcomes.
We examined brain magnetic resonance imaging findings collected at 39 to 44 weeks postmenstrual age from a prospective cohort of 395 infants born very preterm (gestational age of ≤32 weeks). The primary outcome was global brain abnormality score, and the secondary outcomes were global efficiency of structural connectome, diffuse white matter abnormality volume, total brain tissue volume, total gray and white matter volumes, and cerebellar volume. Maternal reports of smoking during pregnancy were obtained. We performed multivariable linear regression analyses to examine the association between prenatal tobacco smoke exposure and our magnetic resonance imaging outcomes, controlling for prospectively collected confounders. Moreover, we performed a mediation analysis to estimate the direct effects of prenatal tobacco smoke exposure on brain abnormalities and any indirect effects through preterm birth.
Overall, 12.6% of infants had prenatal tobacco smoke exposure. Infants with prenatal tobacco smoke exposure had a higher median global brain abnormality score than nonexposed infants (7 [interquartile range, 0–41] vs 5 [interquartile range, 0–34]; P≤.001); the findings remained significant (P<.001) after controlling for antenatal confounders. Global efficiency (P<.001), diffuse white matter volume (P=.037), and total brain tissue volume (P=.047) were significantly different between TSE groups in multivariable analyses. On mediation analysis, preterm birth mediated between 0% and 29% of the indirect effect of prenatal tobacco smoke exposure on several measures of brain abnormality outcomes. Thus, prenatal tobacco smoke exposure had a direct adverse effect between 71% and 100% on brain injury or abnormal development.
Our study has identified multiple adverse effects of prenatal tobacco smoke exposure on sensitive and objective measures of neonatal brain injury and abnormal development; most cases seemed to be a direct effect of prenatal tobacco smoke exposure on fetal brain development. The results underscored the significant adverse neurostructural effects of prenatal tobacco smoke exposure to tobacco smoke pollutants.</description><identifier>ISSN: 2589-9333</identifier><identifier>EISSN: 2589-9333</identifier><identifier>DOI: 10.1016/j.ajogmf.2022.100856</identifier><identifier>PMID: 36592820</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Brain ; Brain Injuries - pathology ; Female ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Magnetic Resonance Imaging ; neurodevelopment ; Pregnancy ; Premature Birth ; Prospective Studies ; tobacco smoke exposure ; Tobacco Smoke Pollution ; white matter abnormality</subject><ispartof>American journal of obstetrics & gynecology MFM, 2023-03, Vol.5 (3), p.100856-100856, Article 100856</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-6849273b1664947fad1e6d93db1e1f80bffa6732e057fc25410aa3e7d0e38f173</citedby><cites>FETCH-LOGICAL-c408t-6849273b1664947fad1e6d93db1e1f80bffa6732e057fc25410aa3e7d0e38f173</cites><orcidid>0000-0002-3893-885X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36592820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahabee-Gittens, E. Melinda</creatorcontrib><creatorcontrib>Kline-Fath, Beth M.</creatorcontrib><creatorcontrib>Harun, Nusrat</creatorcontrib><creatorcontrib>Folger, Alonzo T.</creatorcontrib><creatorcontrib>He, Lili</creatorcontrib><creatorcontrib>Parikh, Nehal A.</creatorcontrib><title>Prenatal tobacco smoke exposure and risk of brain abnormalities on magnetic resonance imaging at term in infants born very preterm</title><title>American journal of obstetrics & gynecology MFM</title><addtitle>Am J Obstet Gynecol MFM</addtitle><description>Prenatal tobacco smoke exposure and preterm birth are associated with abnormal brain and neurodevelopmental outcomes in infants. Studies that can disentangle indirect mediating effects from direct effects of prenatal tobacco smoke exposure on sensitive early brain magnetic resonance imaging biomarkers in very preterm infants are needed.
This study aimed to determine whether prenatal tobacco smoke exposure in preterm infants posed any direct effects on magnetic resonance imaging–determined global brain abnormality score and secondary measures of brain abnormalities after removing any indirect mediating effects of preterm birth on neurostructural outcomes.
We examined brain magnetic resonance imaging findings collected at 39 to 44 weeks postmenstrual age from a prospective cohort of 395 infants born very preterm (gestational age of ≤32 weeks). The primary outcome was global brain abnormality score, and the secondary outcomes were global efficiency of structural connectome, diffuse white matter abnormality volume, total brain tissue volume, total gray and white matter volumes, and cerebellar volume. Maternal reports of smoking during pregnancy were obtained. We performed multivariable linear regression analyses to examine the association between prenatal tobacco smoke exposure and our magnetic resonance imaging outcomes, controlling for prospectively collected confounders. Moreover, we performed a mediation analysis to estimate the direct effects of prenatal tobacco smoke exposure on brain abnormalities and any indirect effects through preterm birth.
Overall, 12.6% of infants had prenatal tobacco smoke exposure. Infants with prenatal tobacco smoke exposure had a higher median global brain abnormality score than nonexposed infants (7 [interquartile range, 0–41] vs 5 [interquartile range, 0–34]; P≤.001); the findings remained significant (P<.001) after controlling for antenatal confounders. Global efficiency (P<.001), diffuse white matter volume (P=.037), and total brain tissue volume (P=.047) were significantly different between TSE groups in multivariable analyses. On mediation analysis, preterm birth mediated between 0% and 29% of the indirect effect of prenatal tobacco smoke exposure on several measures of brain abnormality outcomes. Thus, prenatal tobacco smoke exposure had a direct adverse effect between 71% and 100% on brain injury or abnormal development.
Our study has identified multiple adverse effects of prenatal tobacco smoke exposure on sensitive and objective measures of neonatal brain injury and abnormal development; most cases seemed to be a direct effect of prenatal tobacco smoke exposure on fetal brain development. The results underscored the significant adverse neurostructural effects of prenatal tobacco smoke exposure to tobacco smoke pollutants.</description><subject>Brain</subject><subject>Brain Injuries - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>Magnetic Resonance Imaging</subject><subject>neurodevelopment</subject><subject>Pregnancy</subject><subject>Premature Birth</subject><subject>Prospective Studies</subject><subject>tobacco smoke exposure</subject><subject>Tobacco Smoke Pollution</subject><subject>white matter abnormality</subject><issn>2589-9333</issn><issn>2589-9333</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAQtRAVrUr_AUJz5LKLv-IkFyRUQYtUCQ70bE2c8crbxF5sb0Wv_HKySkGcOM3ozXszmvcYeyP4VnBh3u-3uE-72W8ll3KBeNeYF-xCNl2_6ZVSL__pz9lVKXvOuRRaN9K8YufKNL3sJL9gv75lilhxgpoGdC5BmdMDAf08pHLMBBhHyKE8QPIwZAwRcIgpzziFGqhAijDjLlINDjKVFDE6grBgIe4AK1TKMyyyED3GWmBIOcIj5Sc4ZDoNX7Mzj1Ohq-d6ye4_f_p-fbu5-3rz5frj3cZp3tWN6XQvWzUIY3SvW4-jIDP2ahwECd_xwXs0rZLEm9Y72WjBERW1IyfVedGqS_Zu3XvI6ceRSrVzKI6mCSOlY7GyNbzRrRbdQtUr1eVUSiZvD3l5KT9Zwe0pALu3awD2FIBdA1hkb58vHIeZxr-iP3YvhA8rgZY_HwNlW1ygxbAxZHLVjin8_8JvdQuaVg</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Mahabee-Gittens, E. Melinda</creator><creator>Kline-Fath, Beth M.</creator><creator>Harun, Nusrat</creator><creator>Folger, Alonzo T.</creator><creator>He, Lili</creator><creator>Parikh, Nehal A.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3893-885X</orcidid></search><sort><creationdate>202303</creationdate><title>Prenatal tobacco smoke exposure and risk of brain abnormalities on magnetic resonance imaging at term in infants born very preterm</title><author>Mahabee-Gittens, E. Melinda ; Kline-Fath, Beth M. ; Harun, Nusrat ; Folger, Alonzo T. ; He, Lili ; Parikh, Nehal A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-6849273b1664947fad1e6d93db1e1f80bffa6732e057fc25410aa3e7d0e38f173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Brain</topic><topic>Brain Injuries - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>Magnetic Resonance Imaging</topic><topic>neurodevelopment</topic><topic>Pregnancy</topic><topic>Premature Birth</topic><topic>Prospective Studies</topic><topic>tobacco smoke exposure</topic><topic>Tobacco Smoke Pollution</topic><topic>white matter abnormality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahabee-Gittens, E. Melinda</creatorcontrib><creatorcontrib>Kline-Fath, Beth M.</creatorcontrib><creatorcontrib>Harun, Nusrat</creatorcontrib><creatorcontrib>Folger, Alonzo T.</creatorcontrib><creatorcontrib>He, Lili</creatorcontrib><creatorcontrib>Parikh, Nehal A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics & gynecology MFM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahabee-Gittens, E. Melinda</au><au>Kline-Fath, Beth M.</au><au>Harun, Nusrat</au><au>Folger, Alonzo T.</au><au>He, Lili</au><au>Parikh, Nehal A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prenatal tobacco smoke exposure and risk of brain abnormalities on magnetic resonance imaging at term in infants born very preterm</atitle><jtitle>American journal of obstetrics & gynecology MFM</jtitle><addtitle>Am J Obstet Gynecol MFM</addtitle><date>2023-03</date><risdate>2023</risdate><volume>5</volume><issue>3</issue><spage>100856</spage><epage>100856</epage><pages>100856-100856</pages><artnum>100856</artnum><issn>2589-9333</issn><eissn>2589-9333</eissn><abstract>Prenatal tobacco smoke exposure and preterm birth are associated with abnormal brain and neurodevelopmental outcomes in infants. Studies that can disentangle indirect mediating effects from direct effects of prenatal tobacco smoke exposure on sensitive early brain magnetic resonance imaging biomarkers in very preterm infants are needed.
This study aimed to determine whether prenatal tobacco smoke exposure in preterm infants posed any direct effects on magnetic resonance imaging–determined global brain abnormality score and secondary measures of brain abnormalities after removing any indirect mediating effects of preterm birth on neurostructural outcomes.
We examined brain magnetic resonance imaging findings collected at 39 to 44 weeks postmenstrual age from a prospective cohort of 395 infants born very preterm (gestational age of ≤32 weeks). The primary outcome was global brain abnormality score, and the secondary outcomes were global efficiency of structural connectome, diffuse white matter abnormality volume, total brain tissue volume, total gray and white matter volumes, and cerebellar volume. Maternal reports of smoking during pregnancy were obtained. We performed multivariable linear regression analyses to examine the association between prenatal tobacco smoke exposure and our magnetic resonance imaging outcomes, controlling for prospectively collected confounders. Moreover, we performed a mediation analysis to estimate the direct effects of prenatal tobacco smoke exposure on brain abnormalities and any indirect effects through preterm birth.
Overall, 12.6% of infants had prenatal tobacco smoke exposure. Infants with prenatal tobacco smoke exposure had a higher median global brain abnormality score than nonexposed infants (7 [interquartile range, 0–41] vs 5 [interquartile range, 0–34]; P≤.001); the findings remained significant (P<.001) after controlling for antenatal confounders. Global efficiency (P<.001), diffuse white matter volume (P=.037), and total brain tissue volume (P=.047) were significantly different between TSE groups in multivariable analyses. On mediation analysis, preterm birth mediated between 0% and 29% of the indirect effect of prenatal tobacco smoke exposure on several measures of brain abnormality outcomes. Thus, prenatal tobacco smoke exposure had a direct adverse effect between 71% and 100% on brain injury or abnormal development.
Our study has identified multiple adverse effects of prenatal tobacco smoke exposure on sensitive and objective measures of neonatal brain injury and abnormal development; most cases seemed to be a direct effect of prenatal tobacco smoke exposure on fetal brain development. The results underscored the significant adverse neurostructural effects of prenatal tobacco smoke exposure to tobacco smoke pollutants.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36592820</pmid><doi>10.1016/j.ajogmf.2022.100856</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-3893-885X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Brain Brain Injuries - pathology Female Humans Infant Infant, Extremely Premature Infant, Newborn Magnetic Resonance Imaging neurodevelopment Pregnancy Premature Birth Prospective Studies tobacco smoke exposure Tobacco Smoke Pollution white matter abnormality |
| title | Prenatal tobacco smoke exposure and risk of brain abnormalities on magnetic resonance imaging at term in infants born very preterm |
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