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Further evidence indicates smoking during pregnancy harmful to child
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Mothers who smoke during their pregnancies were more likely to have babies who developed severe bronchiolitis, according to researchers.
Jonathan M. Mansbach, MD, of Harvard Medical School, and colleagues tracked more than 2,200 children aged younger than 2 years who were hospitalized with bronchiolitis during the 2007 to 2010 winter seasons.
Jonathan M. Mansbach
The researchers said about 17% of the children were enrolled in intensive care, and about 42% of the children required continuous positive airway pressure (CPAP) and/or intubation. The researchers interviewed families to determine, among other things, whether the mothers smoked during their pregnancy; the researchers noted that in those mothers who smoked, mechanical ventilation-use was more common. Also, younger age, low birth weight and rapid decline after the onset of respiratory symptoms predicted mechanical ventilation. The most common identified pathogens were respiratory syncytial virus and rhinovirus.
Currently, there is much variability in how babies with bronchiolitis are treated, with nothing consistently proven to be beneficial, aside from supportive measures. Under a 5-year grant, Mansbach and colleagues have begun a study to test and track children hospitalized with bronchiolitis prospectively, to see if the type of infecting virus, among many other factors, predicts long-term outcomes such as recurrent wheezing at age 3 years or asthma at age 6 years.
“In children with bronchiolitis, we found several demographic, historical, and clinical factors that predicted the need for mechanical respiratory support including in-utero smoke exposure,” Mansbach told Infectious Diseases in Children. “We also found a novel sub-group of children with bronchiolitis that have a rapid respiratory decline.”
Disclosure: Dr. Mansbach reports no relevant financial disclosures.
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