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Cohen, G., Vardavas, C., Patelarou, E., Kogevinas, M., Katz-Salamon, M

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

Acta Paediatr., 2014, 103, 4, 386, 92, IF: 1.974, PMID: 24330403

AIM: To 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. METHODS: An observational field study conducted in Crete. We compared 4-6 month-olds of life-long non-smokers 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 BP during brief repositioning manoeuvres performed during a daytime nap, and analysed BPR (% change in blood pressure during head-up tilt) for associations with maternal and infant cotinine. RESULTS: We observed a 20-fold difference between BPR of infants of controls versus passive smokers - exceptional given number of infants (alpha error / confidence level <10% i.e. power >90%). The BPR declined linearly as the infant's (but not mother'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. CONCLUSION: Cardiovascular 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-free. This article is protected by copyright. All rights reserved

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