Intrauterine smoke exposure: a new risk factor for bronchopulmonary dysplasia?

J Perinat Med. 2004;32(3):272-7. doi: 10.1515/JPM.2004.051.


Objective: To evaluate the role of intrauterine smoke exposure and other variables on the development of bronchopulmonary dysplasia (BPD) in infants with birth weight < 1500 g (VLBW).

Methods: This case-control study investigated 277 VLBW infants (141 cases, 136 controls) admitted at birth to neonatal intensive care unit and survived to discharge. A retrospective telephone interview provided detailed parental information supplementing clinical data. Logistic regression assessed the effects of birth weight < 1000 g, gestational age < 30 weeks (GA<30), respiratory distress syndrome (RDS), neonatal mechanical ventilation > 7 days (MV>7), patent ductus arteriosus (PDA), intrauterine smoke exposure > or = 3 months (ISE), and of parental history of asthma on BPD (oxygen dependency at 28 days with characteristic radiographic abnormalities) occurrence.

Results: Including all variables, only GA<30, RDS and MV>7 were significantly associated with BPD. ISE did not contribute significantly to this model (odds ratio [OR] 1.94; 95% confidence interval 0.88-4.26). Excluding iatrogenic variable MV>7, GA<30, RDS, PDA and ISE (OR 2.21; 95% confidence interval 1.03-4.76) were significantly associated with BPD. Analyzing GA as a continuous variable, the OR was 0.63 for each additional week.

Conclusions: Prolonged mechanical ventilation, RDS and low gestational age were the major BPD determinants. Intrauterine smoke exposure seems to influence independently BPD development.

MeSH terms

  • Birth Weight
  • Bronchopulmonary Dysplasia / epidemiology*
  • Bronchopulmonary Dysplasia / etiology
  • Case-Control Studies
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Interviews as Topic
  • Italy / epidemiology
  • Male
  • Maternal Exposure
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*