Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort.

M.E.A Negrão,R.F.L Batista,A.A Ferraro,P.R.H Rocha,M.C.P Saraiva,H Bettiol,V.M.F Simões,M.A Barbieri

doi:10.1590/1414-431x202010252

Abstract

Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities. However, little is currently known about the association of the separate or concomitant use of alcohol and tobacco with infant motor and cognitive development. Thus, the objective of the present study was to investigate the association between maternal consumption of alcohol and/or tobacco during pregnancy and the motor and cognitive development of children starting from the second year of life. The study included 1006 children of a cohort started during the prenatal period (22-25 weeks of pregnancy), evaluated at birth and reevaluated during the second year of life in 2011/2013. The children were divided into four groups according to the alcohol and/or tobacco consumption reported by their mothers at childbirth: no consumption (NC), separate alcohol consumption (AC), separate tobacco consumption (TC), and concomitant use of both (ACTC). The Bayley Scale of Infant and Toddler Development Third Edition screening tool was used for the assessment of motor and cognitive development. Adjusted Poisson regression models were used to determine the association between groups and delayed development. The results indicated that only the ACTC group showed a higher risk of motor delay, specifically regarding fine motor skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol or tobacco consumption was not associated with delayed gross motor or cognitive development. However, the concomitant use of the two substances increased the risk of delayed acquisition of fine motor skills.

Highlights

Habits such as alcohol and/or tobacco consumption during the gestational period are risk factors for both maternal and fetal health [1,2]
The ACTC group showed a higher relative frequency of infants born with intrauterine growth restriction (17.7%) and a higher relative frequency of mothers with depressive symptoms (36.7%), and without a partner (32.2%) (Table 2)
The present study investigated the association of maternal consumption of alcohol or tobacco, or both, during pregnancy with motor and cognitive development of the child during the second year of life

Summary

Introduction

Habits such as alcohol and/or tobacco consumption during the gestational period are risk factors for both maternal and fetal health [1,2]. As a consequence of this process, subtle or even severe modifications may occur during the course of fetal growth and the development of the central nervous system [3,4]. Toxins from cigarettes such as carbon monoxide, nicotine, cyanide, cadmium, and lead may cause changes in placental function, which reduce the oxygen and nutrient supply for the fetus, increasing the risk of perinatal adversities [5,6]. Nicotine acts as a neurological teratogen as it crosses over the placental barrier and can trigger nicotine receptors of acetylcholine, altering the development of nervous tissues. As shown in different studies, fetuses that are exposed to nicotine can present a deficit in the number of neurons and important alterations in sensorial-cognitive functions [7,8,9]

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