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Mom’s smoking causes infant skin disease

Robin Wulffson MD's picture
smoking, pregnancy, skin disease, eczema, dermatitis, nicotine patch

ORLANDO, FL - Countless medical studies have reported that smoking during pregnancy is a form of child abuse. The risk for miscarriage, stillbirth, premature birth, and small for gestational age infants is increased with maternal smoking. In addition, it is linked to an increased risk of respiratory infections and allergic conditions such as asthma. Now, researchers have reported yet another impact on the infant: allergic skin conditions like atopic eczema and dermatitis. Miwa Shinohara, MD, PhD and colleagues from Kochi University in Japan presented their findings at the 2012 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), which was held this month in Orlando, Florida.

The researchers noted that their findings suggests that smoke exposure during the third
trimester (last three months) of pregnancy may have the strongest impact on increasing the development of eczema after birth. Dr. Shinohara explained, “A recent study demonstrated that environmental tobacco smoke exposure was significantly associated with an increased rate of eczema in the offspring, whereas another study found no association. We wanted to see whether a particular trimester might be associated with an increased occurrence of eczema in the offspring.”

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The study group was comprised of 1,436 infants between the age of two and 18 months. Questionnaires were used to acquire family histories of allergic diseases, number of older siblings, the mother’s tobacco smoke exposure during and after pregnancy, and the development of eczema as diagnosed by a physician. The investigators found that the rate of eczema was significantly increased in the infants who had been exposed to tobacco smoke during the third trimester when compared to the infants who had no exposure. Interestingly, there were no significant differences in the incidence of eczema between the infants with no tobacco smoke exposure and those with exposure during the first trimester, during the first six months after birth, and even those with exposure beyond those first six months.

Senior author Kenji Matsumoto, MD, PhD explained, “Tobacco smoke exposure during the third trimester seems to affect the development of the immune system in the offspring, which in turn facilitates development of eczema after birth. This also raises questions of whether or not tobacco smoke exposure may affect the innate immune responses of the skin.”

Take home message:
The evidence is irrefutable that maternal smoking has a significant effect on the infant. The addictive elements of smoking counteract that desire. Some women turn to nicotine replacement with patches or gum to help them quit. However, a new study published by British researchers on March 1 in the New England Journal of Medicine reported that nicotine replacement therapy was ineffective during pregnancy. The best option for a pregnant smoker is to quit cold turkey. In fact, some studies have reported that this approach is as equally effective as nicotine patches.

Reference:American Academy of Allergy, Asthma & Immunology (AAAAI)