ANGELES UNIVERSITY FOUNDATION

College of Nursing
A.Y. 2009-2010

“A JOURNAL READING”

Smoking During Pregnancy Puts Children

At Risk Of Psychotic Symptoms

SUBMITTED TO:
Fe Mallari, R.N.
(DR clinical instructor)

SUBMITTED BY:
DAVID, Charmaine M.
BSN IV-12/ Group 46

November 27, 2009

 Web address:
http://www.sciencedaily.com/releases/20
09/10/
091001081223.htm

Smoking During Pregnancy Puts Children At

Risk Of Psychotic Symptoms

Mothers who smoke during

pregnancy put their children
at greater risk of developing
psychotic symptoms in their
teenage years. (Credit:
iStockphoto/Josu Altzelai)

ScienceDaily (Oct. 1, 2009) — Mothers who smoke during pregnancy put their
children at greater risk of developing psychotic symptoms in their teenage
years.

New research published in the October issue of the British Journal of

Psychiatry shows a link between maternal tobacco use and psychotic
symptoms.

Researchers from Cardiff, Bristol, Nottingham and Warwick Universities

studied 6,356 12-year-olds from the Avon Longitudinal Study of Parents and
Children. All the children completed an interview for psychotic-like symptoms,
such as hallucinations or delusions. Just over 11% of the children (734) had
suspected or definite symptoms of psychosis.
Smoking during pregnancy was found to be associated with an increased risk
of psychotic symptoms in the children. The researchers observed a 'dose-
response effect', meaning that the risk of psychotic symptoms was highest in
the children whose mothers smoked the most heavily during pregnancy.

The study also examined whether alcohol use and cannabis use during
pregnancy was associated with a higher risk of psychotic symptoms.

Drinking during pregnancy was associated with increased psychotic

symptoms, but only in the children of mothers who had drunk more than 21
units of alcohol a week in early pregnancy. Only a few mothers in the study
said they had smoked cannabis during pregnancy, and this was not found to
have any significant association with psychotic symptoms.

The reasons for the link between maternal tobacco use and psychotic
symptoms are uncertain. But the researchers suggest that exposure to
tobacco in the womb may have an indirect impact by affecting children's
impulsivity, attention or cognition. They have called for further studies to
investigate how exposure to tobacco in utero affects on the development and
function of children's brains.

It is estimated that between 15 and 20 per cent of women in the UK continue

to smoke during their pregnancy.

Dr Stanley Zammit, a psychiatrist at Cardiff University's School of Medicine

and lead author of the study, said "In our cohort, approximately 19 per cent
of adolescents who were interviewed had mothers who smoked during
pregnancy.

"If our results are non-biased and reflect a causal relationship, we can
estimate that about 20 per cent of adolescents in this cohort would not have
developed psychotic symptoms if their mothers had not smoked. Therefore,
maternal smoking may be an important risk factor in the development of
psychotic experiences in the population."
SUMMARY:

New research published in the October issue of the British Journal of

Psychiatry shows a link between maternal tobacco use and psychotic
symptoms.

Smoking during pregnancy was found to be associated with an

increased risk of psychotic symptoms in the children. The researchers
observed a 'dose-response effect', meaning that the risk of psychotic
symptoms was highest in the children whose mothers smoked the most
heavily during pregnancy. They also linked alcohol consumption during
pregnancy with the psychotic symptoms that may be manifested by a child
when he/she grows up.

The reasons for the link between maternal tobacco use and psychotic
symptoms are uncertain. But the researchers suggest that exposure to
tobacco in the womb may have an indirect impact by affecting children's
impulsivity, attention or cognition. They have called for further studies to
investigate how exposure to tobacco in utero affects on the development and
function of children's brains.

During the study, the children who were interviewed were found out to
have psychotic-like symptoms, such as hallucinations or delusions. And the
common factor for such behavior is that their mothers are smoking during
their pregnancy.

REACTION:

Research has provided us once again with new knowledge regarding

the so-called human vice health destructor, smoking. This study was trying to
link the tobacco use with that of the psychotic-like symptoms being
manifested by some children whose mothers were smokers when they were
still in the utero.

This article caught my attention because I haven’t read any similar

studies like this before. I didn’t know that smoking during pregnancy has
other effects on the child aside from having a low birth weight. And due to
curiosity, I tried to read some articles similar to this. The following are the
summary of the articles that I’ve read:

a. This apparent increase in prevalence (of hyperactivity) during the past

thirty years has coincided with a wide expansion of cigarette smoking,
particularly cigarette smoking by women. The child of smoking parents
is continually exposed to the products of tobacco combustion and
some of these are able to disrupt the normal activity of the central
nervous system. Therefore, it seemed appropriate to investigate the
prenatal and postnatal exposure of hyperkinetic children to tobacco
smoke, and to compare it with the exposure of non-hyperkinetic
control groups.
b. The hyperkinetic syndrome is the result of several causes and the
effect of any single agent is difficult to discern. Although the apparent
association with heavy maternal smoking, in methylphenidate (Ritalin)-
sensitive cases, does not predicate a causal connection, it does justify
a careful assessment of the possible role of tobacco addiction in the
etiology of this common disorder.

I also found out that nicotine damages brain cell quality as evidenced
by accelerated motor activity, learning and memory deficits in offsprings of
mothers exposed to nicotine during pregnancy. The study revealed that
observable effects of nicotine to the child inside the utero included
significantly reduced thickness of the cerebral cortex, smaller cerebral cortex
neurons, and reduced brain weight.
RECOMMENDATION:

For the pregnant women, I recommend them to avoid smoking. I

would recommend all the women to read this journal for this will help
them understand better the effects of smoking during pregnancy not
only to their health but most especially to their baby’s well-being. This
recommendation may as well be applicable for all women who will be
pregnant in the future.

For the DOH, I recommend them to conduct programs regarding

cessation of smoking to women especially those who are pregnant.
They could also provide some divertional activities and seminars so
that they will not pay much attention to their vices.

For the health care providers and student nurses, I recommend

them to include in their health teachings findings on healthy lifestyle
during pregnancy- one which is similar to this study. I also recommend
the HCPs to educate mothers about the proper nutrition necessary not
only for their well-being, but also for the health of their children.

For the researchers, I recommend them to study on other food

groups or diet which may cause harm to a pregnant woman or which
may be beneficial to her. Common foods being consumed by all types
of women may be listed on the top priority so that the study may
benefit the majority.

SOURCE:

Cardiff University (2009, October 1). Smoking During Pregnancy Puts Children
At Risk Of Psychotic Symptoms. ScienceDaily. Retrieved November 27, 2009,
from http://www.sciencedaily.com /releases/2009/10/091001081223.htm