UNSW Embryology
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Development- Sudden Infant
Death Syndrome
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Embryology Home
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Links IntroductionNHMRC-SIDS
PublicationSmoking
and PregnancyWWW
LinksAbout
Notes
Related Pages: Abnormal Development-
Smoking
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2 | Abnormalities
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Assessment Questions |
Medline
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5 | Maternal Factors
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Smoking
and Pregnancy
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- Smoking doubles the risk of having a
low-birthweight baby and significantly increases
the rate of perinatal mortality and several
other adverse pregnancy outcomes.
- The mean reduction in birthweight for babies
of smoking mothers is 200 g.
- High quality interventions to help pregnant
women quit smoking produce an absolute
difference of 8.1% in validated late-pregnancy
quit rates.
- If abstinence is not achievable, it is
likely that a 50% reduction in smoking would be
the minimum necessary to benefit the health of
mother and baby.
- Healthcare providers perform poorly in
antenatal interventions to stop women smoking.
Midwives deliver interventions at a higher rate
than doctors.
- The efficacy of nicotine replacement therapy
has not been established in pregnancy.
Currently, its use should only be considered in
women smoking more than 10 cigarettes per day
who have made a recent, unsuccessful attempt to
quit and who are motivated to quit.
- Relapse prevention programs have shown
little success in the postpartum period.
Data from: Quitting
smoking in pregnancy Raoul A Walsh, John B
Lowe, Peter J Hopkins (MJA 2001; 175: 320-323)
See also- Abnormal
Development- Smoking
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NHMRC Publication- Risk factors
associated with SIDS (Oct 1991)
- The possible causes of Sudden Infant Death Syndrome
(SIDS), sometimes called cot death, are still not known.
However, population studies have identified risk factors
that may contribute to SIDS. Risk factors that parents
may be able to do something about include; sleeping
posture, feeding practices and passive smoking.
- Recent research suggests that babies who sleep on
their stomach may have a higher risk of SIDS. The NHMRC
recommends that babies should generally sleep on their
side or on their back. If on their side, the lower arm
should be placed well forward so that babies cannot roll
on their stomach. Some babies may need to sleep on their
stomach for medical reasons. Parents should discuss with
their doctor whether this applies to their baby.
- Breast feeding may reduce the risk of SIDS. Breast
milk is the best food for babies. Babies should be breast
fed if at all possible.
- Passive smoking is associated with an increased risk
of SIDS. NHMRC recommends pregnant mothers should not
smoke. This is particularly important during pregnancy
and in the baby's first year. Others should not smoke
near the baby.
- These risk factors alone do not cause SIDS and it is
extremely rare for babies exposed to them to die of SIDS.
However, following the above advice may help reduce the
number of SIDS deaths. Research is continuing to search
for the basic cause of SIDS.
- There has been concern in the community that
immunisation is associated with SIDS. There is no
scientific evidence to support this belief. No
association of immunisation with SIDS has been
documented.
Excerpt from NHMRC
Statement
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The Australian NHMRC
(1988) recommends neonates be assessed for follow-up
care under the following conditions.
(see the NHMRC
WWW Page)
- Birthweight less than 1500g or gestational age less
than 32 weeks
- Small-for-gestational-age neonates
- Perinatal asphyxia
- Apgar score less than 3 at 5 minutes
- clinical evidence of neurological dysfunction
- delay in onset of spontaneous respiration for more
than 5 minutes and requiring mechanical ventilation
- Clinical evidence of central nervous system
abnormalities ie., seizures, hypotonia
- Hyperbilirubinaemia of greater than 350umol/l in full
term neonates
- Genetic, dysmorphic or metabolic disorders or a
family history of serious genetic disorder
- Perinatal or serious neonatal infection including
children of mothers who are HIV positive
- Psychosocial problems eg., infants of drug-addicted
or alcoholic mothers.
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WWW
Links
SIDS Links USA
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For Normal Childhood Development
see
Publications (or
NHMRC WWW Page)
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About Notes
- Notes from the Embryology Program compiled and
written by Dr Mark Hill.
- Note Links to OMIM Entries are copies of originals
for computers without internet access. Computers with
internet access can directly access the database.
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m.hill@unsw.edu.au
Date Last Modified: 17/9/2001
This site maintained by Dr M. Hill
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