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Effect of maternal smoking on ventilatory responses to changes in inspired oxygen levels in infants.

Maternal smoking is a major independent risk factor for sudden infant death syndrome (SIDS). Respiratory control deficits have been implicated in SIDS. The aim of this study was to test the hypothesis that infants born to smoking mothers have reduced ventilatory responses to changes in inspired oxygen. Smoking and nonsmoking women were recruited in midpregnancy and smoking status confirmed by measurement of urinary cotinine. To control for confounding factors of smoking each mother-infant pair in the smoking group was matched to a pair in the nonsmoking group for social class, maternal age and parity, feeding, birthweight, gestational age, and infant sex. Infants were seen overnight at approximately 10 wk of age for tests of respiratory control, using the alternating breath test. Ventilation was measured by respiratory inductance plethysmography and inspired and end-tidal oxygen levels were determined by mass spectrometry. Data were obtained from 40 infants (17 in the smoking group). Responses were similar in both groups for 10 respiratory parameters including respiratory drive and timing, and there were no significant differences. The mean end-tidal oxygen level when 40% O(2) was delivered was an average of 1.13% higher in the smoking group (p = 0.0067), although the inspired oxygen levels were not different. In conclusion, we did not find an independent effect of maternal smoking on respiratory control. The differences in end-tidal oxygen levels during the alternating breath test may represent differences in alveolar ventilation.