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Tobacco is one of the leading preventable causes of death in the United States Nicotine which is an alkaloid derived from the tobacco plant is a potent chemical that has powerful effects on the human body especially when administered rapidly or at high doses Prenatal exposure to nicotine is associated with adverse reproductive outcomes including altered neural structure and functioning cognitive deficits and behavior problems in the offspring 9 At least 20 - 30 of pregnant women are estimated to smoke cigarettes although smoking is associated with low birth weight prematurity and infant mortality In the United States smoking accounts annually for estimated fetal deaths ranging from 19000 to 141000 for 1900 to 4800 deaths during or immediately after parturition and for 1200 to 2200 death from Sudden Infant Death Syndrome 7 Maternal smoking has been implicated in long term deficits in infant mental development and adverse behavioral problems in children such as attention disorder Nicotine crosses the human placenta and has direct effects on the developing fetus Pre-clinical studies suggest that maternal smoking during pregnancy produces changes on the offsprings neural functioning including reductions in uptake of serotonin alterations in dopaminergic systems alterations in peripheral and central noradrenergic neurons and changes in DNA and RNA synthesis in the brain 9 Children prenatally exposed to nicotine consistently score lower in the two subcategories of expressive language and conceptual comprehension Evidence from studies of human neonates suggests that maternal smoking during pregnancy is associated with increased rates of neurobehavioral difficulties Several studies have linked maternal smoking during pregnancy with childhood inattention impulsivity and motor hyperactivity in offspring Similarly maternal smoking during pregnancy has been associated with parent-teacher ratings of conduct problems in children and a criminal record in young adults A study by Yousef Tzabi suggested that cigarette smoking during pregnancy may be one of the causes of hyperactivity and learning deficits in children In a
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