Vascular retinal abnormalities in neonates of mothers who smoked during pregnancy

Objective: To investigate whether maternal smoking during pregnancy causes retinal abnormalities in the newborn. Study design: One hundred sixty-two neonates of smoking mothers and 162 mat ched neonates of nonsmoking mothers (112 appropriate for gestational age [A GA], 30 small for gestational age [SGA], 20 large for gestational age [LGA] in each group) were studied. Results: Retinal arterial narrowing and straightening (RANS) was observed i n 52 and 10 eyes of the newborns of smoking and nonsmoking mothers, respect ively (P <.000001) in association with elevated blood pressure in the neona tes. The frequency of RANS was more than 3-fold greater in the SGA neonates than in the AGA and LGA neonates of the smoking mothers. Retinal venous di latation and tortuosity (RVDT) was found in 100 and 36 eyes of neonates of smoking and nonsmoking mothers, respectively (P <.000001). The frequency of RVDT in the SGA neonates of the smelting mothers was 2.5-fold and 4.2-fold greater than in the AGA infants and the LGA infants, respectively. Also, i ntraretinal hemorrhages were found in 61 and 31 eyes of neonates of smoking and nonsmoking mothers, respectively (P =.0007) in association with elevat ed hematocrit and RVDT, whereas no intraretinal hemorrhages were found when RANS was present. All retinal abnormalities resolved by 6 months in infant s of smoking mothers and by 2 months in infants of nonsmoking mothers. Conclusions: Maternal smoking during pregnancy causes increased frequency o f RANS, RVDT, and intraretinal hemorrhages; but these retinal abnormalities resolve by 6 months of age.