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Nicotine and Cotinine in Infants Dying from Sudden Infant Death Syndrome

NCJ Number
227808
Journal
International Journal of Legal Medicine Volume: 122 Issue: 1 Dated: January 2008 Pages: 23-28
Author(s)
T. Bajanowski; B. Brinkmann; E. A. Mitchell; M. M. Vennemann; H. W. Leukel; K.-P. Larsch; J. Beike
Date Published
January 2008
Length
6 pages
Annotation
In this component of the German Study on Sudden Infant Death, material was taken at autopsy in 100 cases of sudden infant death syndrome (SIDS) in order to determine nicotine concentrations in hair (NCH) as a marker of long-standing exposure to tobacco; continine concentrations in pericardial fluid (CCP); and cotinine concentrations in liquor cerebrospinalis (CCL), which measures recent exposure to tobacco in the last few hours of life.
Abstract
Sixty-one of the SIDS cases were positive for NCH, and 39 were negative. In the 61 cases of NCH-positive infants, the NCH ranged from 0.5 to 258.4 ng/mg. The infants of mothers who said they had smoked during pregnancy had higher NCH than those of nonsmoking mothers. In addition, there was a weak but statistically significant relationship between NCH and the number of cigarettes smoked during pregnancy. There were inconsistencies, however, that require further analysis and discussion. First, there was a significant inter-individual variation of the NCH, CCL, and CCP for each reported amount of cigarettes smoked. Second, there were cases in which reported heavy tobacco consumption was associated with zero concentration. In addition, there were cases in which reported exposure to tobacco was negative but showed high NCH. In addition to the nicotine intake by inhalation of tobacco smoke, an alternative route of intake is through breast feeding. Fivefold higher nicotine concentrations were found in nonbreast-fed infants of parents who smoked compared to all other groups. Thus, nicotine intake by "passive smoking" is much more important than by breast-feeding. The authors advise that both interview data and biochemical measures should be collected in order to understand an infant's true exposure to tobacco smoke. 3 tables, 3 figures, and 33 references