Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb

Hafström, Ola; Milerad, Josef; Sundell, Håkan

doi:10.1164/rccm.2107082

Cited by 50 publications

(46 citation statements)

References 46 publications

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“…27,28 In animal studies, prenatal exposure to pure nicotine indicates disturbances in the control of the cardiorespiratory system, with an increased frequency of apnea during sleep, decreased arousability and a blunted cardiorespiratory response to hypoxia, higher breathing frequency, and lower tidal volume during the neonatal period. 29,30 Our finding of an increased risk of infant apnea, as a sign of disturbed control of the cardiorespiratory system, correlates well with similar findings in animal studies of prenatal nicotine exposure. Huang et al 31 found an increased frequency of apneas during sleep in a group of prenatally nicotine-exposed rat pups during the first 2 postnatal days but not at postnatal day 6.…”

Section: Discussionsupporting

confidence: 86%

Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Maternal smoking is associated with harmful effects on the newborn: preterm birth, fetal growth restriction, and sudden infant death syndrome. Much less is known about the effects of smokeless tobacco, and nicotine-replacement therapy is recommended as a means of smoking cessation during pregnancy. WHAT THIS STUDY ADDS:Maternal snuff use (including predominantly nicotine) is associated with higher risk of neonatal apnea than smoking (containing nicotine and combustion products). Snuff use should not be regarded as safe during pregnancy. abstract BACKGROUND: Maternal smoking is associated with disturbed cardiorespiratory control in the infant. Despite lacking knowledge of whether the harmful effects of smoking are caused by combustion products in tobacco smoke or by nicotine, it has been argued that nicotinereplacement therapy during pregnancy is safer than smoking. OBJECTIVE:The goal of this study was to investigate if the disturbances in cardiorespiratory control associated with maternal smoking are also seen in infants prenatally exposed to snuff. We hypothesized that prenatal nicotine exposure (via moist snuff) causes disturbances in autonomic control and thereby increases the risk of apnea in the newborn. METHODS:In a nationwide Swedish cohort study, we studied associations between maternal tobacco use during pregnancy and neonatal apnea. Of 609 551 live-born singleton infants, 7599 were born to snuffusing mothers, 41 391 and 16 928 were born to light (1-9 cigarettes per day) and heavy (Ն10 cigarettes per day) smokers, respectively. Logistic regression was used to calculate odds ratios, using 95% confidence intervals. RESULTS:Compared with infants of nontobacco users, infants with prenatal exposure to snuff were at an increased risk of apnea even after adjustment for differences in gestational age (odds ratio: 1.96 [95% confidence interval: [1.30 -2.96]) Smoking was associated with increased risk of apnea before, but not after, adjusting for gestational age. CONCLUSIONS:Snuff use during pregnancy is associated with a higher risk of neonatal apnea than smoking. Maternal use of snuff or nicotine-replacement therapy cannot be regarded as an alternative to smoking during pregnancy.

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Section: Discussionsupporting

confidence: 86%

Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea

et al. 2011

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“…Other examples of developmental plasticity include altered adult chemoreflexes caused by maternal separation stress (118) and prenatal nicotine exposures (12,51,70,87,207). In the pond snail Lymnaea stagnalis, preventing lung ventilation from hatching through adulthood alters mechanisms of ventilatory control in adults (92).…”

Section: Developmental Plasticitymentioning

confidence: 99%

Invited Review: Neuroplasticity in respiratory motor control

Mitchell

Johnson

2003

Journal of Applied Physiology

357

313

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Although recent evidence demonstrates considerable neuroplasticity in the respiratory control system, a comprehensive conceptual framework is lacking. Our goals in this review are to define plasticity (and related neural properties) as it pertains to respiratory control and to discuss potential sites, mechanisms, and known categories of respiratory plasticity. Respiratory plasticity is defined as a persistent change in the neural control system based on prior experience. Plasticity may involve structural and/or functional alterations (most commonly both) and can arise from multiple cellular/synaptic mechanisms at different sites in the respiratory control system. Respiratory neuroplasticity is critically dependent on the establishment of necessary preconditions, the stimulus paradigm, the balance between opposing modulatory systems, age, gender, and genetics. Respiratory plasticity can be induced by hypoxia, hypercapnia, exercise, injury, stress, and pharmacological interventions or conditioning and occurs during development as well as in adults. Developmental plasticity is induced by experiences (e.g., altered respiratory gases) during sensitive developmental periods, thereby altering mature respiratory control. The same experience later in life has little or no effect. In adults, neuromodulation plays a prominent role in several forms of respiratory plasticity. For example, serotonergic modulation is thought to initiate and/or maintain respiratory plasticity following intermittent hypoxia, repeated hypercapnic exercise, spinal sensory denervation, spinal cord injury, and at least some conditioned reflexes. Considerable work is necessary before we fully appreciate the biological significance of respiratory plasticity, its underlying cellular/molecular and network mechanisms, and the potential to harness respiratory plasticity as a therapeutic tool.

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“…The lambs were studied at the median (range) ages of 12 (5-17), 25 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 51 (45-61) d, i.e. the earliest possible time after postoperative recovery, as late as practical with this chronic preparation, and once in between.…”

Section: Subjectsmentioning

confidence: 99%

“…the earliest possible time after postoperative recovery, as late as practical with this chronic preparation, and once in between. [Median (range) study ages for each group were 12 (5-17), 26 (24 -34), and 51 (45-61) d for LN lambs; 12 (7-16), 24 (22)(23)(24)(25)(26)(27), and 51 (47-58) d for MN lambs; and 12 (8 -13), 25 (23)(24)(25)(26)(27)(28), and 52 (49 -54) d for the control group.] The research protocol was approved by the Vanderbilt University Animal Care Committee.…”

Section: Subjectsmentioning

confidence: 99%

Altered Lung Development after Prenatal Nicotine Exposure in Young Lambs

et al. 2004

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There is compelling evidence that prenatal nicotine exposure permanently alters lung development and airway function. The aim of this study was to determine how prenatal nicotine exposure alters proximal and distal airway function. Thirteen lambs were continuously exposed during the last fetal trimester to low-dose nicotine (LN) and 12 to a moderate dose (MN) (maternal s.c. dose: 0.5 and 1.5 mg/kg/d, respectively). Ten lambs served as controls (C). Proximal airway function was measured by lung mechanics. A multiple-breath N 2 washout technique was used to measure lung volume (functional residual capacity) and efficiency of gas mixing in distal airways, i.e. terminal respiratory units (moment ratio and nitrogen clearance). In comparison with C, both LN and MN had significantly reduced specific airway conductance to the same extent at a median study age of 12, 25, and 51 d, indicating signs of proximal airway obstruction. Distal airway function showed significant improvement in LN. Ventilation and functional residual capacity were unaffected. In summary, prenatal nicotine exposure induced airway obstruction in proximal airways and improved gas mixing in distal airways, possibly reflecting restriction in proximal airway growth and accelerated maturation of the acinar part of the lung, respectively. We speculate that prenatal nicotine exposure has a disparate impact on airway development and function. The effect on the distal airways seemed to be inversely related to dose, which was not the case in the large airways. The altered airway function persisted during the study period, indicating that the effects of prenatal nicotine exposure might be permanent. Environmental tobacco smoke is a severe health problem, not only for the whole pediatric population but also for the fetus in utero (1). There is compelling evidence that maternal smoking is associated with premature birth, low birth weight, and increased fetal and neonatal morbidity as well as mortality (2, 3). Epidemiologic studies have shown that environmental tobacco smoke is associated with a significantly increased incidence of wheezing, bronchitis, lower respiratory illness, and increased number of hospital admissions during infancy and childhood (4, 5). These studies further suggest that there is a stronger correlation between prenatal, rather than postnatal, exposure and lower respiratory illness in the offspring of smoking mothers.Altered mechanical properties of the lungs have also been found in these infants and children (6 -12). These abnormalities in lung function are dominated by signs of airway obstruction with reduced forced expiratory flow rates at FRC, increased airway resistance, and a decrease in the ratio of time to peak tidal expiratory flow to total expiratory time (Tptef/Te). Low FRC and decreased lung compliance have also been found in infants exposed to environmental tobacco smoke. Studies of sudden infant death victims have shown that infants of mothers who smoked during pregnancy have abnormal airway pathology in the form of greater inn...

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Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb

Cited by 50 publications

References 46 publications

Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea

Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea

Invited Review: Neuroplasticity in respiratory motor control

Altered Lung Development after Prenatal Nicotine Exposure in Young Lambs

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