Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity

Shuffrey, Lauren C.; Myers, Michael; Isler, Joseph R.; Lucchini, Maristella; Sania, Ayesha; Pini, Nicolò; Nugent, J. David; Condon, Carmen; Ochoa, Timothy N.; Brink, Lucy; Plessis, Carlie du; Odendaal, Hein J.; Nelson, Morgan E.; Friedrich, Christa; Angal, Jyoti; Elliott, Amy J.; Groenewald, Coen; Burd, Larry; Fifer, William P.

doi:10.1001/jamanetworkopen.2020.4714

Cited by 26 publications

(25 citation statements)

References 56 publications

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“…Several studies have reported associations of smoking and drinking during pregnancy with negative gestational outcomes and health in offspring ( Schoendorf and Kiely, 1992 ; Scragg et al, 1993 ; Cnattingius, 2004 ; Mamluk et al, 2017 ; Shuffrey et al, 2020 ). Although these reports clearly demonstrate there are adverse effects of PAE and PTE, they do not provide information about the contributions of timing and amount of exposure on fetal ANS function.…”

Section: Discussionmentioning

confidence: 99%

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Lucchini¹,

Shuffrey²,

Nugent³

et al. 2021

Front. Physiol.

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Negative associations of prenatal tobacco and alcohol exposure (PTE and PAE) on birth outcomes and childhood development have been well documented, but less is known about underlying mechanisms. A possible pathway for the adverse fetal outcomes associated with PTE and PAE is the alteration of fetal autonomic nervous system development. This study assessed PTE and PAE effects on measures of fetal autonomic regulation, as quantified by heart rate (HR), heart rate variability (SD-HR), movement, and HR-movement coupling in a population of fetuses at ≥ 34 weeks gestational age. Participants are a subset of the Safe Passage Study, a prospective cohort study that enrolled pregnant women from clinical sites in Cape Town, South Africa, and the Northern Plains region, United States. PAE was defined by six levels: no alcohol, low quit early, high quit early, low continuous, moderate continuous, and high continuous; while PTE by 4 levels: no smoking, quit early, low continuous, and moderate/high continuous. Linear regression analyses of autonomic measures were employed controlling for fetal sex, gestational age at assessment, site, maternal education, household crowding, and depression. Analyses were also stratified by sleep state (1F and 2F) and site (South Africa, N = 4025, Northern Plains, N = 2466). The final sample included 6491 maternal-fetal-dyad assessed in the third trimester [35.21 ± 1.26 (mean ± SD) weeks gestation]. PTE was associated with a decrease in mean HR in state 2F, in a dose dependent fashion, only for fetuses of mothers who continued smoking after the first trimester. In state 1F, there was a significant increase in mean HR in fetuses whose mother quit during the first trimester. This effect was driven by the Norther Plains cohort. PTE was also associated with a significant reduction in fetal movement in the most highly exposed group. In South Africa a significant increase in mean HR both for the high quit early and the high continuous group was observed. In conclusion, this investigation addresses a critical knowledge gap regarding the relationship between PTE and PAE and fetal autonomic regulation. We believe these results can contribute to elucidating mechanisms underlying risk for adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Lucchini¹,

Shuffrey²,

Nugent³

et al. 2021

Front. Physiol.

Self Cite

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“…31,32 Facial abnormalities characteristic of fetal alcohol spectrum disorder can be observed for low levels of alcohol use if exposure occurs when neural crest cells are migrating to form facial structures, 33 and changes in neonatal brain activity are observed with low levels of prenatal alcohol exposure. 34 Alternatively, imprecision or bias in reporting the amount of alcohol consumed may obscure a dosedependent effect. Because alcohol use during pregnancy is stigmatized, information about the amount consumed may be more vulnerable to reporting biases than responses about mere presence or absence of exposure.…”

Section: Risk Of Spontaneous Abortion By Gestational Week With Alcohol Exposure (N[5353)mentioning

confidence: 99%

Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study

Sundermann

Edwards

Slaughter

et al. 2021

American Journal of Obstetrics and Gynecology

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BACKGROUND: Half of women use alcohol in the first weeks of gestation, but most stop once pregnancy is detected. The relationship between timing of alcohol use cessation in early pregnancy and spontaneous abortion risk has not been determined. OBJECTIVE: This study aimed to evaluate the association between week-by-week alcohol consumption in early pregnancy and spontaneous abortion. STUDY DESIGN: Participants in Right from the Start, a communitybased prospective pregnancy cohort, were recruited from 8 metropolitan areas in the United States (2000e2012). In the first trimester, participants provided information about alcohol consumed in the prior 4 months, including whether they altered alcohol use; date of change in use; and frequency, amount, and type of alcohol consumed before and after change. We assessed the association between spontaneous abortion and week of alcohol use, cumulative weeks exposed, number of drinks per week, beverage type, and binge drinking.RESULTS: Among 5353 participants, 49.7% reported using alcohol during early pregnancy and 12.0% miscarried. Median gestational age at change in alcohol use was 29 days (interquartile range, 15e35 days). Alcohol use during weeks 5 through 10 from last menstrual period was associated with increased spontaneous abortion risk, with risk peaking for use in week 9. Each successive week of alcohol use was associated with an 8% increase in spontaneous abortion relative to those who did not drink (adjusted hazard ratio, 1.08; 95% confidence interval, 1.04e1.12). This risk is cumulative. In addition, risk was not related to number of drinks per week, beverage type, or binge drinking. CONCLUSION: Each additional week of alcohol exposure during the first trimester increases risk of spontaneous abortion, even at low levels of consumption and when excluding binge drinking.

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“…The authors claim that the outcomes of their study may suggest the abnormal maturation of cortical networks. Overall, the findings showed that any level of prenatal tobacco exposure has an association with new-born brain activity [ 26 ]. Additionally to this, a study measuring prenatal tobacco exposure on 239 children aged 8 uncovered an association between pregnancy-time cotinine, a nicotine metabolite, level and executive functions evaluated via the Behaviour Rating Inventory of Executive Function.…”

Section: Resultsmentioning

confidence: 99%

Tobacco and Nervous System Development and Function—New Findings 2015–2020

et al. 2021

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Tobacco is a one of the most common addictive stimulants used by people around the world. The smoke generated during tobacco combustion is a toxic mixture of more than 5000 chemicals of which over 30 are known human carcinogens. While its negative effects on the human body are well understood, it remains a serious public health problem. One of the multiple effects of smoking is tobacco’s effect on the nervous system—its development and function. This review aims to summarize the progress made in research on the effects of tobacco on the nervous system both of the perinatal period and adults and both in animals and humans in 2015–2020. The 1245 results that corresponded to the keywords “tobacco, cigarette, nervous system, brain, morphology, function” were reviewed, of which 200 abstracts were considered significant. Most of those articles broadened the knowledge about the negative effects of smoking on the human nervous system. Tobacco has a significant negative impact on the development of nervous structures, neurotransmission and cognitive functions, and promotes the development of neurodegenerative diseases, insomnia and cerebrovascular diseases. The only exception is the protective effect of the dopaminergic system in Parkinson’s disease. In conclusion, in recent years much effort has been devoted to describing, revealing and uncovering new aspects of tobacco detrimental to human life. The nicotine contained in tobacco smoke affects the human body in a multidimensional way, including a serious impact on the broadly understood neurological health.

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Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity

Cited by 26 publications

References 56 publications

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study

Tobacco and Nervous System Development and Function—New Findings 2015–2020

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