Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant

Nordenstam, Felicia; Lundell, Bo; Cohen, Gary; Tessma, Mesfin Kassaye; Raaschou, Pauline; Wickström, Ronny

doi:10.1093/ntr/ntx035

Cited by 24 publications

(37 citation statements)

References 40 publications

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“…Swedish snus contains merely nicotine, and its use during pregnancy has been associated with increased risks of stillbirth, preterm birth, neonatal apnoea, impaired heart rate variations and oral cleft malformations . Interestingly, an earlier study showed that the frequency of breastfeeding was lower not only among smoking, but also snus using mothers than among nontobacco using mothers . This further supports the findings of Bertini et al.…”

supporting

confidence: 82%

“…Safety studies on electronic cigarettes in pregnancy are still lacking, and data on nicotine replacement therapy are difficult to interpret due to poor compliance. Swedish snus contains merely nicotine, and its use during pregnancy has been associated with increased risks of stillbirth, preterm birth, neonatal apnoea, impaired heart rate variations and oral cleft malformations (6)(7)(8)(9)(10). Interestingly, an earlier study showed that the frequency of breastfeeding was lower not only among smoking, but also snus using mothers than among nontobacco using mothers (10).…”

mentioning

confidence: 99%

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The neurotoxic effects of prenatal nicotine exposure may impair breastfeeding

Gunnerbeck

2019

Acta Paediatrica

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supporting

confidence: 82%

mentioning

confidence: 99%

The neurotoxic effects of prenatal nicotine exposure may impair breastfeeding

Gunnerbeck

2019

Acta Paediatrica

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“…The calculation was based on the highest amount for each category and the category of more than seven pouches was estimated as 56 mg. Smoking was quantified similarly (<1, 1-5, 6-10, [11][12][13][14][15][16][17][18][19][20] or >20 cigarettes per day) with an estimated nicotine dose of 2 mg per cigarette (16).…”

Section: Questionnairementioning

confidence: 99%

Snus users had high levels of nicotine, cotinine and 3‐hydroxycotinine in their breastmilk, and the clearance was slower than in smoking mothers

et al. 2018

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Aim Using snus, an oral moist tobacco, has increased among pregnant women in Sweden, the only European Union country where sales are legal. This study evaluated whether snus generated similar concentrations of nicotine and its metabolites in breastmilk to cigarette smoking. Methods We analysed 49 breastmilk samples from 33 nursing mother – 13 snus users, six cigarette smokers and 14 controls – for concentrations of nicotine, cotinine and 3‐hydroxycotinine. The mothers were recruited at antenatal clinics in Sweden from 2007 to 2012. Results The median nicotine concentration in breastmilk of the snus users was 38.7 ng/mL (0–137) versus 24.0 ng/mL (0–56) in smokers, with median cotinine levels of 327.6 ng/mL (37–958) versus 164.4 ng/mL and median 3‐hydroxycotinine levels of 202.7 ng/mL (28–452) versus 112.4 (0–231), respectively. Nicotine was still detected in the breastmilk of eight of the 13 snus users after abstaining from tobacco for a median duration of 11 hours (0.6–12.5), while the breastmilk of the smokers was nicotine‐free after four hours’ abstinence. Conclusion Snus users had high levels of nicotine and metabolites in their breastmilk and nicotine was found even after 12.5 hours of abstinence.

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“…All infant controls had cotinine levels <0.7 ng/mL, snus group ranged from 0 to 408 ng/mL and the cigarette smoking group from 0 to 129 ng/mL. In this study, it was apparent that tobacco, regardless of form, timing and type of exposure, could affect the developing infant .…”

Section: Resultsmentioning

confidence: 63%

“…Adverse effects of snus use in pregnancy were observed in several human studies, as outlined in Table 2, with effects of smoking and snus during pregnancy reported in 10 cohort studies (7,(10)(11)(12)(13)(14)(15)(16)(17) and in one study based upon sibling analysis (18). Furthermore, one case report describing neonatal withdrawal symptoms after exposure to around 20 doses of snus per day during pregnancy was identified (19).…”

Section: Adverse Effects Of Snusmentioning

confidence: 99%

An update on prevalence and risk of snus and nicotine replacement therapy during pregnancy and breastfeeding

et al. 2019

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Aim In parallel with falling smoking rates, use of the oral moist tobacco product snus increases among women in reproductive age. We report an update on prevalence and effects of maternal use of snus and nicotine replacement therapy (NRT) during pregnancy and breastfeeding. Methods A literature search of human studies in Medline, PubMed and EMBASE was conducted from September 2016 to May 2018, with stepwise screening of abstracts and subsequent relevant full‐text papers for inclusion in Scandinavian and English languages. Results Based on three studies, the prevalence of snus use in pregnancy was up to 3.4% in the first trimester and 2.1% in the third trimester. In 12 studies, we found increased risk of several adverse effects, especially preterm delivery, stillbirth and small for gestational age associated with maternal snus use during pregnancy. Knowledge on effects of NRT during pregnancy was conflicting and inconclusive in 10 studies. We did not identify any studies on prevalence or potential health effects of snus or NRT during breastfeeding. Conclusion Few studies with updated data on the prevalence and adverse health effects of maternal use of snus and NRT during pregnancy were found. No studies during breastfeeding were identified.

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Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant

Cited by 24 publications

References 40 publications

The neurotoxic effects of prenatal nicotine exposure may impair breastfeeding

The neurotoxic effects of prenatal nicotine exposure may impair breastfeeding

Snus users had high levels of nicotine, cotinine and 3‐hydroxycotinine in their breastmilk, and the clearance was slower than in smoking mothers

An update on prevalence and risk of snus and nicotine replacement therapy during pregnancy and breastfeeding

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