The Effect of Maternal Smoking on Respiratory and Arousal Patterns in Preterm Infants during Sleep

Sawnani, Hemant; Jackson, Tonya; Murphy, T.K.; Beckerman, Robert C.; Simakajornboon, Narong

doi:10.1164/rccm.200305-692oc

Cited by 83 publications

(45 citation statements)

References 46 publications

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“…Blunted adrenal CAT release during asphyxia contributes to the failure of arousal and elevated neonatal mortality as occurs during sudden infant death syndrome (SIDS) Cohen et al, 2005;Sawnani et al, 2004). Also, cigarette smoking during pregnancy has been linked to an increased risk of SIDS, likely due to the presence of nicotine (Mitchell and Milerad, 2006).…”

Section: Reviewmentioning

confidence: 99%

Ontogeny of O2 and CO2//H+ chemosensitivity in adrenal chromaffin cells: role of innervation

Salman

Buttigieg

Nurse

2014

Journal of Experimental Biology

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The adrenal medulla plays a key role in the physiological responses of developing and mature mammals by releasing catecholamines (CAT) during stress. In rodents and humans, the innervation of CATproducing, adrenomedullary chromaffin cells (AMCs) is immature or absent during early postnatal life, when these cells possess 'direct' hypoxia-and CO 2 /H + -chemosensing mechanisms. During asphyxial stressors at birth, these mechanisms contribute to a CAT surge that is critical for adaptation to extra-uterine life. These direct chemosensing mechanisms regress postnatally, in parallel with maturation of splanchnic innervation. Here, we review the evidence that neurotransmitters released from the splanchnic nerve during innervation activate signaling cascades that ultimately cause regression of direct AMC chemosensitivity to hypoxia and hypercapnia. In particular, we consider the roles of cholinergic and opioid receptor signaling, given that splanchnic nerves release acetylcholine and opiate peptides onto their respective postsynaptic nicotinic and opioid receptors on AMCs. Recent in vivo and in vitro studies in the rat suggest that interactions involving α7 nicotinic acetylcholine receptors (nAChRs), the hypoxia inducible factor (HIF)-2α signaling pathway, protein kinases and ATP-sensitive K + (K ATP ) channels contribute to the selective suppression of hypoxic chemosensitivity. In contrast, interactions involving μ-and/or δ-opiod receptor signaling pathways contribute to the suppression of both hypoxic and hypercapnic chemosensitivity, via regulation of the expression of K ATP channels and carbonic anhydrase (CA I and II), respectively. These data suggest that the ontogeny of O 2 and CO 2 /H + chemosensitivity in chromaffin cells can be regulated by the tonic release of presynaptic neurotransmitters.

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Section: Reviewmentioning

confidence: 99%

Ontogeny of O2 and CO2//H+ chemosensitivity in adrenal chromaffin cells: role of innervation

Salman

Buttigieg

Nurse

2014

Journal of Experimental Biology

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“…Thirdhand smoke refers to residual contamination from tobacco smoke after the cigarette has been extinguished 206 ; there is no research to date on the signifi-cance of thirdhand smoke with regards to SIDS risk. Smoke exposure adversely affects infant arousal [207][208][209][210][211][212][213] ; in addition, smoke exposure increases risk of preterm birth and low birth weight, both of which are risk factors for SIDS. The effect of tobacco smoke exposure on SIDS risk is dosedependent.…”

Section: Smoking During Pregnancy In the Pregnant Woman's Environmenmentioning

confidence: 99%

SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment

Moon¹

2011

Pediatrics

217

115

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Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death occurring during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from being only SIDS-focused to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths including SIDS. The recommendations described in this report include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunization, consideration of a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in this technical report. The recommendations are published in the accompanying “Policy Statement—Sudden Infant Death Syndrome and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment,” which is included in this issue (www.pediatrics.org/cgi/doi/10.1542/peds.2011-2220).

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“…32,33 We found that the smoking-related increased risk of apnea was explained by the increased risk of preterm birth and SGA associated with smoking. Surprisingly, the risk of apnea in infants of snuff users was not only higher than that of smokers, but the risk also remained after adjustment for gestational age and size at birth.…”

Section: Discussionmentioning

confidence: 80%

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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The Effect of Maternal Smoking on Respiratory and Arousal Patterns in Preterm Infants during Sleep

Cited by 83 publications

References 46 publications

Ontogeny of O2 and CO2//H+ chemosensitivity in adrenal chromaffin cells: role of innervation

Ontogeny of O2 and CO2//H+ chemosensitivity in adrenal chromaffin cells: role of innervation

SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment

Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea

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