Tobacco and pregnancy: Overview of exposures and effects

Abstract

This opening article will review the epidemiology of the effects of cigarette smoking and other forms of tobacco exposure on human development. Sources of exposure described include cigarettes and other forms of smoked tobacco, secondhand (environmental) tobacco smoke, several forms of smokeless tobacco, and nicotine from nicotine replacement therapy. Exposure is immense and worldwide, most of it due to smoking, but in some parts of the world and in some populations, smoking is exceeded by smokeless tobacco use. Nicotine and carbon monoxide exposure are of large concern, but cigarette smoke contains over 4000 chemical constituents and additives including known carcinogens, toxic heavy metals, and many chemicals untested for developmental toxicity. The impact of tobacco on human development will be reviewed. Fertility, conception, survival of the conceptus, most phases and aspects of development studied to date, as well as postnatal survival and health are adversely impacted by maternal tobacco use or exposure. Effects in surviving offspring are probably life-long, and are still being elucidated. It is hoped that this review and those to follow in this issue will serve to keep a focus on the critical and continuing problem of tobacco use impacting human development.

Association Between Exposure to Secondhand Smoke During Pregnancy and Low Birthweight: A Narrative Review

“…[1][2][3][4] SHS includes chemicals such as nicotine, carbon monoxide, and carbon dioxide. 5 SHS includes asbestos, arsenic, benzene, radon, and other carcinogens.…”

Nicotine Exposure During Pregnancy Results in Persistent Midline Epithelial Seam With Improper Palatal Fusion

“…Additionally, frequency of stillborn pups was considerably higher in nicotine-treated dams, thus showing the deleterious effect of nicotine on the developing fetus. In terms of litter size, which also includes stillborn pups, all of the above-mentioned developmental anomalies are likely due to the effect of nicotine on morphogenesis and organ development as reviewed in Rogers 36 . It would be also noteworthy to analyze if the higher number of stillborn pups and lower litter size were due to failures during implantation, early development, or late development.…”

Contingency Management for Smoking Cessation in Pregnancy

“…1 Although smoking during pregnancy has decreased in recent decades, it is still considered the top preventable cause of poor birth outcomes in the United States. 2,3 Smokers have an increased risk of ectopic pregnancy, spontaneous abortion, placental abruption, placenta previa, preterm birth, low birthweight (LBW), stillbirth, and sudden infant death syndrome (SIDS). After birth, the children of smokers are at increased risk for behavioral problems, attention deficit disorder, hyperactivity, learning disability, obesity, elevated blood pressure, diabetes, and an increased risk of becoming smokers themselves.…”

“…After birth, the children of smokers are at increased risk for behavioral problems, attention deficit disorder, hyperactivity, learning disability, obesity, elevated blood pressure, diabetes, and an increased risk of becoming smokers themselves. 3 Additionally, the newborn is at increased risk for cognitive problems, ear infections, bronchitis, pneumonia, asthma, and SIDS if exposed to secondhand smoke postpartum. 4 Although the rate of maternal tobacco use during pregnancy has dropped, certain populations such as Appalachians still have high rates of maternal tobacco use during pregnancy and associated high rates of poor birth outcomes.…”