The effect of cigarette smoking on fetal heart rate characteristics*1
Abstract
OBJECTIVE: To evaluate the effect of repeated cigarette smoking on fetal heart rate (FHR) characteristics. METHODS: Fifteen chronic smokers who were between 28 and 36 weeks' gestation were evaluated during an 8-hour smoking session. Baseline FHR and reactivity were evaluated before an initial cigarette and 4 hours later (after the fourth cigarette), when the effects of smoking on FHR were expected to be maximal. Plasma nicotine was measured at baseline and repeated at times of fetal monitoring. RESULTS: Subjects smoked a mean +/- standard deviation of 22 +/- 6 cigarettes per day. They abstained from smoking for 9.2 +/- 3.2 hours before evaluation. The initial baseline FHR was 134 +/- 9 beats per minute versus 135 +/- 11 beats per minute after the fourth cigarette (P =.17). Plasma nicotine increased from 2.6 +/- 5.6 ng/mL to 24 +/- 9.9 ng/mL after the fourth cigarette (P <.001). The initial nonstress test was reactive in 12 of 15 (80%) of the fetuses. After the fourth cigarette, only four of 15 (27%) of the nonstress tests were reactive. A majority of tracings (eight of 15) were initially reactive before smoking and became nonreactive after smoking. Some tracings remained nonreactive (three of 15), and some tracings remained reactive (four of 15) at both assessments. None of the tracings that were initially nonreactive became reactive. The change in reactivity was significant (P =.013). CONCLUSION: Acute, repeated smoking decreases FHR reactivity.
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Fetuses of smokers show more maladaptive responses to the non-stress test, lower heart rate variability, more mouth and self-touch movements, and poorer recognition of maternal voice than fetuses of nonsmokers.
“found greater rates of maladaptive response to the non-stress test (a clinical index of fetal well-being)(96), including reduced heart rate variability, increased mouth and self-touch movements, and impaired recognition of maternal voice in fetuses of smokers compared with those of nonsmokers.”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [96]
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Cites
Jacob, P., Wilson, M., & Benowitz, N. L. (1981) · Journal of Chromatography B Biomedical Sciences and Applications · doi:10.1016/s0378-4347(00)81033-6 · Cited by 444 · see citing works
Hoffmann, D., Djordjevic, M. V., & Hoffmann, I. E. (1997) · Preventive Medicine · doi:10.1006/pmed.1997.0183 · Cited by 421 · see citing works
Milberger, S., Biederman, J., Faraone, S. V., Chen, L., & Jones, J. T. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.9.1138 · Cited by 410 · see citing works
Effect of Maternal Cigarette Smoking on Pregnancy Complications and Sudden Infant Death Syndrome
DiFranza, J. R., & Lew, R. (1995) · European Journal of General Practice · doi:10.3109/13814789509160303 · Cited by 354 · see citing works
Cocaine and Tobacco Use and the Risk of Spontaneous Abortion
Ness, R. B., Grisso, J. A., Hirschinger, N., Marković, N., Shaw, L. M. J., Day, N. L., & Kline, J. K. (1999) · New England Journal of Medicine · doi:10.1056/nejm199902043400501 · Cited by 322 · see citing works
Circadian blood nicotine concentrations during cigarette smoking
Benowitz, N. L., Kuyt, F., & Jacob, P. (1982) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.1982.233 · Cited by 292 · see citing works
Effects of maternal smoking on adverse pregnancy outcomes: examination of the criteria of causation.
Walsh, R. A. (1994) · PubMed · Cited by 220 · see citing works
Cigarette, alcohol, and coffee consumption and spontaneous abortion.
Armstrong, B., McDonald, A. D., & Sloan, M. (1992) · American Journal of Public Health · doi:10.2105/ajph.82.1.85 · Cited by 212 · see citing works
Intellectual Impairment in Children of Women Who Smoke Cigarettes During Pregnancy
Olds, D. L., Henderson, C., & Tatelbaum, R. C. (1994) · PEDIATRICS · doi:10.1542/peds.93.6.973 · Cited by 192 · see citing works
The Fetal Biophysical Profile and Its Predictive Value
Vintzileos, A. M., Campbell, W. A., INGARDIA, C. J., & NOCHIMSON, D. J. (1983) · Obstetrics and Gynecology · doi:10.1097/00006250-198309000-00001 · Cited by 184 · see citing works
Reading and language in 9- to 12-year olds prenatally exposed to cigarettes and marijuana
Fried, P. A., Watkinson, B., & Siegel, L. S. (1997) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(97)00015-9 · Cited by 170 · see citing works
Nicotine Replacement Therapy During Pregnancy
Benowitz, N. L. (1991) · JAMA · doi:10.1001/jama.1991.03470220090034 · Cited by 155 · see citing works
Devoe, L. D., Golde, S. H., Kilman, Y., Morton, D., Shea, K., & Waller, J. L. (2000) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2000.107665 · Cited by 114 · see citing works
Nicotine patch use in pregnant smokers: Nicotine and cotinine levels and fetal effects
Ogburn, P. L., Hurt, R. D., Croghan, I. T., Schroeder, D. R., Ramin, K. D., Offord, K. P., & Moyer, T. P. (1999) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(99)70521-1 · Cited by 83 · see citing works
ONCKEN, C. (1997) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(97)00309-8 · Cited by 77 · cited 1× · see citing works
“The effect is probably less than 1 hour because in our previous study, where NSTs were performed at baseline and again after 4 hours of continued smoking, only one of 15 tracings lost reactivity.(24) However, in that study, NSTs were not standardized in relation to maternal smoking.”
ResultSelf-citationThe use of pharmacotherapies for smoking cessation during pregnancy
Benowitz, N., Dempsey, D., Goldenberg, R., Hughes, J., Dolan-Mullen, P., Ogburn, P., Oncken, C., Orleans, C., Slotkin, T., Whiteside, H. P., et al. (2000) · Tobacco Control · doi:10.1136/tc.9.suppl_3.iii91 · Cited by 67 · see citing works
Cigarette Smoking and Spontaneous Abortion of Known Karyotype: Precise Data but Uncertain Inferences
Kline, J. K., Levin, B. L., Kinney, A. M., STEIN, Z. A., Susser, M. W., & Warburton, D. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117444 · Cited by 65 · see citing works
Graça, L. M., Cardoso, C. G., Clode, N., & Calhaz–Jorge, C. (1991) · Journal of Perinatal Medicine · doi:10.1515/jpme.1991.19.5.385 · Cited by 58 · see citing works
Diminished fetal reactivity with smoking
Phelan, J. P. (1980) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(80)90602-x · Cited by 36 · see citing works
Licit and illicit drug use in NSW
Thackway, S. V., Poder, A., & Summerill, A. (1999) · New South Wales Public Health Bulletin · doi:10.1071/nb99072 · Cited by 27 · see citing works
Acute effects of smoking on fetal heart‐rate variability
Lehtovirta, P., Forss, M., Kariniemi, V., & Rauramo, I. (1983) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1983.tb06736.x · Cited by 21 · see citing works
Acute effects of nicotine on fetal heart rate variability
LEHTOVIRTA, P., FORSS, M., RAURAMO, I., & KARINIEMI, V. (1983) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1983.tb09299.x · Cited by 20 · see citing works
Acute effect of cigarette smoking on the fetal heart nonstress test.
Jm, B., Je, V., & Fh, B. (1981) · PubMed · Cited by 14 · see citing works
Effects of smoking on fetal heart rate variability during gestational weeks 27 to 32
Kariniemi, V., Lehtovirta, P., Rauramo, I., & Forss, M. (1984) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(84)90041-3 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
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Open access intrapartum CTG database
Chudáček, V., Spilka, J., Burša, M., Janků, P., Hruban, L., Huptych, M., & Lhotská, L. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-16 · Cited by 277 · see citing works
England, L. J., Aagaard, K., Bloch, M., Conway, K., Cosgrove, K., Grana, R., Gould, T. J., Hatsukami, D., Jensen, F., Kandel, D., et al. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.11.013 · Cited by 181 · see citing works
Cardiorespiratory effects of nicotine exposure during development
Hafström, O., Milerad, J., Sandberg, K. L., & Sundell, H. W. (2005) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2005.05.004 · Cited by 96 · see citing works
Salisbury, A. L., Fallone, M. D., & Lester, B. M. (2005) · Mental Retardation and Developmental Disabilities Research Reviews · doi:10.1002/mrdd.20058 · Cited by 58 · see citing works
Cells in fluidic environments are sensitive to flow frequency
Balcells, M., Fernández-Suárez, M., Vázquez, M., & Edelman, E. R. (2005) · Journal of Cellular Physiology · doi:10.1002/jcp.20281 · Cited by 54 · see citing works
Maternal cigarette-smoking during pregnancy disrupts rhythms in fetal heart rate
Zeskind, P. S., & Gingras, J. L. (2006) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj031 · Cited by 53 · see citing works
Impact of maternal prenatal smoking on fetal to infant neurobehavioral development
Stroud, L. R., McCallum, M., & Salisbury, A. L. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000676 · Cited by 35 · see citing works
Cardiac Physiology of Pregnancy
May, L. E. (2015) · Comprehensive physiology · doi:10.1002/cphy.c140043 · Cited by 34 · see citing works
Fetal behavior in smoking compared to non-smoking pregnant women
Cowperthwaite, B., Hains, S. M. J., & Kisilevsky, B. S. (2007) · Infant Behavior and Development · doi:10.1016/j.infbeh.2006.12.004 · Cited by 33 · see citing works
Effects of nicotine patch or nasal spray on nicotine and cotinine concentrations in pregnant smokers
Oncken, C. A., Campbell, W. A., Chan, G., Hatsukami, D. K., & Kranzler, H. R. (2009) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767050902994515 · Cited by 27 · see citing works
Self-citationNeurobehavioral Consequences of Prenatal Exposure to Smoking at 6 to 8 Months of Age
Willoughby, M. T., Greenberg, M. T., Blair, C., Stifter, C. A., & The Family Life Investigative Group (2007) · Infancy · doi:10.1111/j.1532-7078.2007.tb00244.x · Cited by 26 · see citing works
Micalizzi, L., & Knopik, V. S. (2017) · Development and Psychopathology · doi:10.1017/s0954579417001687 · Cited by 25 · see citing works
Acute effects of maternal smoking on fetal hemodynamics
Ateş, U., Ata, B., Armagan, F., Has, R., & Sidal, B. (2004) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2004.06.009 · Cited by 21 · see citing works
Smoking in pregnancy affects the fetal heart: possible links to future cardiovascular disease
Kapaya, H., Pipkin, F. B., Hayes-Gill, B., & Loughna, P. (2015) · Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2014.964202 · Cited by 21 · see citing works
Jones, H. A., Eddy, L. D., Rabinovitch, A. E., Snipes, D. J., Wilson, S. A., Parks, A. M., Karjane, N. W., & Svikis, D. S. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22538 · Cited by 17 · see citing works
Effect of Medicaid Coverage of Tobacco-Dependence Treatments on Smoking Cessation
Liu, F. (2009) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph6123143 · Cited by 16 · see citing works
Gopalakrishnan, K., More, A., Hankins, G., Nanovskaya, T., & Kumar, S. (2017) · Reproductive Sciences · doi:10.1177/1933719116673199 · Cited by 12 · see citing works
Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation
Lucchini, M., Shuffrey, L. C., Nugent, J. D., Pini, N., Sania, A., Shair, M. C., Brink, L. T., du Plessis, C., Odendaal, H. J., Nelson, M. E., et al. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.594605 · Cited by 12 · see citing works
The effect of cigarette smoking on fetal heart rate tracing during pregnancy
Spyridou, K., Chouvarda, I., Hadjileontiadis, L. J., & Maglaveras, N. (2016) · Journal of Perinatal Medicine · doi:10.1515/jpm-2015-0275 · Cited by 9 · see citing works
Stroud, L. R., Bublitz, M. H., Crespo, F. A., Lester, B. M., & Salisbury, A. L. (2020) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2020.106894 · Cited by 8 · see citing works
Acute fetal heart rate tracing changes secondary to cigarette smoking in third trimester pregnancies
Kutlu, T., Özkaya, E., Şanverdi, İ., Çakar, E., Ayvacı, H., Devranoğlu, B., & Karateke, A. (2016) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2016.1214708 · Cited by 8 · see citing works
The Effect of Cigarette Smoking on Fetal Heart Rate Characteristics*
Bernardes, J. (2002) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(02)02234-2 · Cited by 7 · see citing works
The Effects of Maternal Opium Abuse on Fetal Heart Rate using Non-Stress Test.
Keikha, F., Vahdani, F. G., & Latifi, S. (2016) · Europe PMC (PubMed Central) · Cited by 6 · see citing works
The Effect of Abused Substances on Antenatal and Intrapartum Fetal Testing and Well-Being
Kopel, E., & HILL, W. C. (2013) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e3182802cad · Cited by 6 · see citing works
Heilbronner, C., & Berlin, I. (2005) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/s0368-2315(05)82901-1 · Cited by 4 · see citing works
Prenatal Risk Factors and Neurodevelopment
Shuffrey, L. C., & Fifer, W. P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.23054-x · Cited by 5 · see citing works
Cardiac Physiology of Pregnancy
May, L. (2015) · Comprehensive Physiology · doi:10.1002/j.2040-4603.2015.tb00637.x · Cited by 23 · see citing works
Conséquences fœtales du tabagisme sur les modes d’accouchement, l’hypoxie et l’acidose per-partum
Grangé, G., & Pannier, E. (2005) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/s0368-2315(05)82982-5 · Cited by 3 · see citing works
Shaffer, B. L., & Parer, J. T. (2012) · Wiley eBooks · doi:10.1002/9781119963783.ch10 · Cited by 2 · see citing works
Nageotte, M. P. (2023) · doi:10.1002/9781119636540.ch9 · Cited by 2 · see citing works
What you need to know about maternal-fetal medicine
Yamashiro, K. J., Galganski, L. A., & Hirose, S. (2019) · Seminars in Pediatric Surgery · doi:10.1053/j.sempedsurg.2019.07.005 · Cited by 1 · see citing works
The Process of Cigarette Smoking
Wang, J., & Wang, X. L. (2011) · doi:10.1002/9783527635320.ch3 · Cited by 1 · see citing works
Shaffer, B. L., & Parer, J. T. (2007) · Wiley eBooks · doi:10.1002/9780470691878.ch11 · Cited by 1 · see citing works
Tabakkonsum und Tabakentwöhnung in der Schwangerschaft
Rasenack, R., & Jähne, A. (2010) · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · doi:10.1024/0939-5911/a000031
- Authors
- ONCKEN, C.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- ONCKEN, C
- ORCID
- ONCKEN, C
- Venue
- Obstetrics & Gynecology
- Published
- 2002-05
- Volume
- 99
- Issue
- 5
- Pages
- 751-755
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2075093007
- Cited by
- 34
- References
- 24
- Citations by year
- 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 5 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1k02aa000239-01)
- National Institute on Alcohol Abuse and Alcoholism (K02-AA00239)
- National Center for Research Resources (M01RR006192, M01 RR 06192)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- cigarette smoking, fetal heart rate, fetal heart rate reactivity, nonstress test, plasma nicotine, chronic smokers, pregnancy, fetal monitoring
- MeSH terms
- Female, Fetal Monitoring, Gestational Age, Heart Rate, Fetal, Humans, Nicotine, Pregnancy, Prospective Studies, Smoking
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