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Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant

Nordenstam, Felicia, Lundell, Bo, Cohen, Gary, Tessma, Mesfin K., Raaschou, Pauline, Wickström, Ronny·2017·Nicotine & Tobacco Research
DOI 10.1093/ntr/ntx035
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Abstract

Introduction Maternal use of smoked tobacco during pregnancy causes significant morbidity and mortality in the human infant including alterations in autonomic control with increased risk of sudden infant death syndrome. We hypothesized that maternal snus (smokeless tobacco) use during pregnancy affects autonomic cardiac regulation in the infant, as measured by heart rate variability (HRV) and the low frequency and high frequency ratio (LF/HF ratio). Methods A prospective observational study of 56 infants of women who used snus (n = 23) or cigarettes (n = 13) during pregnancy versus tobacco- and nicotine-free controls (n = 19). The nicotine dose was estimated by questionnaires at 4 timepoints pre- and post-natally. The infants' urine cotinine concentration and HRV during 2 hours of sleep were studied 1-2 months after birth. Results LF/HF ratio was higher in snus (mean 3.31; 95% CI 2.78-3.83) and smoke (3.51;2.54-4.47) compared to controls (2.15; 1.76-2.54, p = .002). Early prenatal nicotine exposure "without" any further exposure increased the LF/HF ratio (3.19; 2.55-3.84, p = .02). Continuous prenatal nicotine exposure "without" postnatal exposure was also associated with a residual increase in LF/HF ratio (4.40; 3.38-5.42, p Conclusion Infants to mothers who used snus during pregnancy showed lower vagal activity with an increased LF/HF ratio compared to controls, and similar to infants of smokers. Even early prenatal exposure to snus has a lasting impact on autonomic cardiac…

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Metadata

Authors
Nordenstam, F., Lundell, B., Cohen, G., Tessma, M. K., Raaschou, P., & Wickström, R.
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2017-02-20
Volume
19
Issue
7
Pages
797-803
ISSN
  • 1462-2203
  • 1469-994X
DOI
10.1093/ntr/ntx035
Cited by
21
References
6
Language
en

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Nordenstam, F., Lundell, B., Cohen, G., Tessma, M. K., Raaschou, P., & Wickström, R. (2017). Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntx035