Behavioral and Neural Consequences of Prenatal Exposure to Nicotine
Abstract
Objective To review evidence for the neurodevelopmental effects of in utero exposure to nicotine. Concerns about long-term cognitive and behavioral effects of prenatal exposure to nicotine arise from reports of increased rates of disruptive behavioral disorders in children whose mothers smoked during pregnancy. The relatively high rate of tobacco smoking among pregnant women (25% of all pregnancies in the U.S.) underlines the seriousness of these concerns. Method This review examines the largest and most recent epidemiological and clinical studies that investigated the association of prenatal nicotine exposure with health, behavioral, and cognitive problems. Because of the numerous potential confounding variables in human research, findings from animal studies, in which environmental factors are strictly controlled, are also discussed. Finally, neural and molecular mechanisms that are likely to underlie neurodevelopmental disruptions produced by prenatal nicotine exposure are outlined. Results A dose-response relationship between maternal smoking rates and low birth weight (potentially associated with lower cognitive ability) and spontaneous abortion is consistently found, whereas long-term developmental and behavioral effects in the offspring are still controversial, perhaps because of the difficulty of separating them from other genetic and environmental factors. Despite the wide variability of experimental paradigms used in animal studies, common physical and behavioral effects of prenatal exposure to nicotine have been observed, including low birth weight, enhanced locomotor activity, and cognitive impairment. Finally, disturbances in neuronal pathfinding, abnormalities in cell proliferation and differentiation, and disruptions in the development of the cholinergic and catecholaminergic systems all have been reported in molecular animal studies of in utero exposure to nicotine. Conclusions Prenatal exposure to nicotine may lead to dysregulation in neurodevelopment and can indicate higher risk for psychiatric problems, including substance abuse. Knowledge of prenatal exposure to nicotine should prompt child psychiatrists to closely monitor at-risk patients.
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The most consistent associations of maternal smoking during pregnancy with offspring behavior are externalizing and disruptive behaviors, such as conduct disorder and oppositional defiant disorder, from infancy through adulthood.
“The most consistent associations are with externalizing and disruptive behaviors, such as conduct disorder (antisocial personality disorder in adults) and oppositional defiant disorder, from infancy through adulthood, as well as the precursors of these behaviors.”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [148]
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- Authors
- ERNST, M., MOOLCHAN, E. T., & ROBINSON, M. L.
- Affiliations
- National Institute on Drug Abuse (US)
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2001-06
- Volume
- 40
- Issue
- 6
- Pages
- 630-641
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2028431671
- Cited by
- 590
- References
- 9
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 15 · 2023: 9 · 2022: 16 · 2021: 22 · 2020: 19 · 2019: 22 · 2018: 12 · 2017: 17 · 2016: 18 · 2015: 25 · 2014: 28 · 2013: 43 · 2012: 30
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Keywords
- prenatal nicotine exposure, maternal smoking, brain development, low birth weight, miscarriage, disruptive behavior disorders, cognitive impairment, locomotor activity, neuronal pathfinding, cholinergic system, catecholaminergic system, substance abuse risk, child psychiatry
- MeSH terms
- Animals, Attention Deficit Disorder with Hyperactivity, Brain, Child, Preschool, Cognition Disorders, Dose-Response Relationship, Drug, Female, Fetal Diseases, Humans, Infant, Maternal Behavior, Nicotine, Pregnancy, Prenatal Exposure Delayed Effects, Receptors, Nicotinic, Smoking, Time, Attention Deficit and Disruptive Behavior Disorders, Rats
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