Prenatal nicotine-exposure alters fetal autonomic activity and medullary neurotransmitter receptors: Implications for sudden infant death syndrome
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During pregnancy, exposure to nicotine and other compounds in cigarette smoke increases the risk of the sudden infant death syndrome (SIDS) two- to fivefold. Serotonergic (5-HT) abnormalities are found, in infants who die of SIDS, in regions of the medulla oblongata known to modulate cardiorespiratory function. Using a baboon model, we tested the hypothesis that prenatal exposure to nicotine alters 5-HT receptor and/or transporter binding in the fetal medullary 5-HT system in association with cardiorespiratory dysfunction. At 87 (mean) days gestation (dg), mothers were continuously infused with saline (n = 5) or nicotine (n = 5) at 0.5 mg/h. Fetuses were surgically instrumented at 129 dg for cardiorespiratory monitoring. Cesarean section delivery and retrieval of fetal medulla were performed at 161 (mean) dg for autoradiographic analyses of nicotinic and 5-HT receptor and transporter binding. In nicotine-exposed fetuses, high-frequency heart rate variability was increased 55%, possibly reflecting increases in the parasympathetic control of heart rate. This effect was more pronounced with greater levels of fetal breathing and age. These changes in heart rate variability were associated with increased 5-HT(1A) receptor binding in the raphé obscurus (P = 0.04) and increased nicotinic receptor binding in the raphé obscurus and vagal complex (P < 0.05) in the nicotine-exposed animals compared with controls (n = 6). The shift in autonomic balance in the fetal primate toward parasympathetic predominance with chronic exposure to nicotine may be related, in part, to abnormal 5-HT-nicotine alterations in the raphé obscurus. Thus increased risk for SIDS due to maternal smoking may be partly related to the effects of nicotine on 5-HT and/or nicotinic receptors.
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Maternal smoking is a major cause of sudden infant death syndrome (SIDS) which has often been attributed to dysfunction in the brainstem.
“Maternal smoking is a major cause of sudden infant death syndrome (SIDS) which has often been attributed to dysfunction in the brainstem [28–30].”
From Nicotine on the developing brain. (2023) · cites this paper as [29]
The Abstract (page not supplied) calls maternal smoking during pregnancy the major modifiable risk factor for SIDS and reports brain-stem neurotransmitter abnormalities in infants who died of SIDS. It does not establish smoking as a cause: it says the mechanism linking smoke exposure to increased SIDS risk is unknown, and the discussion (section labeled “5 controls,” page not supplied) describes a plausible mechanism rather than a demonstrated cause. (LLM, conf=0.86)
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- Authors
- Duncan, J. R., Garland, M., Myers, M. M., Fifer, W. P., Yang, M., Kinney, H. C., & Stark, R. I.
- Affiliations
- Boston Children's Hospital (US)
- Pediatrics and Genetics (US)
- Columbia University Irving Medical Center (US)
- New England Research Institutes (US)
- Corresponding author
- Kinney, Hannah C.
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2009-11
- Volume
- 107
- Issue
- 5
- Pages
- 1579-1590
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- PMC
- PMC2777800
- OpenAlex
- W2142392262
- Cited by
- 93
- References
- 76
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 6 · 2019: 9 · 2018: 9 · 2017: 1 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 6 · 2012: 10
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Applied Physiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01HD13063, P01HD013063, R37HD032774)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- prenatal nicotine exposure, sudden infant death syndrome, heart rate variability, serotonergic system, 5-HT1A receptor, nicotinic acetylcholine receptors, medulla oblongata, raphe obscurus, parasympathetic dominance, fetal breathing movements, maternal smoking, cardiorespiratory dysfunction, baboon model
- MeSH terms
- Animals, Animals, Newborn, Autonomic Nervous System, Disease Models, Animal, Female, Heart Rate, Humans, Infant, Newborn, Maternal-Fetal Exchange, Medulla Oblongata, Nicotine, Papio, Pregnancy, Receptors, Serotonin, Sudden Infant Death, Respiratory Mechanics
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