The role of maternal smoking in sudden fetal and infant death pathogenesis
Open accessAbstract
Maternal smoking is a risk factor for both sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death syndrome (SIUDS). Both SIDS and SIUDS are more frequently observed in infants of smoking mothers. The global prevalence of smoking during pregnancy is 1.7% and up to 8.1% of women in Europe smoke during pregnancy and worldwide 250 million women smoke during pregnancy. Infants born to mothers who smoke have an abnormal response to hypoxia and hypercarbia and they also have reduced arousal responses. The harmful effects of tobacco smoke are mainly mediated by release of carbon monoxide and nicotine. Nicotine can enter the fetal circulation and affect multiple developing organs including the lungs, adrenal glands and the brain. Abnormalities in brainstem nuclei crucial to respiratory control, the cerebral cortex and the autonomic nervous system have been demonstrated. In addition, hypodevelopment of the intermediolateral nucleus in the spinal cord has been reported. It initiates episodic respiratory movements that facilitate lung development. Furthermore, abnormal maturation and transmitter levels in the carotid bodies have been described which would make infants more vulnerable to hypoxic challenges. Unfortunately, smoking cessation programs do not appear to have significantly reduced the number of pregnant women who smoke.
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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 [30]
The Introduction describes maternal smoking as an important, modifiable risk factor for sudden infant death, but says the pathophysiology is likely multifactorial and qualifies a causal estimate with “If causality is assumed.” Calling smoking a major cause is therefore stronger than the source supports. The Central Nervous System section does support the brainstem component, reporting abnormal functioning in brainstem nuclei in SIDS cases. (LLM, conf=0.88)
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References 98 · Cited by 53
- Authors
- Bednarczuk, N., Milner, A., & Greenough, A.
- Affiliations
- King's College London (GB)
- National Health Service (GB)
- Corresponding author
- Greenough, Anne
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2020-10-23
- Volume
- 11
- Pages
- 586068-586068
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC7644853
- OpenAlex
- W3094244474
- Cited by
- 53
- References
- 98
- Citations by year
- 2026: 14 · 2025: 8 · 2024: 11 · 2023: 8 · 2022: 7 · 2021: 5
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research
- King's College London
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- maternal smoking, sudden infant death syndrome, SIDS pathogenesis, carbon monoxide, nicotine, fetal hypoxia, respiratory control, brainstem, intermediolateral nucleus, carotid body, smoking cessation, pregnancy
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