Title : Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficit
Maternal tobacco use and nicotine exposure during pregnancy have been associated with adverse birth outcomes in infants and can lead to preventable pregnancy complications. Exposure to nicotine and other compounds in tobacco and electronic cigarettes (e-cigarettes) has been shown to increases the risk of miscarriage, prematurity, stillbirth, low birth weight, perinatal morbidity, and sudden infant death syndrome (SIDS). Additionally, recent data provided by clinical and pre-clinical research demonstrates that nicotine exposure during pregnancy may heighten the risk for adverse neurodevelopmental disorders such as Attention-Deficit Hyperactivity (ADHD), anxiety, and depression along with altering the infants underlying brain circuitry, response to neurotransmitters, and brain volume. In the United States, one in fourteen women (7.2%) reported to have smoked cigarettes during their pregnancy with the global prevalence of smoking during pregnancy estimated to be 1.7%. Due to the large percentage of women utilizing nicotine products during pregnancy in the United States and globally, this review seeks to centralize pre-clinical and clinical studies focused on the neurobehavioral and neurodevelopmental complications associated with prenatal nicotine exposure (PNE) such as alterations to the hypothalamic-pituitary-adrenal (HPA) axis and brain regions such as the prefrontal cortex (PFC), ventral tegmental area (VTA), nucleus accumbens (NA), hippocampus, and caudate as well as changes to nAChrR and cholinergic receptor signaling, long-term drug seeking behavior following PNE, and other related developmental disorders. Current literature analyzing the association between PNE and the risk for offspring developing schizophrenia, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), major depression disorder (MDD), anxiety, and obesity will also be discussed. Additionally, this review seeks to highlight the risks of nicotine replacement therapy and e-cigarette use during pregnancy and strategies for initiating smoking cessation in pregnant women.
Key Words: Nicotine, tobacco, prenatal nicotine exposure, neurodevelopmental disorders, neonatal exposure, teratogen
Audience Take Away
- Recent advancements in our understanding of prenatal nicotine’s effects on neurodevelopment and neurocognition during childhood and adolescence.
- Our review is novel in that both pre-clinical and clinical literature were utilized to create a comprehensive understanding of how nicotine affects prenatal and early postnatal development, neurobehavioral development, and the offspring’s likelihood for future adolescent substance abuse
- Due to the multifaceted nature of our review, both medical providers and basic or translational researchers will benefit from an in-depth review on the risks of smoking during pregnancy