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Heart rate and blood pressure control in infants exposed to maternal cigarette smoking
S Viskari-Lähdeoja1, T Hytinantti, S Andersson
1Hospital for Children and Adolescents, Helsinki, Finland.
Insights
Maternal smoking during pregnancy alters infant cardiovascular responses to motion, potentially increasing sudden infant death syndrome (SIDS) risk. These findings highlight the impact of prenatal smoke exposure on infant autonomic regulation.
Area of Science:
- Pediatric cardiology
- Neonatal physiology
- Autonomic nervous system function
Background:
- Maternal cigarette smoking is a significant risk factor for sudden infant death syndrome (SIDS).
- Prenatal and postnatal smoke exposure may impact cardiovascular control mechanisms in infants.
- Understanding these effects is crucial for identifying infants at higher risk for SIDS.
Purpose of the Study:
- To investigate the effects of maternal cigarette smoking on cardiovascular responses in infants.
- To compare heart rate (HR) and blood pressure (BP) reactions to vestibular stimulation between smoke-exposed and non-exposed infants.
- To explore potential links between altered cardiovascular control and SIDS risk.
Main Methods:
- Studied 11 infants exposed to maternal smoking and 20 age-matched controls.
- Performed side motion and head-up tilt tests during NREM3 sleep.
- Measured heart rate and blood pressure responses to stimuli.
Main Results:
- Control infants exhibited typical biphasic HR and BP responses to side motion.
- Smoke-exposed infants showed significantly blunted initial HR and BP responses to side motion.
- A more pronounced subsequent decrease in BP was observed in smoke-exposed infants.
Conclusions:
- Maternal cigarette smoking appears to alter vestibulo-mediated cardiovascular control in early infancy.
- These alterations in autonomic regulation may contribute to the increased risk of SIDS.
- Further research is warranted to confirm these findings and explore interventions.
Aim:
Exposure to maternal cigarette smoking is a major risk factor for sudden infant death syndrome (SIDS). Foetal and postnatal smoke-exposure may alter cardiovascular control in infants. We studied heart rate (HR) and blood pressure (BP) responses in smoke-exposed infants.
Methods:
Eleven infants exposed to maternal cigarette smoking were studied at the age of 12 +/- 2.1 (range 10-16) weeks. Twenty healthy, age-matched infants from non-smoking families served as controls. During confirmed slow-wave sleep (NREM3), 3-5 sec side motion and 45 sec 45 degrees head-up tilt tests were performed.
Results:
Control infants showed consistent biphasic HR and BP responses to side motion, with an initial 2-5% increase followed by a 2% decrease (p < 0.0001). In smoke-exposed infants, the initial HR (p = 0.009) and BP responses (p < 0.0001) were markedly reduced, and the subsequent decrease in BP was more prominent (systolic blood pressure, SBP, p = 0.005; diastolic blood pressure, DBP, p = 0.03). No differences were observed between the groups in tilt test results, HR variability or HR responses to spontaneous arousals.
Conclusion:
Maternal cigarette smoking may alter vestibulo-mediated cardiovascular control in early infancy. This may contribute to increased SIDS risk.
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