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Published on: October 19, 2013
Long-term reprogramming of cardiovascular function in infants of active smokers
Gary Cohen1, Heather Jeffery, Hugo Lagercrantz
1Department of Women and Child Health, Neonatal Unit, Karolinska Institute, Elevhemmet H1-02, S-171 76 Stockholm, Sweden. Gary.Cohen@ki.se
Insights
Maternal smoking causes lasting changes in infant cardiovascular regulation. Exposed infants show impaired blood pressure control and exaggerated heart rate responses, potentially increasing hypertension risk.
Area of Science:
- Cardiovascular physiology
- Neonatal health
- Developmental pediatrics
Background:
- Newborn infants exposed to maternal smoking exhibit cardiovascular stress hyperreactivity.
- Persistent hyperreactivity may elevate the risk of short- and long-term complications, including hypertension.
Purpose of the Study:
- To investigate the persistence and progression of cardiovascular dysfunction in infants exposed to maternal smoking from birth to one year.
- To compare the longitudinal cardiovascular reflex function between control and tobacco-exposed infants.
Main Methods:
- Longitudinal study comparing infants of non-smoking mothers (controls, n=19) and moderate smoking mothers (n=17).
- Non-invasive recording of blood pressure and heart rate during passive head-up tilt at 1-3 weeks, 3 months, and 1 year of age.
- Assessment of cardiovascular reflex responses to postural changes during sleep.
Main Results:
- Control infants showed a progressive increase in blood pressure response to tilt from 1 week to 1 year (+2% to +10%).
- Tobacco-exposed infants exhibited a reversed trend, with a diminished blood pressure response at 1 year (+10% at 1 week to +4% at 1 year).
- Tobacco-exposed infants displayed significantly exaggerated heart rate responses to tilt at 3 months and 1 year.
Conclusions:
- Maternal smoking induces long-lasting "reprogramming" of infant blood pressure control mechanisms.
- The observed cardiovascular dysfunction in infants of smokers may serve as an early marker for long-term susceptibility to elevated blood pressure.
- This study highlights the persistent impact of prenatal tobacco exposure on infant cardiovascular autonomic regulation.
Abstract:
Newborn infants of smokers show symptoms of cardiovascular stress hyperreactivity. Persistent hyperreactivity could increase the risk of short- and/or long-term complications, such as hypertension. Here we determined whether incipient dysfunction in a smoker's infant persists or worsens with age, by comparing cardiovascular reflex function of control and tobacco-exposed infants longitudinally from birth to 1 year. We compared infants born at term to nonsmoking couples (controls; n=19) and mothers who smoked moderately (average consumption=15 cigarettes per day; n=17). All were tested at 1 to 3 weeks, 3 months, and 1 year during sleep. We recorded blood pressure and heart rate noninvasively during passive repositioning (60 degrees head-up tilt). Tilting control infants raised blood pressure slightly above baseline at 1 week (+2%) and much more at 1 year (+10%). This trend was reversed in the tobacco-exposed cohort (+10% at 1 week but only +4% at 1 year). At 3 months and 1 year, the heart rate response of tobacco-exposed infants to tilt was also abnormal (highly exaggerated). Our study reveals that maternal smoking leads to long-lasting "reprogramming" of infant blood pressure control mechanisms. The underlying dysfunction in a smoker's infant could plausibly be a precursor or early marker of long-term susceptibility to complications, such as raised blood pressure.