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The dynamics of cardiac autonomic control in sleeping preterm neonates exposed in utero to smoking
Erwan Stéphan-Blanchard1, Karen Chardon1, Djamal-Dine Djeddi2
1PériTox Laboratory UMR-I-01, University of Picardy Jules Verne, Amiens, France.
Insights
Prenatal smoking exposure alters cardiac autonomic control in preterm infants. This may increase risks for future neurological and cardiovascular issues.
Area of Science:
- Neonatal physiology
- Cardiovascular health
- Autonomic nervous system function
Background:
- Maternal smoking during pregnancy is a significant public health concern.
- Preterm infants are a vulnerable population with developing organ systems.
- Cardiac autonomic control plays a crucial role in infant health and development.
Purpose of the Study:
- To investigate the impact of in utero smoking exposure on cardiac autonomic control in preterm infants.
- To determine if sleep state influences these effects.
- To hypothesize that prenatal smoking exposure alters autonomic control in preterm neonates.
Main Methods:
- Studied healthy preterm neonates with (n=16) and without (n=18) in utero smoking exposure.
- Monitored cardiac autonomic control using heart rate variability (HRV) analysis.
- Assessed HRV with linear and non-linear methods across different sleep states.
Main Results:
- Preterm infants exposed to smoking in utero showed altered cardiac autonomic control.
- Observed were reduced vagal activity and increased sympathetic activity.
- Heart rate control dynamics exhibited lower complexity and adaptability.
Conclusions:
- Direct evidence confirms altered cardiac autonomic activity in preterm infants exposed to prenatal smoke.
- These findings highlight potential long-term health risks.
- Such alterations may predispose infants to neurological and cardiovascular complications.
Objective:
We aimed to determine whether in utero exposure to smoking may influence the activity and dynamics of cardiac autonomic control in preterm infants. We hypothesized that cardiac autonomic control is altered in preterm infants exposed prenatally to smoking and that these effects may vary as a function of the sleep state.
Methods:
We studied healthy, preterm neonates born to mothers who had smoked throughout pregnancy but not since birth (n=16). In utero-exposed neonates were matched with control preterm neonates born to non-smoking mothers (n=18). Cardiac autonomic control was monitored as a function of the sleep state by assessing heart rate variability with both linear and non-linear methods.
Results:
Preterm neonates with in utero exposure to smoking displayed alterations (relative to control neonates) in short-term cardiac autonomic control in all sleep states. These alterations included low vagal activity, elevated sympathetic activity, and low complexity and adaptability in heart rate control dynamics.
Conclusions:
Our results constitute direct evidence that cardiac autonomic activity and control are altered in sleeping preterm infants exposed to smoking in utero.
Significance:
These alterations may place the affected infants at a higher risk of neurological and cardiovascular complications, which could conceivably persist throughout childhood and adulthood.
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