title: Prenatal nicotine-exposure alters fetal autonomic activity and medullary neurotransmitter receptors: implications for sudden infant death syndrome.
abstract: During pregnancy, exposure to nicotine and other compounds in cigarette smoke increases the risk of the sudden infant death syndrome (SIDS) two- to fivefold. Serotonergic (5-HT) abnormalities are found, in infants who die of SIDS, in regions of the medulla oblongata known to modulate cardiorespiratory function. Using a baboon model, we tested the hypothesis that prenatal exposure to nicotine alters 5-HT receptor and/or transporter binding in the fetal medullary 5-HT system in association with cardiorespiratory dysfunction. At 87 (mean) days gestation (dg), mothers were continuously infused with saline (n = 5) or nicotine (n = 5) at 0.5 mg/h. Fetuses were surgically instrumented at 129 dg for cardiorespiratory monitoring. Cesarean section delivery and retrieval of fetal medulla were performed at 161 (mean) dg for autoradiographic analyses of nicotinic and 5-HT receptor and transporter binding. In nicotine-exposed fetuses, high-frequency heart rate variability was increased 55%, possibly reflecting increases in the parasympathetic control of heart rate. This effect was more pronounced with greater levels of fetal breathing and age. These changes in heart rate variability were associated with increased 5-HT(1A) receptor binding in the raphé obscurus (P = 0.04) and increased nicotinic receptor binding in the raphé obscurus and vagal complex (P < 0.05) in the nicotine-exposed animals compared with controls (n = 6). The shift in autonomic balance in the fetal primate toward parasympathetic predominance with chronic exposure to nicotine may be related, in part, to abnormal 5-HT-nicotine alterations in the raphé obscurus. Thus increased risk for SIDS due to maternal smoking may be partly related to the effects of nicotine on 5-HT and/or nicotinic receptors.
authors.affiliation: Dept. of Pathology, Enders 1112.1, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA.
authors.forename: Jhodie R
authors.initials: JR
authors.lastname: Duncan
authors.forename: Marianne
authors.initials: M
authors.lastname: Garland
authors.forename: Michael M
authors.initials: MM
authors.lastname: Myers
authors.forename: William P
authors.initials: WP
authors.lastname: Fifer
authors.forename: May
authors.initials: M
authors.lastname: Yang
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Kinney
authors.forename: Raymond I
authors.initials: RI
authors.lastname: Stark
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology*; D004195:Disease Models, Animal; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008526:Medulla Oblongata / Q000187:drug effects / Q000503:physiopathology*; D009538:Nicotine / Q000009:adverse effects*; D010215:Papio; D011247:Pregnancy; D011985:Receptors, Serotonin / Q000378:metabolism*; D015656:Respiratory Mechanics / Q000187:drug effects*; D013398:Sudden Infant Death / Q000209:etiology
chemical_list: D011985:Receptors, Serotonin; D009538:Nicotine