Altered Arousal Response in Infants Exposed to Cigarette Smoke

Overview

Journal Arch Dis Child

Specialty Pediatrics

Date 2002 Dec 24

PMID 12495956

Citations 11

Authors

A B Chang

S J Wilson

I B Masters

M Yuill

J Williams

G Williams

M Hubbard

Affiliations

Soon will be listed here.

Abstract

Aims: A failure of the arousal mechanism is a key feature in the apnoea theory for sudden infant death syndrome (SIDS). In infants studied at an age when the incidence of SIDS is highest, we evaluated whether in utero smoke exposed infants have altered arousal response to standardised auditory stimuli, and/or sleep pattern, as recorded on overnight complex sleep polysomnography.

Methods: A standardised sequence of audiology stimuli was applied binaurally to 20 in utero smoke and non-smoke exposed infants aged 8-12 weeks during a rapid eye movement (REM) and NREM epoch, in a controlled (temperature, position, pacifier use, noise) sleep environment. Infants were monitored for 10-12 hours using complex sleep polysomnography.

Results: Five infants exposed to in utero tobacco smoke did not have behavioural arousal response, whereas all non-smoke exposed infants aroused during NREM (p = 0.016). There was, however, no difference in REM sleep, and the groups did not differ in routine overnight complex sleep polysomnography parameters.

Conclusion: At the age when the incidence of SIDS is at its peak, infants of smoking mothers are less rousable than those of non-smoking mothers in NREM sleep; this may partly explain why such infants are more at risk of SIDS.

Citing Articles

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Cardiovascular autonomic dysfunction in sudden infant death syndrome.

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Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995-2013.

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The Role of Nicotine in the Effects of Maternal Smoking during Pregnancy on Lung Development and Childhood Respiratory Disease. Implications for Dangers of E-Cigarettes.

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References

Hunt C . Sudden infant death syndrome and other causes of infant mortality: diagnosis, mechanisms, and risk for recurrence in siblings. Am J Respir Crit Care Med. 2001; 164(3):346-57. DOI: 10.1164/ajrccm.164.3.9910045. View

Shao X, Feldman J . Mechanisms underlying regulation of respiratory pattern by nicotine in preBötzinger complex. J Neurophysiol. 2001; 85(6):2461-7. PMC: 4346250. DOI: 10.1152/jn.2001.85.6.2461. View

NEWMAN N, Trinder J, Phillips K, Jordan K, Cruickshank J . Arousal deficit: mechanism of the sudden infant death syndrome?. Aust Paediatr J. 1989; 25(4):196-201. View

Trinder J, NEWMAN N, Le Grande M, Whitworth F, KAY A, PIRKIS J . Behavioural and EEG responses to auditory stimuli during sleep in newborn infants and in infants aged 3 months. Biol Psychol. 1990; 31(3):213-27. DOI: 10.1016/0301-0511(90)90035-u. View

Kahn A, Groswasser J, Rebuffat E, Sottiaux M, Blum D, Foerster M . Sleep and cardiorespiratory characteristics of infant victims of sudden death: a prospective case-control study. Sleep. 1992; 15(4):287-92. DOI: 10.1093/sleep/15.4.287. View

Mitchell E, Ford R, Stewart A, Taylor B, BECROFT D, Thompson J . Smoking and the sudden infant death syndrome. Pediatrics. 1993; 91(5):893-6. View

Milerad J, SUNDELL H . Nicotine exposure and the risk of SIDS. Acta Paediatr Suppl. 1993; 82 Suppl 389:70-2. DOI: 10.1111/j.1651-2227.1993.tb12882.x. View

Kinney H, ODonnell T, Kriger P, White W . Early developmental changes in [3H]nicotine binding in the human brainstem. Neuroscience. 1993; 55(4):1127-38. DOI: 10.1016/0306-4522(93)90326-b. View

Kahn A, Groswasser J, Sottiaux M, Kelmanson I, Rebuffat E, Franco P . Prenatal exposure to cigarettes in infants with obstructive sleep apneas. Pediatrics. 1994; 93(5):778-83. View

10.

Gulya A . Environmental tobacco smoke and otitis media. Otolaryngol Head Neck Surg. 1994; 111(1):6-8. DOI: 10.1177/019459989411100103. View

11.

Taylor J, Sanderson M . A reexamination of the risk factors for the sudden infant death syndrome. J Pediatr. 1995; 126(6):887-91. DOI: 10.1016/s0022-3476(95)70202-4. View

12.

Gaultier C . Cardiorespiratory adaptation during sleep in infants and children. Pediatr Pulmonol. 1995; 19(2):105-17. DOI: 10.1002/ppul.1950190206. View

13.

Lewis S . Predictors of cost-related outcomes of neonatal intensive care. J Pediatr. 1995; 127(4):668-9. DOI: 10.1016/s0022-3476(95)70140-0. View

14.

Blair P, Fleming P, Bensley D, Smith I, Bacon C, Taylor E . Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. BMJ. 1996; 313(7051):195-8. PMC: 2351602. DOI: 10.1136/bmj.313.7051.195. View

15.

Potter A, Lumley J, Watson L . The 'new' risk factors for SIDS: is there an association with the ethnic and place of birth differences in incidence in Victoria, Australia?. Early Hum Dev. 1996; 45(1-2):119-31. DOI: 10.1016/0378-3782(96)01726-4. View

16.

Bamford O, Schuen J, Carroll J . Effect of nicotine exposure on postnatal ventilatory responses to hypoxia and hypercapnia. Respir Physiol. 1996; 106(1):1-11. DOI: 10.1016/0034-5687(96)00051-5. View

17.

McNamara F, Issa F, Sullivan C . Arousal pattern following central and obstructive breathing abnormalities in infants and children. J Appl Physiol (1985). 1996; 81(6):2651-7. DOI: 10.1152/jappl.1996.81.6.2651. View

18.

Golding J . Sudden infant death syndrome and parental smoking--a literature review. Paediatr Perinat Epidemiol. 1997; 11(1):67-77. DOI: 10.1046/j.1365-3016.1997.d01-12.x. View

19.

Thach B, Lijowska A . Arousals in infants. Sleep. 1996; 19(10 Suppl):S271-3. DOI: 10.1093/sleep/19.suppl_10.s271. View

20.

Hills B, Chen Y, Masters I, Hills Y . Raised bile acid concentrations in SIDS lungs at necropsy. Arch Dis Child. 1997; 77(2):120-3. PMC: 1717294. DOI: 10.1136/adc.77.2.120. View