Kids exposed to smokeless tobacco in fetal life at increased risk CVD in later life

To test the hypothesis, they conducted a longitudinal follow‐up cohort study comprising children aged 5 to 6 years exposed to high doses of nicotine in utero. Women exclusively using prenatal smokeless tobacco and unexposed controls were enrolled in early pregnancy (gestational age range, 6–12 weeks). Collection of exposure data was done during and after pregnancy with questionnaires from both groups.

The exposure group included only children of women using g >48 mg of nicotine per day during their entire pregnancy. Outcomes were investigated in 40 healthy children (21 exposed to snus in utero). Ultrasonography of the common carotid artery was used to determine the carotid intima‐media thickness and calculate the arterial stiffness index from the relationship between pulsatile changes in arterial diameter and arterial pressure.

The researchers reported the following findings:

• Children exposed to prenatal smokeless tobacco in fetal life had higher carotid stiffness (median 4.1 versus 2.9) than tobacco‐free controls.
• Carotid strain (relative diameter change) was lower in children exposed to snus (mean 16% versus 21%) than in controls.
• Carotid intima‐media thickness did not differ significantly between children exposed to snus and controls.

"Preschool children exposed to snus in utero exhibit stiffer carotid arteries compared to unexposed children," the researchers wrote. "Although these changes are asymptomatic during childhood, they may have implications for future follow‐up and risk of CV events in adult life."

Reference:

The study titled, "Arterial Stiffness and Carotid Intima‐Media Thickness in Children Exposed to Smokeless Tobacco in Fetal Life," was published online in the Journal of the American Heart Association.

DOI: https://doi.org/10.1161/JAHA.123.032384