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Kids exposed to smokeless tobacco in fetal life at increased risk CVD in later life
Sweden: A recent study published in the Journal of the American Heart Association focused on perinatal exposure to smokeless tobacco (i.e., nicotine), highlighting the long-term cardiovascular (CV) risks associated with it.
Felicia Nordenstam, Karolinska University Hospital, Stockholm, Sweden, and colleagues revealed that children exposed to high nicotine doses in utero demonstrated increased carotid artery stiffness and reduced carotid arterial strain during preschool age. They found no significant difference in carotid intima‐media thickness between the exposed and non-exposed children.
In the study of perinatal smokeless tobacco exposure, the researchers reported that preschool children with prenatal smokeless tobacco‐using mothers during pregnancy had a 41% higher arterial stiffness index compared with tobacco‐free controls.
This finding adds to current recommendations that women should abstain from all forms of nicotine and tobacco products during pregnancy.
Increased intima‐media thickness and arterial stiffness can be seen as early as childhood and are tied to an increased risk of CV events in adult life. Dr. Nordenstam and the team hypothesized that exposure to prenatal smokeless tobacco (Swedish snus) without additional nicotine exposure after the breastfeeding period would be associated with increased arterial stiffness and intima‐media thickening in preschool children.
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
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751