Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy

Allan Jenkinson; Nadja Bednarczuk; Ourania Kaltsogianni; Emma E. Williams; Rebecca Lee; Ravindra Bhat; Theodore Dassios; Anthony D. Milner; Anne Greenough

doi:10.1007/s00431-023-04991-5

Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy

Allan Jenkinson, Nadja Bednarczuk, Ourania Kaltsogianni, Emma E. Williams, Rebecca Lee, Ravindra Bhat, Theodore Dassios, Anthony D. Milner, Anne Greenough^*

^*Corresponding author for this work

Women & Children's Health

Research output: Contribution to journal › Article › peer-review

Abstract

Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. In utero nicotine exposure has been shown to blunt the infant ventilatory response to hypercapnia, which could increase the risk of sudden infant death syndrome. The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. The aim of this study was to assess ventilatory response to added dead-space (inducing hypercapnia) in infants with second-hand smoke exposure during pregnancy, in infants whose mothers smoked and in controls (non-smoke exposed). Infants breathed through a face mask and specialised “tube-breathing” circuit, incorporating a dead space of 4.4 ml/kg body weight. The maximum minute ventilation (MMV) during added dead space breathing was determined and the time taken to achieve 63% of the MMV calculated (the time constant (TC) of the response). Infants were studied on the postnatal ward prior to discharge home. Thirty infants (ten in each group) were studied with a median gestational age of 39 [range 37–41] weeks, birthweight of 3.1 [2.2–4.0] kg, and postnatal age of 33 (21–62) h. The infants whose mothers had second-hand smoke exposure (median TC 42 s, p = 0.001), and the infants of cigarette smoking mothers (median TC 37 s, p = 0.002) had longer time constants than the controls (median TC 29 s). There was no significant difference between the TC of the infants whose mothers had second-hand smoke exposure and those whose mothers smoked (p = 0.112). Conclusion: Second-hand smoke exposure during pregnancy was associated with a delayed newborn ventilatory response. What is Known: • Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. • The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. What is New: • We have assessed the ventilatory response to added dead-space (inducing hypercapnia) in newborns with second-hand smoke exposure during pregnancy, in infants whose mothers smoked, and in controls (non-smoke exposed). • Maternal second-hand smoke exposure, as well as maternal smoking, during pregnancy was associated with a delayed newborn ventilatory response.

Original language	English
Pages (from-to)	3301-3306
Number of pages	6
Journal	European Journal of Pediatrics
Volume	182
Issue number	7
DOIs	https://doi.org/10.1007/s00431-023-04991-5
Publication status	Published - Jul 2023

Keywords

Antenatal smoke exposure
Maternal smoking
Minute ventilation
Nicotine
Respiratory control

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00431-023-04991-5

Cite this

@article{acde54dbe6734a6882613956f6f622ab,

title = "Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy",

abstract = "Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. In utero nicotine exposure has been shown to blunt the infant ventilatory response to hypercapnia, which could increase the risk of sudden infant death syndrome. The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. The aim of this study was to assess ventilatory response to added dead-space (inducing hypercapnia) in infants with second-hand smoke exposure during pregnancy, in infants whose mothers smoked and in controls (non-smoke exposed). Infants breathed through a face mask and specialised “tube-breathing” circuit, incorporating a dead space of 4.4 ml/kg body weight. The maximum minute ventilation (MMV) during added dead space breathing was determined and the time taken to achieve 63% of the MMV calculated (the time constant (TC) of the response). Infants were studied on the postnatal ward prior to discharge home. Thirty infants (ten in each group) were studied with a median gestational age of 39 [range 37–41] weeks, birthweight of 3.1 [2.2–4.0] kg, and postnatal age of 33 (21–62) h. The infants whose mothers had second-hand smoke exposure (median TC 42 s, p = 0.001), and the infants of cigarette smoking mothers (median TC 37 s, p = 0.002) had longer time constants than the controls (median TC 29 s). There was no significant difference between the TC of the infants whose mothers had second-hand smoke exposure and those whose mothers smoked (p = 0.112). Conclusion: Second-hand smoke exposure during pregnancy was associated with a delayed newborn ventilatory response. What is Known: • Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. • The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. What is New: • We have assessed the ventilatory response to added dead-space (inducing hypercapnia) in newborns with second-hand smoke exposure during pregnancy, in infants whose mothers smoked, and in controls (non-smoke exposed). • Maternal second-hand smoke exposure, as well as maternal smoking, during pregnancy was associated with a delayed newborn ventilatory response.",

keywords = "Antenatal smoke exposure, Maternal smoking, Minute ventilation, Nicotine, Respiratory control",

author = "Allan Jenkinson and Nadja Bednarczuk and Ourania Kaltsogianni and Williams, {Emma E.} and Rebecca Lee and Ravindra Bhat and Theodore Dassios and Milner, {Anthony D.} and Anne Greenough",

note = "Funding Information: This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy{\textquoteright}s and St Thomas{\textquoteright} NHS Foundation Trust and King{\textquoteright}s College London. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = jul,

doi = "10.1007/s00431-023-04991-5",

language = "English",

volume = "182",

pages = "3301--3306",

journal = "European Journal of Pediatrics",

issn = "0340-6199",

publisher = "Springer Verlag",

number = "7",

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TY - JOUR

T1 - Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy

AU - Jenkinson, Allan

AU - Bednarczuk, Nadja

AU - Kaltsogianni, Ourania

AU - Williams, Emma E.

AU - Lee, Rebecca

AU - Bhat, Ravindra

AU - Dassios, Theodore

AU - Milner, Anthony D.

AU - Greenough, Anne

N1 - Funding Information: This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. Publisher Copyright: © 2023, The Author(s).

PY - 2023/7

Y1 - 2023/7

N2 - Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. In utero nicotine exposure has been shown to blunt the infant ventilatory response to hypercapnia, which could increase the risk of sudden infant death syndrome. The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. The aim of this study was to assess ventilatory response to added dead-space (inducing hypercapnia) in infants with second-hand smoke exposure during pregnancy, in infants whose mothers smoked and in controls (non-smoke exposed). Infants breathed through a face mask and specialised “tube-breathing” circuit, incorporating a dead space of 4.4 ml/kg body weight. The maximum minute ventilation (MMV) during added dead space breathing was determined and the time taken to achieve 63% of the MMV calculated (the time constant (TC) of the response). Infants were studied on the postnatal ward prior to discharge home. Thirty infants (ten in each group) were studied with a median gestational age of 39 [range 37–41] weeks, birthweight of 3.1 [2.2–4.0] kg, and postnatal age of 33 (21–62) h. The infants whose mothers had second-hand smoke exposure (median TC 42 s, p = 0.001), and the infants of cigarette smoking mothers (median TC 37 s, p = 0.002) had longer time constants than the controls (median TC 29 s). There was no significant difference between the TC of the infants whose mothers had second-hand smoke exposure and those whose mothers smoked (p = 0.112). Conclusion: Second-hand smoke exposure during pregnancy was associated with a delayed newborn ventilatory response. What is Known: • Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. • The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. What is New: • We have assessed the ventilatory response to added dead-space (inducing hypercapnia) in newborns with second-hand smoke exposure during pregnancy, in infants whose mothers smoked, and in controls (non-smoke exposed). • Maternal second-hand smoke exposure, as well as maternal smoking, during pregnancy was associated with a delayed newborn ventilatory response.

AB - Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. In utero nicotine exposure has been shown to blunt the infant ventilatory response to hypercapnia, which could increase the risk of sudden infant death syndrome. The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. The aim of this study was to assess ventilatory response to added dead-space (inducing hypercapnia) in infants with second-hand smoke exposure during pregnancy, in infants whose mothers smoked and in controls (non-smoke exposed). Infants breathed through a face mask and specialised “tube-breathing” circuit, incorporating a dead space of 4.4 ml/kg body weight. The maximum minute ventilation (MMV) during added dead space breathing was determined and the time taken to achieve 63% of the MMV calculated (the time constant (TC) of the response). Infants were studied on the postnatal ward prior to discharge home. Thirty infants (ten in each group) were studied with a median gestational age of 39 [range 37–41] weeks, birthweight of 3.1 [2.2–4.0] kg, and postnatal age of 33 (21–62) h. The infants whose mothers had second-hand smoke exposure (median TC 42 s, p = 0.001), and the infants of cigarette smoking mothers (median TC 37 s, p = 0.002) had longer time constants than the controls (median TC 29 s). There was no significant difference between the TC of the infants whose mothers had second-hand smoke exposure and those whose mothers smoked (p = 0.112). Conclusion: Second-hand smoke exposure during pregnancy was associated with a delayed newborn ventilatory response. What is Known: • Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. • The potential impact of maternal second-hand smoke exposure, however, has not yet been determined. What is New: • We have assessed the ventilatory response to added dead-space (inducing hypercapnia) in newborns with second-hand smoke exposure during pregnancy, in infants whose mothers smoked, and in controls (non-smoke exposed). • Maternal second-hand smoke exposure, as well as maternal smoking, during pregnancy was associated with a delayed newborn ventilatory response.

KW - Antenatal smoke exposure

KW - Maternal smoking

KW - Minute ventilation

KW - Nicotine

KW - Respiratory control

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U2 - 10.1007/s00431-023-04991-5

DO - 10.1007/s00431-023-04991-5

M3 - Article

C2 - 37166537

AN - SCOPUS:85159337411

SN - 0340-6199

VL - 182

SP - 3301

EP - 3306

JO - European Journal of Pediatrics

JF - European Journal of Pediatrics

IS - 7

ER -

Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy

Abstract

Keywords

UN SDGs

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