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Pini N, Sania A, Rao S, Shuffrey LC, Nugent JD, Lucchini M, McSweeney M, Hockett C, Morales S, Yoder L, Ziegler K, Perzanowski MS, Fox NA, Elliott AJ, Myers MM, Fifer WP. In Utero Exposure to Alcohol and Tobacco and Electroencephalogram Power During Childhood. JAMA Netw Open 2024; 7:e2350528. [PMID: 38180758 PMCID: PMC10770777 DOI: 10.1001/jamanetworkopen.2023.50528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/16/2023] [Indexed: 01/06/2024] Open
Abstract
Importance Prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) are risk factors associated with adverse neurobehavioral and cognitive outcomes. Objective To quantify long-term associations of PAE and PTE with brain activity in early and middle childhood via electroencephalography (EEG). Design, Setting, and Participants This cohort study included participants enrolled in the Safe Passage Study (August 2007 to January 2015), from which a subset of 649 participants were followed up in the Environmental Influences on Child Health Outcomes Program. From September 2018 through November 2022, EEG recordings were obtained at ages 4, 5, 7, 9, or 11 years. Data were analyzed from November 2022 to November 2023. Exposures Maternal self-reported consumptions of alcohol and tobacco during pregnancy were captured at the recruitment interview and at up to 3 visits during pregnancy (20-24, 28-32, and ≥34 weeks' gestation). Classifications of PAE (continuous drinking, quit-early drinking, and nondrinking) and PTE (continuous smoking, quit-early smoking, and nonsmoking) were previously obtained. Main Outcomes and Measures EEG band powers (theta, alpha, beta, gamma) were extracted from the EEG recordings. Linear regression models were used to estimate the associations of PAE and PTE with EEG estimates. Results The final sample included 649 participants (333 [51.3%] female) aged 4, 5, 7, 9, or 11 years. Children whose mothers were in the quit-early drinking cluster had increased alpha power (0.116 [95% CI, 0.023 to 0.209] μV2; P = .02) compared with individuals without PAE. The magnitude of this increase was approximately double for children exposed to continuous drinking (0.211 [95% CI, 0.005 to 0.417] μV2; P = .04). Children whose mothers were in the continuous smoking cluster had decreased beta power (-0.031 [95% CI, -0.059 to -0.003] μV2; P = .03) and gamma power (-0.020 [95% CI, -0.039 to -0.000] μV2; P = .04) compared with the nonsmoking cluster. In exploratory sex-stratified models, male participants in the quit-early PAE cluster had greater EEG power in the alpha band (0.159 [95% CI, 0.003 to 0.315] μV2; P = .04) compared with those with no PAE, and the difference was approximately double for male participants with continuous PAE (0.354 [95% CI, 0.041 to 0.667] μV2; P = .03). Male participants in the continuous PTE cluster had decreased beta (-0.048 [95% CI, -0.090 to - 0.007] μV2; P = .02) and gamma (-0.032 [95% CI, -0.061 - 0.002] μV2; P = .04) power compared with those with no PTE. Conclusions and Relevance These findings suggest that even low levels of PAE and PTE were associated with long-term alterations of brain activity.
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Affiliation(s)
- Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
| | - Shreya Rao
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
| | - Lauren C. Shuffrey
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York
| | - J. David Nugent
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
| | - Marco McSweeney
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Christine Hockett
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Santiago Morales
- Department of Psychology, University of Southern California, Los Angeles
| | - Lydia Yoder
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Katherine Ziegler
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Matthew S. Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Amy J. Elliott
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Michael M. Myers
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
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Maxwell JR, DiDomenico J, Roberts MH, Marquez LE, Rai R, Weinberg J, Jacobson SW, Stephen J, Bakhireva LN. Impact of low-level prenatal alcohol exposure and maternal stress on autonomic regulation. Pediatr Res 2024; 95:350-358. [PMID: 37674025 PMCID: PMC11089775 DOI: 10.1038/s41390-023-02799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/07/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) impacts the neurodevelopment of the fetus, including the infant's ability to self-regulate. Heart rate variability (HRV), that is, the beat-to-beat variability in heart rate, is a non-invasive measurement that can indicate autonomic nervous system (ANS) function/dysfunction. METHODS The study consisted of a subset of our ENRICH-2 cohort: 80 participants (32 PAE and 48 Controls) who had completed three visits during pregnancy. The participants completed a comprehensive assessment of PAE and other substances throughout pregnancy and assessments for stress, anxiety, and depression in the third trimester. At 24 h of age, infant HRV was assessed in the hospital during the clinically indicated heel lance; 3- to 5-min HRV epochs were obtained during baseline, heel lancing, and recovery episodes. RESULTS Parameters of HRV differed in infants with PAE compared to Controls during the recovery phase of the heel lance (respiratory sinus arrhythmia (RSA) and high-frequency (HF), p < 0.05). Increased maternal stress was also strongly associated with abnormalities in RSA, HF, and low-frequency / high-frequency (LF/HF, p's < 0.05). CONCLUSIONS Alterations in ANS regulation associated with PAE and maternal stress may reflect abnormal development of the hypothalamic-pituitary-adrenal axis and have long term implications for infant responsiveness and self-regulation. IMPACT Previous studies have focused on effects of moderate to heavy prenatal alcohol exposure (PAE) on autonomic dysregulation, but little is known about the effects of lower levels of PAE on infant self-regulation and heart rate variability (HRV). Prenatal stress is another risk factor for autonomic dysregulation. Mild PAE impacts infant self-regulation, which can be assessed using HRV. However, the effect of prenatal stress is stronger than that of mild PAE or other mental health variables on autonomic dysregulation.
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Affiliation(s)
- Jessie R Maxwell
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, Mexico.
- Department of Neurosciences, University of New Mexico, Albuquerque, NM, Mexico.
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Lidia Enriquez Marquez
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Rajani Rai
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Joanne Weinberg
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Julia Stephen
- The Mind Research Network, a Division of Lovelace Biomedical Research Institute, University of New Mexico, Albuquerque, NM, Mexico
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
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Kobus M, Sitek A, Antoszewski B, Rożniecki JJ, Pełka J, Żądzińska E. The impact of exposure to tobacco smoking and maternal trauma in fetal life on risk of migraine. Front Neurosci 2023; 17:1191091. [PMID: 37456999 PMCID: PMC10338879 DOI: 10.3389/fnins.2023.1191091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/29/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Prenatal period is the key time in human development. Many prenatal factors are well-known and increase the risk of developing diseases' after birth. Few studies indicated the link between the prenatal period and the prevalence of migraine in childhood and adolescence so far. We decided to broaden current knowledge and investigate whether the prenatal factors influence the prevalence of migraine in adulthood. The objective of this study is to provide evidence of relationship between in utero environment and risk of migraine. Methods In total 266 females (136 in the migraine group, 130 in the control group) and 80 males (35 in the migraine group, 45 in the control group), aged 18-65 participated in the study. The quality of prenatal environment was characterized on the basis of mother's and father's education, tobacco smoke exposure, alcohol consumption, and traumatic event during pregnancy, which are considered as prenatal factors and affect on fetal development. Results Migraine occurrence in adulthood was significantly associated with maternal tobacco smoking during pregnancy (OR 3.42, 95% CI 1.54-7.61, p = 0.036) and traumatic event during pregnancy (OR 2.27, 95% CI 1.24-4.13, p = 0.020). Discussion Our study suggests that the fetal programming effect of tobacco smoking exposure and maternal trauma is not limited to prenatal life and is suggested as having a role in adulthood. Our findings support evidence that migraine adulthood can be partly influenced by early life conditions.
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Affiliation(s)
- Magdalena Kobus
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Aneta Sitek
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Bogusław Antoszewski
- Department of Plastic, Reconstructive and Esthetic Surgery, Institute of Surgery, Medical University of Lodz, Łódź, Poland
| | - Jacek J. Rożniecki
- Department of Neurology, Stroke and Neurorehabilitation, Medical University of Lodz, Lodz, Poland
| | - Jacek Pełka
- Department of Neurology, Norbert Barlicki Memory University Teaching Hospital, Lodz, Poland
| | - Elżbieta Żądzińska
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
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Sania A, Myers MM, Pini N, Lucchini M, Nugent JD, Shuffrey LC, Rao S, Barbosa J, Angal J, Elliott AJ, Odendaal HJ, Fifer WP. Prenatal smoking and drinking are associated with altered newborn autonomic functions. Pediatr Res 2023; 93:242-252. [PMID: 35440768 PMCID: PMC9579213 DOI: 10.1038/s41390-022-02060-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Prenatal smoking and drinking are associated with sudden infant death syndrome and neurodevelopmental disorders. Infants with these outcomes also have altered autonomic nervous system (ANS) regulation. We examined the effects of prenatal smoking and drinking on newborn ANS function. METHODS Pregnant women were enrolled in Northern Plains, USA (NP) and Cape Town (CT), South Africa. Daily drinking and weekly smoking data were collected prenatally. Physiological measures were obtained during sleep 12-96 h post-delivery. RESULTS In all, 2913 infants from NP and 4072 from CT were included. In active sleep, newborns of mothers who smoked throughout pregnancy, compared to non-smokers, had higher breathing rates (2.2 breaths/min; 95% CI: 0.95, 3.49). Quit-early smoking was associated with reductions in beat-to-beat heart rate variability (HRV) in active (-0.08 s) and quiet sleep (-0.11 s) in CT. In girls, moderate-high continuous smoking was associated with increased systolic (3.0 mmHg, CI: 0.70, 5.24) and diastolic blood pressure (2.9 mmHg, CI: 0.72, 5.02). In quiet sleep, low-continuous drinking was associated with slower heart rate (-4.5 beat/min). In boys, low-continuous drinking was associated with a reduced ratio of low-to-high frequency HRV (-0.11, CI: -0.21, -0.02). CONCLUSIONS These findings highlight potential ANS pathways through which prenatal drinking and smoking may contribute to neurodevelopment outcomes. IMPACT In this prospective cohort study of 6985 mother-infant dyads prenatal drinking and smoking were associated with multiple ANS parameters. Smoking was associated with increased neonatal breathing rates among all infants, and heart rate variability (HRV) and blood pressure (BP) among girls. Drinking was associated with reductions in HR and BP among all newborns, and reductions in the ratio of low to-high frequency HRV among boys. These findings suggest that prenatal smoking and drinking alter newborn ANS which may presage future neurodevelopmental disorders.
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Affiliation(s)
- Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA. .,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Michael M. Myers
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - J David Nugent
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Shreya Rao
- Department of Statistics, Columbia University, New York, NY 10032
| | - Jennifer Barbosa
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032
| | - Jyoti Angal
- Avera Research Institute, Sioux Falls, SD 57108,Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, SD 57108,Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105
| | - Hein J. Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, Western Cape, South Africa 7530
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032
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