Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

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dc.contributor.authorLucchini, Maristellaen_ZA
dc.contributor.authorShuffrey, Lauren C.en_Za
dc.contributor.authorNugent, J. Daviden_ZA
dc.contributor.authorPini, Nicolóen_ZA
dc.contributor.authorSania, Ayeshaen_ZA
dc.contributor.authorShair, Margareten_ZA
dc.contributor.authorBrink, Lucyen_ZA
dc.contributor.authorDu Plessis, Carlieen_ZA
dc.contributor.authorOdendaal, Hein J.en_ZA
dc.contributor.authorNelson, Morgan E.en_ZA
dc.contributor.authorFriedrich, Christaen_ZA
dc.contributor.authorAngal, Jyotien_ZA
dc.contributor.authorElliott, Amy J.en_ZA
dc.contributor.authorGroenewald, Coen A.en_ZA
dc.contributor.authorBurd, Larry T.en_ZA
dc.contributor.authorMyers, Michael M.en_ZA
dc.contributor.authorFifer, William P.en_ZA
dc.date.accessioned2023-04-25T13:59:09Zen_ZA
dc.date.available2023-04-25T13:59:09Zen_ZA
dc.date.issued2021-07en_ZA
dc.descriptionCITATION: Lucchini M, Shuffrey LC, Nugent JD, Pini N, Sania A, Shair M, Brink L, du Plessis C, Odendaal HJ, Nelson ME, Friedrich C, Angal J, Elliott AJ, Groenewald CA, Burd LT, Myers MM and Fifer WP (2021) Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation. Front. Physiol. 12:594605. doi.10.3389/fphys.2021.594605en_ZA
dc.descriptionThe original publication is available at: frontiersin.orgen_ZA
dc.description.abstractegative associations of prenatal tobacco and alcohol exposure (PTE and PAE) on birth outcomes and childhood development have been well documented, but less is known about underlying mechanisms. A possible pathway for the adverse fetal outcomes associated with PTE and PAE is the alteration of fetal autonomic nervous system development. This study assessed PTE and PAE effects on measures of fetal autonomic regulation, as quantified by heart rate (HR), heart rate variability (SD-HR), movement, and HR-movement coupling in a population of fetuses at ≥ 34 weeks gestational age. Participants are a subset of the Safe Passage Study, a prospective cohort study that enrolled pregnant women from clinical sites in Cape Town, South Africa, and the Northern Plains region, United States. PAE was defined by six levels: no alcohol, low quit early, high quit early, low continuous, moderate continuous, and high continuous; while PTE by 4 levels: no smoking, quit early, low continuous, and moderate/high continuous. Linear regression analyses of autonomic measures were employed controlling for fetal sex, gestational age at assessment, site, maternal education, household crowding, and depression. Analyses were also stratified by sleep state (1F and 2F) and site (South Africa, N = 4025, Northern Plains, N = 2466). The final sample included 6491 maternal-fetal-dyad assessed in the third trimester [35.21 ± 1.26 (mean ± SD) weeks gestation]. PTE was associated with a decrease in mean HR in state 2F, in a dose dependent fashion, only for fetuses of mothers who continued smoking after the first trimester. In state 1F, there was a significant increase in mean HR in fetuses whose mother quit during the first trimester. This effect was driven by the Norther Plains cohort. PTE was also associated with a significant reduction in fetal movement in the most highly exposed group. In South Africa a significant increase in mean HR both for the high quit early and the high continuous group was observed. In conclusion, this investigation addresses a critical knowledge gap regarding the relationship between PTE and PAE and fetal autonomic regulation. We believe these results can contribute to elucidating mechanisms underlying risk for adverse outcomes.en_ZA
dc.description.versionPublisher’s versionen_ZA
dc.format.extent16 pagesen_ZA
dc.identifier.citationLucchini M, Shuffrey LC, Nugent JD, Pini N, Sania A, Shair M, Brink L, du Plessis C, Odendaal HJ, Nelson ME, Friedrich C, Angal J, Elliott AJ, Groenewald CA, Burd LT, Myers MM and Fifer WP (2021) Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation. Front. Physiol. 12:594605. doi.10.3389/fphys.2021.594605en_ZA
dc.identifier.issn1664-462X (online)en_ZA
dc.identifier.otherdoi.10.3389/fphys.2021.594605en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126831en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherFrontiers Mediaen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectFetal heart rate monitoringen_ZA
dc.subjectFetus – Movementsen_ZA
dc.subjectChild developmenten_ZA
dc.subjectSubstance abuse in pregnancyen_ZA
dc.subjectAutonomic nervous systemen_ZA
dc.subjectPregnant women -- Alcohol useen_ZA
dc.subjectPregnant women -- Tobacco useen_ZA
dc.titleEffects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulationen_ZA
dc.typeArticleen_ZA
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