Pregnant and Still Smoking

If you or anyone you know is smoking while pregnant, a compelling new study about the long-term damage to the unborn child may finally spur help for the addiction to cigarettes.

Mice exposed to nicotine during early development show behavioral problems that mimic attention deficit disorder.

Researchers have discovered that early exposure to nicotine can trigger widespread genetic changes that affect brain cell connections well after birth.

“We launched this study because several studies showed that there was an association between maternal smoking and later diagnosis of ADHD in their kids who had been exposed to tobacco smoke during pregnancy and early development,” said Marina Picciotto, PhD, a professor of psychiatry and senior author of the paper.

“We didn’t know if this was due to the nicotine in tobacco changing the brain or any of the other constituents of tobacco smoke, or whether it was due to shared genes between moms and their kids that predisposed them to both nicotine addiction and ADHD. This study used a basic science model to pull that apart and showed that the nicotine alone was enough to change nerve cell structure, gene expression and behavior in ways that are consistent with attentional dysfunction,” she told LifeZette.

The Yale-led review found that when a mother smokes, the nicotine affects a master regulator of DNA packaging, which in turn influences the activity of genes crucial to the formation and stabilization of synapses between brain cells.

“When this regulator is induced in mice, they pay attention to a stimulus they should ignore,” said Picciotto. An inability to focus, of course, is the hallmark of ADHD and other behavioral disorders.

Genes essential to the creation of brain synapses were heavily effected. And the damage was long-term. The genetic changes were still present even in adult mice, the scientists found.

“Understanding these molecular and cellular pathways could lead to the identification of ways to reverse the changes in adulthood.”

“It is exciting to find a signal that could explain the long-lasting effects of nicotine on brain cell structure and behavior,” Picciotto said.

“The hope would be that understanding these molecular and cellular pathways could lead to the identification of ways to reverse the changes in adulthood, although this is still very far away,” she told LifeZette.

The primary takeaway from the study, Picciotto said, is that moms should continue to be encouraged not to smoke during pregnancy.

“In addition, nicotine replacement could result in some of these changes and should be used with great caution during pregnancy. Finally, kids who have been exposed to tobacco smoke in utero may benefit from early intervention if they show signs of attentional problems.”

Most women who smoke during pregnancy today don’t want to be smoking, said Dr. Michael Fiore, a national tobacco cessation expert and founder of the Center for Tobacco Research and Intervention at the University of Wisconsin.

“They often feel terrible that they continue to smoke — many have a number of episodes of abstinence during pregnancy. But these are women who dependent on an addictive drug. They struggle to overcome that,” Fiore told LifeZette.

He said the women who continue to smoke while pregnant are often those who face some of the greatest challenges in general — they tend to be poor, less educated single moms with chaotic and stressful lives. And while they shouldn’t get a free pass, they may just need more help, more education on the topic, he added, and in turn, more incentive to quit.

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Low birth weight, preterm birth, stillbirths, and an increased risk of birth defects are some of the other major complications of smoking during pregnancy.

In addition to the issues detailed above, infants exposed to nicotine in the womb may later be more prone to developing asthma and respiratory infections, physical growth deficiencies, and obesity.

And during pregnancy isn’t the only time a mom’s (or anyone else’s ) smoking will affect a child.

“A number of women are able to quit during pregnancy and often have their first cigarette on the drive back home after delivery. The rate of relapse postpartum is incredibly high, and this is of enormous importance. We know that secondhand smoke exposure to a new baby is a substantial health risk — including a leading cause of SIDS deaths, behavioral issues, lower educational attainment by the kids and a whole variety of other things.”

Women in any state have access to the resources at 1(800) QUIT-NOW, noted Fiore. There is specialized counseling available at that number for women who are pregnant.