Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, SE5 9RS, United Kingdom.
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, SE5 9RS, United Kingdom; Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, SE5 9RS, United Kingdom.
Early Hum Dev. 2022 Jan;164:105509. doi: 10.1016/j.earlhumdev.2021.105509. Epub 2021 Nov 20.
Nicotine replacement therapy (NRT) and e-cigarettes are recommended to pregnant women who wish to stop smoking. Albeit eliminating other harmful components of cigarettes, those alternatives still expose the developing fetus to nicotine. The lungs may be particularly vulnerable to damage by nicotine as there is widespread nicotinic-acetylcholine receptor expression in the lungs. There is, however, a paucity of information about the effect of NRT and e-cigarette use in pregnancy on infant respiratory outcomes.
To explore the effect of NRT and e-cigarettes on the developing lung.
A literature search was undertaken to examine the use and safety of nicotine-replacement strategies in pregnancy, with a focus on infant respiratory outcomes. This included experimental studies investigating the effect of isolated "gestational" nicotine on the developing lung.
Respiratory outcomes in animal studies and infants.
Animal studies investigating the effect of gestational nicotine exposure on fetal lung development demonstrated abnormal lung growth; including abnormal airway branching and alveolar development. Consequently, offspring display altered pulmonary mechanics, including both increased respiratory rate and airway resistance. These findings mirror respiratory pathology observed in infants born to smoking mothers. Human trials of NRT and e-cigarette use in pregnancy have not identified adverse perinatal outcomes regarding reduced birthweight or prematurity, but have not considered infant and childhood respiratory outcomes.
Nicotine can impair fetal lung development, leading to concerns regarding the safety of NRT and e-cigarettes in pregnancy. Studies have yet to explore the impact of these nicotine-containing products on infant respiratory outcomes.
建议希望戒烟的孕妇使用尼古丁替代疗法（NRT）和电子烟。尽管这些替代品消除了香烟中的其他有害成分，但它们仍会使发育中的胎儿接触到尼古丁。由于尼古丁广泛存在于肺部的烟碱乙酰胆碱受体中，因此肺部可能特别容易受到尼古丁的损害。然而，关于怀孕期间使用 NRT 和电子烟对婴儿呼吸结果的影响，信息仍然匮乏。
探讨 NRT 和电子烟对发育中肺部的影响。
进行了文献检索，以检查怀孕期间使用尼古丁替代策略的情况和安全性，重点关注婴儿呼吸结果。这包括研究孤立的“妊娠”尼古丁对发育中肺部影响的实验研究。
动物研究中的呼吸结果和婴儿。
动物研究表明，妊娠期暴露于尼古丁会影响胎儿肺部发育，导致气道分支和肺泡发育异常。因此，后代表现出改变的肺力学，包括呼吸频率增加和气道阻力增加。这些发现与在吸烟母亲所生婴儿中观察到的呼吸病理学相似。关于使用 NRT 和电子烟进行妊娠的人体试验并未发现与降低出生体重或早产有关的不良围产期结局，但未考虑婴儿和儿童的呼吸结果。
尼古丁会损害胎儿肺部发育，这引发了对怀孕期间使用 NRT 和电子烟的安全性的担忧。这些含尼古丁的产品对婴儿呼吸结果的影响尚未得到研究。
