Increased Risk of Sudden Infant Death with Exposure to Nicotine During Pregnancy

According to a thorough registry study from Sweden’s Karolinska Institute and published in the journal Paediatric Research, babies whose mothers consumed snus (a moist oral tobacco product) during pregnancy have an increased chance of dying suddenly. If the woman gave up snus before the first antenatal appointment, the risk was significantly reduced. All nicotine products should be avoided during pregnancy, the researchers say.

“Fortunately, the incidence of sudden infant death is very low, but we can see that taking snus or smoking while pregnant is associated with an increased risk,” says Anna Gunnerbeck, a pediatrician at the Astrid Lindgren Children’s Hospital and researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institute.

Two Million New-borns Examined

Little study has been done on snus and other nicotine products, despite the fact that it is well-recognized that smoking during pregnancy increases the risk of abrupt infant death. The researchers undertook a registry analysis including more than two million infants born in Sweden between 1999 and 2019 to address this. Only two infants out of every 10,000 were killed abruptly while sleeping during this time. This is known as sudden newborn death.

Just over 1% of the women used snus, and 7% smoked when they signed up for maternal care. Snus usage during pregnancy was linked to a three-fold increase in the risk of abrupt newborn death and a seventy percent increase in the chance of baby death throughout the first year, regardless of cause. Snus use carried hazards similar to those of moderate smoking (one to nine cigarettes a day). Over ten cigarettes smoked, each day carried the greatest hazards.

Nicotine Products to Be Avoided

When compared to ongoing usage, the risk was lower when quitting snus and smoking before the first visit to the prenatal clinic. Swedish snus includes a lot of nicotine, but unlike cigarettes, it doesn’t burn; making it significantly less damaging to health.

“Given the dramatic rise in the use of snus among young women of fertile age in Sweden over the past few years and the growing popularity of e-cigarettes, women need to be informed of the potential risk to fetuses and infants,” says Dr. Gunnerbeck. Our study indicates that nicotine is a risk factor of sudden infant death, so we conclude that all types of nicotine products should be avoided during pregnancy.

Causal Relationship Unestablished

The researchers were able to account for a variety of significant possible risk factors for sudden infant mortality, including socioeconomic status and the age of the mother, by connecting various registries. However, because unidentified factors could have influenced the findings, the researchers are unable to establish any causal correlations.

It is challenging to distinguish between exposure to cigarette smoke and nicotine in breast milk after the infant is born and the risk to the fetus associated with snus and smoking. Additionally, mothers who gave up smoking or using snus early in their pregnancies might have later started back up. The amount of snus used during pregnancy or the nicotine level that might have negative consequences were unknown to the researchers.

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