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Journal of Pediatric Psychology Advance Access published online on May 19, 2005

Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj031
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Journal of Pediatric Psychology © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org
Received March 11, 2005
Accepted March 11, 2005

Article

Maternal Cigarette-Smoking During Pregnancy Disrupts Rhythms in Fetal Heart Rate

Philip Sanford Zeskind PhD1* and Jeannine L. Gingras MD2

1 Department of Pediatrics, Carolinas Medical Center, The University of North Carolina-Chapel Hill School of Medicine
2 Department of Pediatric Research, Carolinas Medical Center

* To whom correspondence should be addressed.
Philip Sanford Zeskind, E-mail: philip.zeskind{at}carolinashealthcare.org


   Abstract

Objective To examine the effects of maternal cigarette smoking during pregnancy on the developing infant’s autonomic regulation before the possible effects of parturition and neonatal withdrawal could alter outcome measures. Methods Heart rate variability (HRV) was assessed for 10 min during late gestation for 21 cigarette-exposed (CE) and 22 nonexposed (NE) fetuses. Results HRV was significantly lower in fetuses whose mothers smoked cigarettes during pregnancy. Spectrum analysis of that variability showed temporally organized rhythms at a frequency similar to rhythms previously found in fetal cyclic motility (approximately .3 cycles per min). Lower powered rhythms--associated with poorer development--at the first, second, and dominant rhythms, as well as lower overall power of the power spectrum, were found for CE fetuses. Pearson correlations showed significant negative correlations between the amount of maternal cigarette smoking during the first trimester of pregnancy and measures of fetal HRV and power of spectral peaks. Conclusions Results show that CE fetuses have lower HRV and disrupted temporal organization of autonomic regulation before effects of parturition, postnatal adaptation, and possible nicotine withdrawal contributes to differences in infant neurobehavioral function.

Keywords: fetus, heart rate, prenatal environment, prenatal drug exposure, cigarette smoking.
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