Exposure to nicotine during pregnancy increases risk of sudden infant death

By James Gamble via SWNS

Exposure to nicotine products during pregnancy significantly increases the risk of sudden infant death, new research suggests.

Researchers found that even snus, an orally administered tobacco pouch, can increase the risk of sudden death in babies by up to three times when used by mothers during pregnancy.

Despite previous research highlighting the dangers of smoking during pregnancy, little research has been conducted on alternatives to cigarettes.

Moist tobacco pouches resembling small tea bags and placed behind the upper lip, known as "snus," are widely popular in Sweden and are considered to be far safer than smoking.

Though high in nicotine, snus does not contain the combustive products present in cigarettes.

However, researchers from the Karolinska Institute in Sweden found the products still led to an increase in the risk of sudden infant deaths.

The study, published in the journal Pediatric Research, comprised a registry of more than two million babies born in Sweden between 1999 and 2019.

Over these two decades, two in 10,000 babies suffered a sudden infant death – a death that occurs during sleep for no apparent reason.

When registering for maternal care, just over one percent of the mothers on the registry took snus, whilst another seven percent smoked.

The researchers found that taking snus during pregnancy was linked to a 70 percent rise in the risk of infant death during their first year, regardless of cause, and a three-fold increase in the risk of sudden infant death.

These risks associated with snus pouches were comparable to moderate smoking of one to nine cigarettes per day.

The study also found that mothers who quit snus or cigarettes early on in their pregnancies lowered the risk of sudden infant death in their babies, compared with continued use.

Dr. Anna Gunnerbeck, a pediatrician at the Astrid Lindgren Children’s Hospital and researcher at the Karolinska Institute’s Department of Medical Epidemiology and Biostatistics, said the study highlighted that all types of nicotine products should be avoided during pregnancy.

She said: “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.

“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.

“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.”

In linking different registries together, researchers were able to adjust for a number of potential risk factors of sudden infant death, such as socioeconomic status and the age of the mother.

However, the researchers are unable to identify any causal relationships since unknown factors may have impacted the study’s results.

The study also acknowledged the fact that it is difficult to separate the risk for the fetus associated with snus and smoking from exposure to tobacco smoke and nicotine in the breast milk after the birth of the baby.

The researchers further had no information on how much snus was consumed during pregnancy or what dosage of nicotine could have harmful effects, nor whether mothers who stopped smoking or taking snus early in their pregnancies later resumed their habits.