Nicotine Replacement Therapies and Infant Respiratory Control
Research type
Research Study
Full title
Investigating the ventilatory response to added dead space in newborns of mothers utilising nicotine replacement therapies and e-cigarettes
IRAS ID
293608
Contact name
Anne Greenough
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Nicotine replacement therapy (NRT), such as patches and e-cigarettes, are considered to be safer alternatives to cigarette smoking during pregnancy. However, the full effect of NRT-use during pregnancy on babies is not yet fully explored. Multiple studies have highlighted the harmful effects of in-utero exposure to nicotine from cigarettes, including abnormal lung development and function. We are interested in understanding if alternative forms of nicotine, such as NRT and e-cigarettes, have an effect, if at all, on infants’ breathing, and how this compares to babies of mothers that smoked cigarettes during pregnancy and babies of non-smoking mothers.
The present study will consider the breathing response to carbon dioxide levels induced by added dead space “tube breathing” in term infants exposed to nicotine replacement therapies, including e-cigarettes, on the postnatal ward. The response will be measured by placing a soft mask attached to a tube over their face for 2-3 minutes. We will measure how quickly babies adapt to breathing through this tube. Previous studies have shown that term infants can fully adapt to the added deadspace/carbon dioxide load by increasing how fast and hard they breath. Although term infants of smoking mothers also adapted to the added deadspace, their response was slower. The impact of nicotine alone, delivered by NRT or e-cigarettes, has not, however, been explored.
The method in this study mimics a common stressor, transiently raised carbon dioxide levels, which infants may be exposed to in their home environment for example if their nose is blocked with secretions because of an infection. Adequate adaptation to this is vital and could play a key role in mediating adverse outcomes. Accordingly, investigating the impact of nicotine exposure, including NRT and e-cigarettes, on infants’ breathing is key in assessing infant risk for adverse outcomes and guiding smoking cessation therapies in pregnancy.
REC name
London - Brent Research Ethics Committee
REC reference
21/PR/0519
Date of REC Opinion
17 May 2021
REC opinion
Further Information Favourable Opinion