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At 87 (mean) days gestation (dg), mothers were continuously infused with saline ( n = 5) or nicotine ( n = 5) at 0.5 mg\/h. Fetuses were surgically instrumented at 129 dg for cardiorespiratory monitoring. Cesarean section delivery and retrieval of fetal medulla were performed at 161 (mean) dg for autoradiographic analyses of nicotinic and 5-HT receptor and transporter binding. In nicotine-exposed fetuses, high-frequency heart rate variability was increased 55%, possibly reflecting increases in the parasympathetic control of heart rate. This effect was more pronounced with greater levels of fetal breathing and age. These changes in heart rate variability were associated with increased 5-HT<jats:sub>1A<\/jats:sub>receptor binding in the raph\u00e9 obscurus ( P = 0.04) and increased nicotinic receptor binding in the raph\u00e9 obscurus and vagal complex ( P &lt; 0.05) in the nicotine-exposed animals compared with controls ( n = 6). The shift in autonomic balance in the fetal primate toward parasympathetic predominance with chronic exposure to nicotine may be related, in part, to abnormal 5-HT-nicotine alterations in the raph\u00e9 obscurus. Thus increased risk for SIDS due to maternal smoking may be partly related to the effects of nicotine on 5-HT and\/or nicotinic receptors.<\/jats:p>","DOI":"10.1152\/japplphysiol.91629.2008","type":"journal-article","created":{"date-parts":[[2009,9,4]],"date-time":"2009-09-04T02:19:53Z","timestamp":1252030793000},"page":"1579-1590","source":"Crossref","is-referenced-by-count":75,"title":["Prenatal nicotine-exposure alters fetal autonomic activity and medullary neurotransmitter receptors: implications for sudden infant death syndrome"],"prefix":"10.1152","volume":"107","author":[{"given":"Jhodie R.","family":"Duncan","sequence":"first","affiliation":[{"name":"Department of Pathology, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Garland","sequence":"additional","affiliation":[{"name":"Departments of 2Pediatrics 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