{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:10:30Z","timestamp":1785499830065,"version":"3.56.0"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,9,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Maternal smoking is associated with disturbed cardiorespiratory control in the infant. Despite lacking knowledge of whether the harmful effects of smoking are caused by combustion products in tobacco smoke or by nicotine, it has been argued that nicotine-replacement therapy during pregnancy is safer than smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>The goal of this study was to investigate if the disturbances in cardiorespiratory control associated with maternal smoking are also seen in infants prenatally exposed to snuff. We hypothesized that prenatal nicotine exposure (via moist snuff) causes disturbances in autonomic control and thereby increases the risk of apnea in the newborn.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In a nationwide Swedish cohort study, we studied associations between maternal tobacco use during pregnancy and neonatal apnea. Of 609 551 live-born singleton infants, 7599 were born to snuff-using mothers, 41 391 and 16 928 were born to light (1\u20139 cigarettes per day) and heavy (\u226510 cigarettes per day) smokers, respectively. Logistic regression was used to calculate odds ratios, using 95% confidence intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Compared with infants of nontobacco users, infants with prenatal exposure to snuff were at an increased risk of apnea even after adjustment for differences in gestational age (odds ratio: 1.96 [95% confidence interval: [1.30\u20132.96]) Smoking was associated with increased risk of apnea before, but not after, adjusting for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Snuff use during pregnancy is associated with a higher risk of neonatal apnea than smoking. Maternal use of snuff or nicotine-replacement therapy cannot be regarded as an alternative to smoking during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2010-3811","type":"journal-article","created":{"date-parts":[[2011,8,29]],"date-time":"2011-08-29T00:13:27Z","timestamp":1314576807000},"page":"503-509","source":"Crossref","is-referenced-by-count":40,"title":["Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea"],"prefix":"10.1542","volume":"128","author":[{"given":"Anna","family":"Gunnerbeck","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institutet,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Karin","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; and"},{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Karin Edstedt","family":"Bonamy","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institutet,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Wickstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institutet,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Cnattingius","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2011,9,1]]},"reference":[{"key":"2021120823423317400_B1","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.1080\/14622200410001669187","article-title":"The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes","volume":"6","author":"Cnattingius","year":"2004","journal-title":"Nicotine Tob Res"},{"issue":"2","key":"2021120823423317400_B2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.reprotox.2009.03.012","article-title":"Tobacco and pregnancy","volume":"28","author":"Rogers","year":"2009","journal-title":"Reprod Toxicol"},{"issue":"5","key":"2021120823423317400_B3","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1164\/rccm.200803-432OC","article-title":"Prenatal cigarette smoke exposure attenuates recovery from hypoxemic challenge in preterm infants","volume":"178","author":"Schneider","year":"2008","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"2021120823423317400_B4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.earlhumdev.2004.04.005","article-title":"Influences of maternal cigarette smoking on infant arousability","volume":"79","author":"Horne","year":"2004","journal-title":"Early Hum Dev"},{"issue":"8","key":"2021120823423317400_B5","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S1701-2163(16)34281-5","article-title":"Nicotine replacement therapy during pregnancy: recommended or not recommended?","volume":"31","author":"Osadchy","year":"2009","journal-title":"J Obstet Gynaecol Can"},{"issue":"6","key":"2021120823423317400_B6","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1517\/14740330802196756","article-title":"Smoking cessation in pregnancy","volume":"7","author":"Rore","year":"2008","journal-title":"Expert Opin Drug Saf"},{"issue":"4","key":"2021120823423317400_B7","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1136\/tc.12.4.349","article-title":"Effect of smokeless tobacco (snus) on smoking and public health in Sweden","volume":"12","author":"Foulds","year":"2003","journal-title":"Tob Control"},{"issue":"2","key":"2021120823423317400_B8","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.drugpo.2009.10.008","article-title":"Harm reduction policies for tobacco users","volume":"21","author":"Gartner","year":"2010","journal-title":"Int J Drug Policy"},{"issue":"9","key":"2021120823423317400_B9","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1111\/j.1360-0443.2009.02706.x","article-title":"The potential role of snus in tobacco harm reduction","volume":"104","author":"Gartner","year":"2009","journal-title":"Addiction"},{"issue":"9594","key":"2021120823423317400_B10","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/S0140-6736(07)61531-1","article-title":"Swedish snus for tobacco harm reduction","volume":"370","author":"Lambe","year":"2007","journal-title":"Lancet"},{"key":"2021120823423317400_B11","unstructured":"Statistiska Centralbyran. 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