How do stress hormones during pregnancy predict adult nicotine addiction?

Miriam Hospital study findings highlight importance of smoking and maternal health -- both physical and mental -- during pregnancy

2013-10-07

(Press-News.org) (PROVIDENCE, R.I.) -- Adult women whose mothers had increased levels of stress hormones while they were pregnant are at greater risk of becoming addicted to nicotine, according to a new study led by a Miriam Hospital researcher.

The 40-year longitudinal study provides the first evidence that prenatal exposure to the class of stress hormones known as glucocorticoids predicts nicotine dependence later in life – but only for daughters. It also confirms previous research that babies born to moms who smoked when pregnant have an increased risk of nicotine addiction in adulthood.

The study found that effects of maternal stress hormones and maternal smoking in pregnancy were additive in predicting nicotine addiction in adult daughters. The findings, published online by the journal Biological Psychiatry, point to the enduring influence of the prenatal environment and the importance of maternal health and well-being during pregnancy.

Lead author Laura Stroud, Ph.D., from the Centers for Behavioral and Preventive Medicine at The Miriam Hospital, says the study supports the critical role of the prenatal environment when it comes to risk factors for adult disease, meaning some people may be predisposed to, or 'programmed' for, certain conditions later in life because of exposures during pregnancy, such as stress and maternal smoking.

"While maternal smoking during pregnancy has been shown to be an independent risk factor for nicotine dependence, we didn't really know – until now – which pathways or mechanisms were responsible. Most prior research involving biological mechanisms had been conducted in animals not humans," she said.

"Our study suggests that maternal smoking and high stress hormones—often linked to high stress and adverse social conditions—represent a 'double-hit' in terms of increasing an offspring's risk for nicotine addiction as an adult." Because mothers who smoke are often more stressed and living in adverse conditions– these findings represent a public health concern and highlight the need to help smoking moms quit and reduce stress levels and improve social conditions for poor pregnant mothers," Stroud added.

Associations between prenatal exposure to both glucocorticoids – particularly cortisol – and tobacco smoke emerged only for daughters, which Stroud says it consistent with some recent research findings.

"Our findings highlight the particular vulnerability of daughters to long-term adverse outcomes following maternal stress and smoking during pregnancy," she said. "We don't yet know why this is, but possible mechanisms include sex differences in stress hormone regulation in the placenta and adaptation to prenatal environmental exposures. Also, cortisol and nicotine may affect developing male and female brains differently."

"Furthermore, if daughters of smoking mothers are more likely to grow up nicotine dependent, the result is dangerous cycle of intergenerational transmission of nicotine addiction," she added.

Despite the warnings and known health risks, approximately one in five expectant moms in the United States continue to smoke during pregnancy. Studies have consistently found that prenatal cigarette smoke exposure is associated with increased rates of behavior problems, irritability, attention-deficit and hyperactivity disorder, the risk of violent offenses, conduct disorder, adolescent onset of drug dependence and the risk for criminal arrest in offspring. This study adds another potential negative outcome – nicotine dependence – to the list of reasons for mothers to stop smoking while pregnant.

Stroud and colleagues studied 1,086 pairs of mothers and their adult children (59 percent female) from the New England Family Study, a 40-year longitudinal follow-up of the Collaborative Perinatal Project based at Brown University. Maternal smoking during pregnancy was assessed prospectively at each prenatal visit, and the mother's cortisol, testosterone and cotinine (a nicotine metabolite passed from mother to infant) levels were measured during the third trimester. The adult children's lifetime nicotine dependence was assessed during a structured interview; the average age at this follow-up was 39.

By studying both maternal smoking and cortisol levels as independent factors, researchers were able to observe whether these two pathways contributed to nicotine dependence in the adult children. They found increased exposure to prenatal glucocorticoids was associated with a 13 percent increased risk of nictotine dependence in daughters only over the 40-year follow-up. Mothers who smoked 15 cigarettes a day or more during pregnancy were 52 percent more likely to have a daughter addicted to nicotine.

"Cigarette smoking is the number one cause of preventable disease, illness and premature death worldwide," said Stroud. "Eliminating smoking during pregnancy and improving the environmental conditions of poor pregnant mothers continues to be a vital challenge for both clinicians and the public health community."

She adds that the findings highlight both the need for enhanced strategies for smoking cessation during pregnancy along with the possibility of targeted smoking cessation efforts later in life, where more intense efforts may be warranted for those with a history of family smoking including prenatal exposure.

### Preparation of this paper was supported by grants from the National Institutes of Health (R01 HD043844 to LRS/RN and P50 CA84719) and the Flight Attendant Medical Research Institute Clinical Innovator Award to Stroud. Study co-authors include George D. Papandonatos, Ph.D., Daniel Rodriguez, Ph.D., Stephen L. Buka, Sc.D., and Lewis P. Lipsitt, Ph.D., from Brown University; Edmond Shenassa, Sc.D., from the University of Maryland School of Public Health; Raymond Niaura, Ph.D., from the American Legacy Foundation's Schroeder Institute for Tobacco Research and Policy Studies; and Kaja Z. LeWinn, Sc.D, M.S., from the University of California, San Francisco.

The principal affiliation of Laura Stroud, Ph.D., is The Miriam Hospital (a member hospital of the Lifespan health system in Rhode Island) and direct financial and infrastructure support for this project was received through the Lifespan Office of Research Administration. Stroud is also an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University.

The report, titled "Prenatal Glucocorticoids and Maternal Smoking During Pregnancy Independently Program Adult Nicotine Dependence in Daughters: A 40-Year Prospective Study," was published online on September 10, 2013.

About The Miriam Hospital The Miriam Hospital is a 247-bed, not-for-profit teaching hospital affiliated with The Warren Alpert Medical School of Brown University. It offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery and is home to the state's first Joint Commission-certified Stroke Center and robotic surgery program. The hospital, which received more than $23 million in external research funding last year, is nationally known for its HIV/AIDS and behavioral and preventive medicine research, including weight control, physical activity and smoking cessation. The Miriam Hospital has been awarded Magnet Recognition for Excellence in Nursing Services four times and is a founding member of the Lifespan health system. Follow us on Facebook and on Twitter (@MiriamHospital).

ELSE PRESS RELEASES FROM THIS DATE:

Numerically identifying pollen grains improves on conventional ID method

2013-10-07

CHAMPAIGN, Ill. — Researchers have developed a new quantitative – rather than qualitative – method of identifying pollen grains that is certainly nothing to sneeze at. The research appears in the journal Proceedings of the Royal Society B: Biological Sciences. Since the invention of the earliest light microscopes, the classification and identification of pollen and spores has been a highly subjective venture for those who use these tiny particles to study vegetation in their field, palynology. However, according to the lead author of the study, Luke Mander, a former ...

Scientists unlock secret of cattle ticks' resistance to pesticide

2013-10-07

Scientists have discovered how a tick which transmits devastating diseases to cattle has developed resistance to one of the main pesticides used to kill it. Approximately 80% of cattle around the world, mostly in the tropics and sub-tropics, are exposed to the cattle tick – Rhipicephalis microplus – which can cause anaemia, reduced rate of growth and death, resulting in a major economic impact on farmers. Prevention of disease is through frequent treatment of cattle with acarides –pesticides for ticks and mites – mainly amitraz, ivermectins and pyrethroids, but ticks ...

Infanticide linked to wet-nursing in meerkats

2013-10-07

Subordinate female meerkats who try to breed often lose their offspring to infanticide by the dominant female or are evicted from the group. These recently bereaved or ostracised mothers may then become wet-nurses for the dominant female, an activity that may be a form of "rent" that allows them to remain in the community. Wet-nursing another mother's offspring – called allolactation – occurs across a variety of mammals and is thought to provide survival benefits to the nursed offspring and to the mother of the pups. However, little has been definitively known of why ...

Study: Lance Armstrong failed social media, too

2013-10-07

CLEMSON, S.C. — Lance Armstrong used Twitter to employ image-repair strategies in a way that cultivated followers and countered media reports. However, he neglected to enact any image-repair tweets following his admission to using performance-enhancing drugs in a nationally staged interview with Oprah Winfrey, researchers say. Clemson University communication studies assistant professor Jimmy Sanderson said traditional media like television and newspapers have been a staple of image repair, but with the rise of social media, athletes now have an additional avenue for ...

South Africa reverses mortality trend in children under 5

2013-10-07

Philadelphia, Pa. (October 7, 2013) – Over the past decade, South Africa has made a dramatic reversal in child survival—mainly because of improvements in HIV/AIDS care, reports a study in AIDS, official journal of the International AIDS Society. AIDS is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. "After years of rising mortality rates, the mortality picture for South Africa's children has shifted drastically," according to the report by Kate Kerber, MPH, of University of the Western Cape, Belleville, South Africa, supported by the global ...

How JC Polyomavirus invades cells

2013-10-07

For more than a decade the research group of Brown University Professor Walter Atwood has doggedly pursued the workings of the JC polyomavirus, which causes a disease called PML that fatally degrades the central nervous system of patients with weakened immune systems. In a study published online Oct. 2 in the Journal of Virology, his team describes how it gains entry into cells: It breaks in via certain receptors of the neurotransmitter serotonin called 5-HT2 receptors. Atwood, lead author and graduate student Benedetta Assetta and their co-authors showed this by inserting ...

Facial recognition is more accurate in photos showing whole person

2013-10-07

Subtle body cues allow people to identify others with surprising accuracy when faces are difficult to differentiate. This skill may help researchers improve person-recognition software and expand their understanding of how humans recognize each other. A study published in Psychological Science by researchers at The University of Texas at Dallas demonstrates that humans rely on non-facial cues, such as body shape and build, to identify people in challenging viewing conditions, such as poor lighting. "Psychologists and computer scientists have concentrated almost exclusively ...

Where in the world are young people using the internet?

2013-10-07

According to a common myth, today's young people are all glued to the Internet. But in fact, only 30 percent of the world's youth population between the ages of 15 and 24 years old has been active online for at least five years. In South Korea, 99.6 percent of young people are active, the highest percentage in the world. The least? The Asian island of Timor Leste with less than 1 percent. Those are among the many findings in a study from the Georgia Institute of Technology and International Telecommunication Union (ITU). The study is the first attempt to measure, by ...

Sending multiple sclerosis up in smoke

2013-10-07

Multiple sclerosis is an inflammatory disease in which the immune system attacks the nervous system. The result can be a wide range of debilitating motor, physical, and mental problems. No one knows why people get the disease or how to treat it. In a new study published in the Journal of Neuroimmune Pharmacology, Drs. Ewa Kozela, Ana Juknat, Neta Rimmerman and Zvi Vogel of Tel Aviv University's Dr. Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases and Sackler Faculty of Medicine demonstrate that some chemical compounds found in marijuana can help ...

Improving the quality of clinical ethics consultants

2013-10-07

Clinical ethicists play a vital role in hospitals and other health care systems by helping to resolve ethical conflicts that arise between patients, families, and clinicians about end-of-life care and other important medical decisions. To improve the quality of clinical ethics consultants, the American Society for Bioethics and Humanities (ASBH) has proposed a method for assessing them. An article in the Hastings Center Report describes the process and explains its importance. Questionable credentials and unacceptable variations in practice patterns "may be placing patients ...