Maternal cigarette smoking is the most modifiable risk factor for sudden infant death syndrome. Although the mechanism underlying the association between maternal smoking and sudden infant death syndrome is unknown, the effect of in utero cigarette smoke exposure on respiratory control development is speculated as the important causative mechanism. In human, several studies have linked maternal smoking and alterations in breathing pattern, ventilatory, and arousal responses in infants during the early postnatal age. Cigarette contains many compounds, but nicotine has been identified as the main culprit underlying changes in respiratory control. Further investigations in animal models have demonstrated that perinatal nicotine exposure results in alteration in baseline ventilation, ventilatory response to hypoxia, arousals, and autoresuscitation processes in developing animals. The mechanisms underlying the effect of nicotine exposure on respiratory control may be related to modulation of neurotransmitters and signal transductions mediating ventilatory control and arousal responses. Findings from these studies will help to understand how perinatal cigarette smoke exposure interferes with respiratory control development, and may lead to more effective preventive strategies and therapeutic intervention for this significant health problem.
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