Evidence map›Paper›PMID 42693684›Full record

ReviewBirth defects research2026

Nicotine Exposure During Gestation: From Placental Dysfunction to Long-Term Neurobehavioral Outcomes.

Harsh Dave, Shubham Maru, Kaid Johar Sr

Abstract readReview
In one paragraph

Review in Birth defects research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Harsh DaveDepartment of Zoology, Biomedical Technology, Human Genetics, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India.ORCID https://orcid.org/0009-0004-1246-7190
Shubham MaruDepartment of Zoology, Biomedical Technology, Human Genetics, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India.ORCID https://orcid.org/0009-0008-0441-6683
Kaid Johar SrDepartment of Zoology, Biomedical Technology, Human Genetics, School of Sciences, Gujarat University, Ahmedabad, Gujarat, India.ORCID https://orcid.org/0000-0002-1703-6611

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrenatal nicotine exposure (PNE) remains a significant public health concern due to persistent tobacco use, electronic nicotine delivery systems, and second-hand exposure during pregnancy. Epidemiological and experimental evidence has demonstrated that nicotine can readily cross the placenta, disrupt placental development, and interfere with tightly regulated processes of fetal organogenesis. These early perturbations are increasingly recognized as initiating a cascade of structural, functional, and molecular alterations that extend beyond gestation and influence health trajectories across the lifespan. However, existing studies are often compartmentalized by developmental stage, limiting mechanistic integration across prenatal, natal, postnatal, and later-life outcomes.

methodsThis review aims to (i) synthesize evidence from placental biology, developmental toxicology, neurobiology, and epigenetics to propose an integrated, life-course cascade model of PNE; (ii) delineate how nicotine-induced placental dysfunction and fetal hypoxia during prenatal development transition into structural, physiological, perinatal autonomic, and cardiorespiratory vulnerability, contributing to adverse birth outcomes and increased risk of sudden infant death syndrome; and (iii) examine how early disruption of nicotinic acetylcholine receptor mediated signaling alters neuronal differentiation, synaptic maturation, neuroimmune interactions, and stress-response pathways, leading to persistent cognitive, behavioral, and psychiatric susceptibility in postnatal life and adulthood. Emerging evidence for epigenetic reprogramming, sex-specific vulnerability, and intergenerational transmission, including paternal contributions, is also evaluated.

resultsEvidence synthesized across placental biology, developmental toxicology, neurobiology, and epigenetics supports a cascade in which nicotine-induced placental dysfunction and fetal hypoxia contribute to structural, physiological, perinatal autonomic, and cardiorespiratory vulnerability, adverse birth outcomes, and increased risk of sudden infant death syndrome. Early disruption of nicotinic acetylcholine receptor-mediated signaling is associated with alterations in neuronal differentiation, synaptic maturation, neuroimmune interactions, and stress-response pathways, contributing to persistent cognitive, behavioral, and psychiatric susceptibility in postnatal life and adulthood. Emerging evidence also supports roles for epigenetic reprogramming, sex-specific vulnerability, and intergenerational transmission, including paternal contributions.

conclusionBy integrating temporally distinct findings into a unified mechanistic framework, this review identifies critical developmental windows and molecular targets for intervention. Such an approach is essential for advancing preventive strategies, informing public health policy, and mitigating the long-term and transgenerational consequences of nicotine exposure.

Indexed as

NicotinePlacentaPrenatal Exposure Delayed EffectsAnimalsDevelopmental Origins of Health and DiseaseFemaleFetal DevelopmentHumansPregnancyNicotinebirth complicationsneurobehaviorplacentapregnancyprenatal nicotine exposureSIDStobacco

Identifiers

PMID42693684
PMCPMC13542631

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.