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Review
. 2023 Jul 19;20(14):6398.
doi: 10.3390/ijerph20146398.

Vascular Effects, Potential Pathways and Mediators of Fetal Exposure to Alcohol and Cigarette Smoking during Pregnancy: A Narrative Review

Tammy C Hartel  1 , André Oelofse  1 , Juléy J A De Smidt  1
Affiliations
Review

Vascular Effects, Potential Pathways and Mediators of Fetal Exposure to Alcohol and Cigarette Smoking during Pregnancy: A Narrative Review

Tammy C Hartel et al. Int J Environ Res Public Health. .

Abstract

(1) Background: Programming of atherosclerosis results in vascular structure and function alterations, which may be attributed to fetal exposure to maternal tobacco smoking, alcohol consumption and several lifestyle factors in the first few years of life. This review aims to study the effects of teratogen exposure in utero on vascular dysfunction in offspring and consider mediators and pathways originating from the fetal environment. (2) Methods: Eligible studies were identified in the PubMed, Scopus and Web of Science databases. After the full-text screening, 20 articles were included in the narrative synthesis. (3) Results: The literature presents evidence supporting the detrimental effects of fetal exposure to tobacco smoking on vascular alterations in both human and animal studies. Alcohol exposure impaired endothelial dilation in animal studies, but human studies on both tobacco and alcohol exposure are still sparse. Reduction in nitric oxide (NO) bioavailability and alterations in the epigenome in infants through the upregulation of pro-oxidative and proinflammatory genes may be the common denominators. (4) Conclusion: While maternal smoking and alcohol consumption have more negative outcomes on the infant in the short term, several factors during the first few years of life may mediate the development of vascular dysfunction. Therefore, more prospective studies are needed to ascertain the long-term effects of teratogen exposure, specifically in South Africa.

Keywords: alcohol consumption; arterial health; children’s health; maternal tobacco smoking; prenatal exposure; toxic effects.

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Conflict of interest statement

Author Tammy Hartel received funding from The Council for Scientific and Industrial Research to study for her PhD and is required to acknowledge the funding institution in her thesis and research outputs. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

Figures

Figure 1
Figure 1
Flow chart of study selection for narrative synthesis.
Figure 2
Figure 2
(A). A graphical network generated in VOSviewer™ shows the commonality of keywords in the literature search for this review. (B). A network showing the most common terms co-occurring with the term “endothelial dysfunction” indicated by the yellow arrow. (C). A network showing the most common terms co-occurring with the keyword “children” indicated by the yellow arrow.
Figure 3
Figure 3
Fishbone diagram summarizing the effects of maternal cigarette smoking and alcohol consumption on cardiometabolic risk in children and several factors throughout childhood that may exacerbate these effects in the development of cardiometabolic risk factors and vascular dysfunction.
See this image and copyright information in PMC

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