Effect of Nicotine and Alcohol Exposure in utero on Vascular Intima Medial Thickness, Endothelial Function, and the Development of Cardiometabolic Risk Factors in Children in a Low-Income Setting.

Abstract

Foetal exposure to nicotine and alcohol during pregnancy may result in cardiovascular disease (CVD) later in life. In low socioeconomic regions, CVD risk factors have also presented in children and adolescents. The Developmental origins of Health and Disease (DoHaD) hypothesised that prenatal exposures will result in long-lasting, if not permanent adaptations in the structure, physiology and metabolism in the foetus, therefore predisposing children to CVD later in life. Several studies have reported associations between increased intima medial thickness (IMT) and CVD risk factors in offspring with in utero exposure to alcohol and nicotine. Studies have also proposed potential mechanisms of nicotine and alcohol such as oxidative stress, induced by chronic hypoxia in utero which affects nitric oxide (NO) bioavailability in the vascular endothelium. Aim: The aim of this study is to determine the effect of in utero exposure to nicotine and alcohol on vascular structure and function, and the development of cardiometabolic risk factors in adolescents in a low-income setting. Methods: This is a case-control study in 307 children aged 10-14 years. In Phase I, cardiometabolic parameters such as body mass index (BMI), waist circumference, subscapular and triceps skinfold thickness, blood pressure, lipid profiles and non-fasting blood glucose concentrations were measured. Mothers were interviewed to obtain data regarding maternal smoking and alcohol use, health status, and demographic characteristics. In phase II, subclinical signs of atherosclerosis were measured using non-invasive methods. Endothelial function was measured in the brachial artery (BA) using flow mediated dilation (FMD) to measure blood flow velocity and arterial diameter using Doppler and B-mode ultrasonography, respectively. Carotid artery IMT was measured using B-mode ultrasonography. All data was analysed using SPSS® software version 30.