Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies

Angela Ratsch; Fiona Bogossian; Elizabeth A. Burmeister; BoMi Ryu; Kathryn J. Steadman

doi:10.1186/s12889-022-14609-4

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Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies

Journal article

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Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies

Angela Ratsch, Fiona Bogossian, Elizabeth A. Burmeister, BoMi Ryu and Kathryn J. Steadman

BMC Public Health, Vol.22, pp.1-15

2022

DOI: https://doi.org/10.1186/s12889-022-14609-4

PMCID: PMC9685874

PMID: 36419022

Appears in UniSC Diversity and Inclusion Research Collection

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Abstract

Australian Aboriginal and Torres Strait Islander people

Central Australia

Maternal

Neonatal

Nicotine

Pituri

Pregnancy

Smokeless tobacco

Smoking

Tobacco

UniSC Diversity Area - Aboriginal and Torres Strait Islander Engagement

UniSC Diversity Area - Life Stages

Background: In central Australia, Aboriginal women use wild tobacco plants, Nicotiana spp. (locally known as pituri) as a chewed smokeless tobacco, with this use continuing throughout pregnancy and lactation. Our aim was to describe the biological concentrations of nicotine and metabolites in samples from mothers and neonates and examine the relationships between maternal self-reported tobacco use and maternal and neonatal outcomes. Methods: Central Australian Aboriginal mothers (and their neonates) who planned to birth at the Alice Springs Hospital (Northern Territory, Australia) provided biological samples: maternal blood, arterial and venous cord blood, amniotic fluid, maternal and neonatal urine, and breast milk. These were analysed for concentrations of nicotine and five metabolites. Results: A sample of 73 women were enrolled who self-reported: no-tobacco use (n = 31), tobacco chewing (n = 19), or smoking (n = 23). Not all biological samples were obtained from all mothers and neonates. In those where samples were available, higher total concentrations of nicotine and metabolites were found in the maternal plasma, urine, breast milk, cord bloods and Day 1 neonatal urine of chewers compared with smokers and no-tobacco users. Tobacco-exposed mothers (chewers and smokers) with elevated blood glucose had higher nicotine and metabolite concentrations than tobacco-exposed mothers without elevated glucose, and this was associated with increased neonatal birthweight. Neonates exposed to higher maternal nicotine levels were more likely to be admitted to Special Care Nursery. By Day 3, urinary concentrations in tobacco-exposed neonates had reduced from Day 1, although these remained higher than concentrations from neonates in the no-tobacco group. Conclusions: This research provides the first evidence that maternal pituri chewing results in high nicotine concentrations in a wide range of maternal and neonatal biological samples and that exposure may be associated with adverse maternal and neonatal outcomes. Screening for the use of all tobacco and nicotine products during pregnancy rather than focusing solely on smoking would provide a more comprehensive assessment and contribute to a more accurate determination of tobacco and nicotine exposure. This knowledge will better inform maternal and foetal care, direct attention to targeted cessation strategies and ultimately improve long-term clinical outcomes, not only in this vulnerable population, but also for the wider population.

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Title: Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies
Authors: Angela Ratsch (Author) - Wide Bay Hospital and Health Service (Australia)
Fiona Bogossian (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
Elizabeth A. Burmeister (Author) - Wide Bay Hospital and Health Service (Australia)
BoMi Ryu (Author) - Jeju National University
Kathryn J. Steadman (Author) - The University of Queensland
Publication details: BMC Public Health, Vol.22, pp.1-15
Publisher: BioMed Central Ltd.
Date published: 2022
DOI: 10.1186/s12889-022-14609-4
ISSN: 1471-2458
PMID: 36419022; PMC9685874
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Organisation Unit: School of Health; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99695749202621
Output Type: Journal article

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