Maternal nicotine exposure induces congenital heart defects in the offspring of mice

J Cell Mol Med. 2022 Jun;26(11):3223-3234. doi: 10.1111/jcmm.17328. Epub 2022 May 6.


Maternal cigarette smoking is a risk factor for congenital heart defects (CHDs). Nicotine replacement therapies are often offered to pregnant women following failed attempts of smoking cessation. However, the impact of nicotine on embryonic heart development is not well understood. In the present study, the effects of maternal nicotine exposure (MNE) during pregnancy on foetal heart morphogenesis were studied. Adult female mice were treated with nicotine using subcutaneous osmotic pumps at 0.75 or 1.5 mg/kg/day and subsequently bred with male mice. Our results show that MNE dose-dependently increased CHDs in foetal mice. CHDs included atrial and ventricular septal defects, double outlet right ventricle, unguarded tricuspid orifice, hypoplastic left ventricle, thickened aortic and pulmonary valves, and ventricular hypertrophy. MNE also significantly reduced coronary artery size and vessel abundance in foetal hearts. Moreover, MNE resulted in higher levels of oxidative stress and altered the expression of key cardiogenic regulators in the developing heart. Nicotine exposure reduced epicardial-to-mesenchymal transition in foetal hearts. In conclusion, MNE induces CHDs and coronary artery malformation in mice. These findings provide insight into the adverse outcomes of foetuses by MNE during pregnancy.

Keywords: congenital heart defects; embryonic heart development; maternal nicotine exposure; nicotine replacement therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Female
  • Heart Defects, Congenital* / chemically induced
  • Humans
  • Male
  • Mice
  • Nicotine / adverse effects
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Smoking Cessation*
  • Tobacco Use Cessation Devices / adverse effects


  • Nicotine

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