Effects of Prenatal Nicotine Exposure on Short-Term and Long-Term Memory: A Literature Review

Abstract

Introduction: Prenatal nicotine exposure occurs when pregnant individuals use nicotine products, exposing the fetus to nicotine, which readily crosses the placental and blood-brain barriers, accumulating in fetal circulation and amniotic fluid. As nicotine is a neuroteratogenic agent, prenatal nicotine exposure disrupts fetal brain development, in regions critical for memory and cognition, like the hippocampus and prefrontal cortex. These disruptions can have a profound long-term impact on short and long-term memory. This literature review aims to understand how prenatal nicotine exposure affects short- and long-term memory.

Methods: A literature search was performed using Boolean operators to find pre-clinical studies, clinical studies and reviews on the effects of prenatal nicotine exposure on memory published between 2010 and 2024. The databases used were Web of Science, PubMed, EMBASE, and the JAMA Network. After removing duplicates and studies that did not meet inclusion criteria, 22 studies remained. 

Results: 12 preclinical studies, 6 clinical studies, and 4 reviews met the inclusion criteria and were included in this review. The studies found the exposed participants did not perform as well as the non-exposed control participants in memory and learning tests. Impaired brain function, hyperactivity, reduced nAChRs, and decreased integrity of the brain and neuronal structures were found in exposed subjects across multiple studies.  

Discussion: Prenatal nicotine exposure impairs memory with distinct neural and cognitive implications. It alters brain structures such as the hippocampus, prefrontal cortex, and cerebellum, disrupting cholinergic and glutamatergic pathways critical for memory function. Short-term memory deficits are linked to compensatory neural mechanisms, while long-term memory impairments involve structural changes like reduced hippocampal and cortical volumes. Sex-dependent effects show males experiencing greater spatial memory deficits, while females exhibit heightened exploratory tendencies. Due to impaired development of the brain and neuronal regions critical for memory, memory and learning deficits can carry into adolescence and adulthood of exposed participants. 

Conclusion: The information summarized in this review can be used to guide future research and aid in public education on the negative effects of maternal smoking. Therapeutic and public health strategies can be developed to reduce the effects of prenatal nicotine exposure on cognitive development.