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Fang F, Luo ZC, Dejemli A, Delvin E, Zhang J. Maternal Smoking and Metabolic Health Biomarkers in Newborns. PLoS One 2015; 10:e0143660. [PMID: 26599278 PMCID: PMC4658089 DOI: 10.1371/journal.pone.0143660] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 11/06/2015] [Indexed: 11/19/2022] Open
Abstract
Background Maternal smoking has been associated with elevated risk of type 2 diabetes among the offspring in adulthood. The mechanisms underlying this fetal “programming” effect remain unclear. The present study sought to explore whether maternal smoking affects metabolic health biomarkers in fetuses/newborns. Methods In a prospective singleton pregnancy cohort (n = 248), we compared metabolic health biomarkers in the newborns of smoking and non-smoking mothers. Outcomes included cord plasma insulin, proinsulin, insulin-like growth factor I (IGF-I), IGF-II, leptin and adiponectin concentrations, glucose-to-insulin ratio (an indicator of insulin sensitivity) and proinsulin-to-insulin ratio (an indicator of β-cell function). Results Independent of maternal (glucose tolerance, age, ethnicity, parity, education, body mass index, alcohol use) and infant (sex, gestational age, birth weight z score, mode of delivery, cord blood glucose concentration) characteristics, the newborns of smoking mothers had lower IGF-I concentrations (mean: 6.7 vs. 8.4 nmol/L, adjusted p = 0.006), and marginally higher proinsulin-to-insulin ratios (0.94 vs. 0.72, adjusted p = 0.06) than the newborns of non-smoking mothers. Cord plasma insulin, proinsulin, IGF-II, leptin and adiponectin concentrations and glucose-to-insulin ratios were similar in the newborns of smoking and non-smoking mothers. Conclusions Maternal smoking was associated with decreased fetal IGF-I levels, and borderline lower fetal β-cell function. Larger cohort studies are required to confirm the latter finding. The preliminary findings prompt the hypothesis that these early life metabolic changes may be involved in the impact of maternal smoking on future risk of metabolic syndrome related disorders in the offspring.
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Affiliation(s)
- Fang Fang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China
| | - Zhong-Cheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China
- Departments of Obstetrics and Gynecology, Sainte-Justine Hospital Research Center, University of Montreal, Montreal, H3T 1C5, Canada
- * E-mail:
| | - Anissa Dejemli
- Department of Clinical Biochemistry, Sainte-Justine Hospital Research Center, University of Montreal, Montreal, H3T 1C5, Canada
| | - Edgard Delvin
- Department of Clinical Biochemistry, Sainte-Justine Hospital Research Center, University of Montreal, Montreal, H3T 1C5, Canada
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China
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52
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Polen KND, Sandhu PK, Honein MA, Green KK, Berkowitz JM, Pace J, Rasmussen SA. Knowledge and attitudes of adults towards smoking in pregnancy: results from the HealthStyles© 2008 survey. Matern Child Health J 2015; 19:144-54. [PMID: 24825031 DOI: 10.1007/s10995-014-1505-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Smoking during pregnancy is causally associated with many adverse health outcomes. Quitting smoking, even late in pregnancy, improves some outcomes. Among adults in general and reproductive-aged women, we sought to understand knowledge and attitudes towards prenatal smoking and its effects on pregnancy outcomes. Using data from the 2008 HealthStyles© survey, we assessed knowledge and attitudes about prenatal smoking and smoking cessation. We classified respondents as having high knowledge if they gave ≥ 5 correct responses to six knowledge questions regarding the health effects of prenatal smoking. We calculated frequencies of correct responses to assess knowledge about prenatal smoking and estimated relative risk to examine knowledge by demographic and lifestyle factors. Only 15 % of all respondents and 23 % of reproductive-aged women had high knowledge of the adverse effects of prenatal smoking on pregnancy outcomes. Preterm birth and low birth weight were most often recognized as adverse outcomes associated with prenatal smoking. Nearly 70 % of reproductive-aged women smokers reported they would quit smoking if they became pregnant without any specific reasons from their doctor. Few respondents recognized the benefits of quitting smoking after the first trimester of pregnancy. Our results suggest that many women lack knowledge regarding the increased risks for adverse outcomes associated with prenatal smoking. Healthcare providers should follow the recommendations provided by the American Congress of Obstetricians and Gynecologists, which include educating women about the health risks of prenatal smoking and the benefits of quitting. Healthcare providers should emphasize quitting smoking even after the first trimester of pregnancy.
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Affiliation(s)
- Kara N D Polen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-86, Atlanta, GA, 30333, USA,
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Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study. Sci Rep 2015; 5:13020. [PMID: 26268789 PMCID: PMC4534797 DOI: 10.1038/srep13020] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/14/2015] [Indexed: 11/17/2022] Open
Abstract
Smoke-free legislation is associated with improved early-life outcomes; however its impact on perinatal survival is unclear. We linked individual-level data with death certificates for all registered singletons births in England (1995–2011). We used interrupted time series logistic regression analysis to study changes in key adverse perinatal events following the July 2007 national, comprehensive smoke-free legislation. We studied 52,163 stillbirths and 10,238,950 live-births. Smoke-free legislation was associated with an immediate 7.8% (95%CI 3.5–11.8; p < 0.001) reduction in stillbirth, a 3.9% (95%CI 2.6–5.1; p < 0.001) reduction in low birth weight, and a 7.6% (95%CI 3.4–11.7; p = 0.001) reduction in neonatal mortality. No significant impact on SIDS was observed. Using a counterfactual scenario, we estimated that in the first four years following smoke-free legislation, 991 stillbirths, 5,470 cases of low birth weight, and 430 neonatal deaths were prevented. In conclusion, smoke-free legislation in England was associated with clinically important reductions in severe adverse perinatal outcomes.
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54
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van Voorst SF, Vos AA, de Jong-Potjer LC, Waelput AJM, Steegers EAP, Denktas¸ S. Effectiveness of general preconception care accompanied by a recruitment approach: protocol of a community-based cohort study (the Healthy Pregnancy 4 All study). BMJ Open 2015; 5:e006284. [PMID: 25795685 PMCID: PMC4368984 DOI: 10.1136/bmjopen-2014-006284] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Promotion of healthy pregnancies has gained high priority in the Netherlands because of the relative unfavourable perinatal outcomes. In response, a nationwide study Healthy Pregnancy 4 All (HP4ALL) has been initiated. One of the substudies within HP4ALL focuses on preconception care (PCC). PCC is an opportunity to detect and eliminate risk factors before conception to optimise health before organogenesis and placentation. The main objectives of the PCC substudy are (1) to assess the effectiveness of a recruitment strategy for the PCC health services and (2) to assess the effectiveness of individual PCC consultations. METHODS/ANALYSIS Prospective cohort study in neighbourhoods of 14 municipalities with perinatal mortality and morbidity rates exceeding the nation's average. The theoretical framework of the PCC substudy is based on Andersen's model of healthcare utilisation (a model that evaluates the utilisation of healthcare services from a sociological perspective). Women aged 18 up to and including 41 years are targeted for utilisation of the PCC health service by a four armed recruitment strategy. The PCC health service consists of an individual PCC consultation consisting of (1) initial risk assessment and risk management and (2) a follow-up consultation to assess adherence to the management plan. The primary outcomes regarding the effectiveness of consultations is behavioural change regarding folic acid supplementation, smoking cessation, cessation of alcohol consumption and illicit substance use. The primary outcome regarding the effectiveness of the recruitment strategy is the number of women successfully recruited and the outreach in terms of which population is reached in comparison to the approached population. Data collection consists of registration in the database of women that enrol for a visit to the individual PCC consultations (women successfully recruited), and preconsultation and postconsultation measurements among the included study population (by questionnaires, anthropometric measurements and biomarkers). Sample size calculation resulted in a sample size of n=839 women. ETHICS AND DISSEMINATION Approval for this study has been obtained from the Medical Ethical Committee of the Erasmus Medical Center of Rotterdam (MEC 2012-425). Results will be published and presented at international conferences.
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Affiliation(s)
- Sabine F van Voorst
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Amber A Vos
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Lieke C de Jong-Potjer
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Adja J M Waelput
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Semiha Denktas¸
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Social and Behavioural Sciences, Erasmus University College, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Noah AJ, Landale NS, Sparks CS. How Does the Context of Reception Matter? The Role of Residential Enclaves in Maternal Smoking During Pregnancy Among Mexican-Origin Mothers. Matern Child Health J 2015; 19:1825-33. [PMID: 25652060 DOI: 10.1007/s10995-015-1696-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigated whether and how different patterns of group exposure within residential contexts (i.e., living in a Mexican immigrant enclave, a Mexican ethnic enclave, a pan-Hispanic enclave, or a non-Hispanic white neighborhood) are associated with smoking during pregnancy among Mexican-origin mothers. Using a hierarchical linear modeling approach, we found that Mexican-origin mothers' residential contexts are important for understanding their smoking during pregnancy. Residence in an ethnic enclave is associated with decreased odds of smoking during pregnancy, while residence in a non-Hispanic white neighborhood is associated with increased odds of smoking during pregnancy, above and beyond the mothers' individual characteristics. The magnitude of the associations between residence in an ethnic enclave and smoking during pregnancy is similar across the different types of ethnic enclaves examined. The important roles of inter- and intra-group exposures suggests that in order to help Mexican-origin women, policy makers should more carefully design place-based programs and interventions that target geographic areas and the specific types of residential contexts in which women are at greater risk.
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Affiliation(s)
- Aggie J Noah
- Department of Sociology, Pennsylvania State University, 211 Oswald Tower, University Park, PA, USA,
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Ekblad M, Korkeila J, Lehtonen L. Smoking during pregnancy affects foetal brain development. Acta Paediatr 2015; 104:12-8. [PMID: 25169748 DOI: 10.1111/apa.12791] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 07/12/2014] [Accepted: 08/25/2014] [Indexed: 11/26/2022]
Abstract
UNLABELLED Environmental factors such as maternal smoking can significantly modulate genetically programmed brain development during foetal life. This review looks at how prenatal smoking exposure modulates brain development, including new evidence on the effects of smoking on foetal brain development and function. CONCLUSION Smoking during pregnancy exposes the foetus to thousands of health-threatening chemicals, restricting foetal body and head growth. Alterations in brain structure and function have been seen in children exposed to prenatal smoking.
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Affiliation(s)
- Mikael Ekblad
- Department of Pediatrics; Turku University Hospital, and University of Turku; Turku Finland
| | - Jyrki Korkeila
- Department of Psychiatry; University of Turku; Turku Finland
- Department of Psychiatry; Harjavalta Hospital; Satakunta Hospital District; Harjavalta Finland
| | - Liisa Lehtonen
- Department of Pediatrics; Turku University Hospital, and University of Turku; Turku Finland
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Tsinisizeli N, Sotiroudis G, Xenakis A, Lykeridou KE. Determination of nicotine and cotinine in meconium from Greek neonates and correlation with birth weight and gestational age at birth. CHEMOSPHERE 2015; 119:1200-1207. [PMID: 25460762 DOI: 10.1016/j.chemosphere.2014.09.094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 09/11/2014] [Accepted: 09/21/2014] [Indexed: 06/04/2023]
Abstract
Tobacco exposure during pregnancy is a major factor of morbidity and mortality for both the pregnant woman and the fetus. Several studies in the past have detected and quantified tobacco smoke biomarkers in infant meconium samples. Aim of this study was to measure prenatal exposure to tobacco smoke by detecting nicotine and cotinine in meconium and to try to evaluate the extent of exposure to smoke through passive smoking as well as the relationship between tobacco biomarker meconium concentrations and neonatal outcomes. Tobacco smoke biomarkers nicotine and cotinine were detected and quantitated in meconium from tobacco exposed and non-exposed Greek neonates using liquid chromatography-tandem mass spectrometry. The study included 45 neonates from active, passive and non-smoking women during pregnancy. The results showed significant values of nicotine and cotinine concentration in neonates from both active and passive smokers which reached 125 ng g(-1) for nicotine and 98.5 ng g(-1) for cotinine and varied according to the type and level of exposure. In general nicotine and cotinine concentrations correlated with the degree of active smoking by the mother. Similarly, nicotine and cotinine were measured in the meconium of infants of passive smokers at concentrations comparable to those of infants whose mothers were moderate smokers. Our findings show that exposure of the fetus to tobacco biomarkers can be substantial even in passive maternal smoking and there is a statistically significant negative correlation between nicotine or cotinine concentrations in meconium and birth weight or gestational age at birth.
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Affiliation(s)
- Nikoleta Tsinisizeli
- Faculty of Health and Caring Professions, Midwifery Department, Technological Educational Institute of Athens, Agiou Spyridonos Str., 12210 Egaleo, Greece; Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, 48 Vassileos Constantinou Ave., 11635 Athens, Greece.
| | - Georgios Sotiroudis
- Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, 48 Vassileos Constantinou Ave., 11635 Athens, Greece.
| | - Aristotelis Xenakis
- Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, 48 Vassileos Constantinou Ave., 11635 Athens, Greece.
| | - Katerina E Lykeridou
- Faculty of Health and Caring Professions, Midwifery Department, Technological Educational Institute of Athens, Agiou Spyridonos Str., 12210 Egaleo, Greece.
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58
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Rosenthal DG, Weitzman M. Examining the Effects of Intrauterine and Postnatal Exposure to Tobacco Smoke on Childhood Cognitive and Behavioral Development. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2014. [DOI: 10.2753/imh0020-7411400103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ruckart PZ, Bove FJ, Maslia M. Evaluation of contaminated drinking water and preterm birth, small for gestational age, and birth weight at Marine Corps Base Camp Lejeune, North Carolina: a cross-sectional study. Environ Health 2014; 13:99. [PMID: 25413571 PMCID: PMC4247681 DOI: 10.1186/1476-069x-13-99] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/03/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Births during 1968-1985 at Camp Lejeune were exposed to drinking water contaminated with trichloroethylene (TCE), tetrachloroethylene (PCE), and benzene. METHODS We conducted a cross-sectional study to evaluate associations between residential prenatal exposure to contaminated drinking water at Camp Lejeune during 1968-1985 and preterm birth, small for gestational age (SGA), term low birth weight (TLBW), and mean birth weight (MBW) deficit. Birth certificates identified mothers residing at Camp Lejeune at delivery. We analyzed exposure data for the entire pregnancy and individual trimesters. For each period examined, births were categorized as unexposed if mothers did not reside at Camp Lejeune or if their residence on base received uncontaminated drinking water. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels at residences. For PCE and TCE, the exposed group was divided into four levels: < median value, ≥ median value, ≥75th percentile, and ≥90th percentile. For benzene, the exposed group was categorized as <1 part per billion (ppb) versus ≥1 ppb because of sparse data. Magnitude of effect estimates and exposure response relationships were used to assess associations. Confidence intervals (CIs) indicated precision of estimates. RESULTS For the highest TCE exposure category during the entire pregnancy, odds ratios (ORs) were 1.5 (95% CI: 1.2, 1.9) and 1.3 (95% CI: 0.8, 2.2) for SGA and TLBW, respectively, and reduced MBW β = -78.3 g (95% CI: -115.0, -41.7). The OR =1.3 (95% CI: 1.0, 1.6) for preterm birth and the highest PCE exposure category during the entire pregnancy. Monotonic exposure-response relationships were observed for benzene exposure during the entire pregnancy and TLBW (highest category OR =1.5, 85% CI: 0.9, 2.3). Although a monotonic association between benzene and adjusted MBW difference was also observed (highest category β = -36.2 g, 95% CI: -72.3, -0.1), the association disappeared when TCE was also added to the model. We found no evidence suggesting any other associations between outcomes and exposures. CONCLUSION Findings suggested associations between in utero exposures to TCE and SGA, TLBW and reduced MBW; benzene and TLBW; and PCE and preterm birth.
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Affiliation(s)
- Perri Zeitz Ruckart
- />Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58 Atlanta, GA 30341 USA
| | - Frank J Bove
- />Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58 Atlanta, GA 30341 USA
| | - Morris Maslia
- />Division of Community Health Investigations, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58, Atlanta, GA 30341 USA
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Physical, behavioral, and cognitive effects of prenatal tobacco and postnatal secondhand smoke exposure. Curr Probl Pediatr Adolesc Health Care 2014; 44:219-41. [PMID: 25106748 PMCID: PMC6876620 DOI: 10.1016/j.cppeds.2014.03.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/03/2014] [Accepted: 03/04/2014] [Indexed: 01/19/2023]
Abstract
The purpose of this review is to examine the rapidly expanding literature regarding the effects of prenatal tobacco and postnatal secondhand smoke (SHS) exposure on child health and development. Mechanisms of SHS exposure are reviewed, including critical periods during which exposure to tobacco products appears to be particularly harmful to the developing fetus and child. The biological, biochemical, and neurologic effects of the small fraction of identified components of SHS are described. Research describing these adverse effects of both in utero and childhood exposure is reviewed, including findings from both animal models and humans. The following adverse physical outcomes are discussed: sudden infant death syndrome, low birth weight, decreased head circumference, respiratory infections, otitis media, asthma, childhood cancer, hearing loss, dental caries, and the metabolic syndrome. In addition, the association between the following adverse cognitive and behavioral outcomes and such exposures is described: conduct disorder, attention-deficit/hyperactivity disorder, poor academic achievement, and cognitive impairment. The evidence supporting the adverse effects of SHS exposure is extensive yet rapidly expanding due to improving technology and increased awareness of this profound public health problem. The growing use of alternative tobacco products, such as hookahs (a.k.a. waterpipes), and the scant literature on possible effects from prenatal and secondhand smoke exposure from these products are also discussed. A review of the current knowledge of this important subject has implications for future research as well as public policy and clinical practice.
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Krstev S, Marinković J, Simić S, Kocev N, Bondy SJ. The influence of maternal smoking and exposure to residential ETS on pregnancy outcomes: a retrospective national study. Matern Child Health J 2014; 17:1591-8. [PMID: 23090285 DOI: 10.1007/s10995-012-1169-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In a nationwide study of Serbian births, in 2008, we estimated the influence of maternal prenatal smoking and environmental tobacco smoke (ETS) exposure on birth outcomes. Using stratified two-stage random cluster sampling, 2,721 women were interviewed in-person (response rates 98.1 %), and 2,613 singleton live births were included. Date of birth, gender, birthweight, birth height and head circumference were copied from the official hospital Birth Certificate. Six exposure categories were defined according to mother's smoking history and exposure to ETS. We calculated adjusted mean values and group differences by analysis of covariance, and adjusted odds ratios for the low birthweight (LBW < 2,500 g). Compared to the reference category (non-smoking, non-exposed to ETS) we observed birthweight reductions in infants whose mothers smoked continuously during the pregnancy and were exposed to ETS (-162.6 g) and whose mothers were not exposed to ETS (-173 g) (p = 0.000, and p = 0.003, respectively), as well as reduction in birth length (-1.01 and -1.06 cm; p = 0.003 and p = 0.000, respectively). Reduction in birthweight and birth length related to exposure categories was not linear. Adjusted OR for LBW was almost tripled for mothers who smoked over the entire pregnancy and were non-exposed to ETS (aOR 2.85; 95 % CI 1.46-5.08), and who were exposed to ETS (aOR 2.68; 95 % CI 1.15-6.25). Our results showed strong effects of smoking throughout the pregnancy on reduced birthweight, birth length and head circumference, and increased risk for LBW. We were not able to detect an effect for ETS exposure alone.
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Affiliation(s)
- Srmena Krstev
- Serbian Institute of Occupational Health "Dr. Dragomir Karajovic", Deligradska 29, 11 000, Belgrade, Serbia,
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Indoor exposure and adverse birth outcomes related to fetal growth, miscarriage and prematurity-a systematic review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:5904-33. [PMID: 24896737 PMCID: PMC4078555 DOI: 10.3390/ijerph110605904] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/19/2014] [Accepted: 05/21/2014] [Indexed: 11/24/2022]
Abstract
The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of MEDLINE and EMBASE databases with the aim of summarizing and evaluating the results of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed indoor air pollution and all-day personal exposure with specific quantitative methods. This comprehensive literature search identified 16 independent studies which were deemed relevant for further review and two additional studies were added through searching the reference lists of all included studies. Two reviewers independently and critically appraised all eligible articles using the Critical Appraisal Skills Programme (CASP) tool. Of the 18 selected studies, 14 adopted a prospective cohort design, three were case-controls and one was a retrospective cohort study. In terms of pollutants of interest, seven studies assessed exposure to electro-magnetic fields, four studies assessed exposure to polycyclic aromatic hydrocarbons, four studies assessed PM2.5 exposure and three studies assessed benzene, phthalates and noise exposure respectively. Furthermore, 12 studies examined infant growth as the main birth outcome of interest, six examined spontaneous abortion and three studies assessed gestational age at birth and preterm delivery. This survey demonstrates that there is insufficient research on the possible association of indoor exposure and early life effects and that further research is needed.
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Erlingsdottir A, Sigurdsson EL, Jonsson JS, Kristjansdottir H, Sigurdsson JA. Smoking during pregnancy: childbirth and health study in primary care in Iceland. Scand J Prim Health Care 2014; 32:11-6. [PMID: 24533844 PMCID: PMC4137896 DOI: 10.3109/02813432.2013.869409] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To study the prevalence and possible predictors for smoking during pregnancy in Iceland. DESIGN A cross-sectional study. SETTING Twenty-six primary health care centres in Iceland 2009-2010. SUBJECTS. Women attending antenatal care in the 11th-16th week of pregnancy were invited to participate by convenient consecutive manner, stratified according to residency. A total of 1111 women provided data in this first phase of the cohort study. MAIN OUTCOME MEASURES Smoking habits before and during early pregnancy were assessed with a postal questionnaire, which also included questions about socio-demographic background, physical and emotional well-being, and use of medications. RESULTS The prevalence of smoking prior to pregnancy was 20% (223/1111). During early pregnancy, it was 5% (53/1111). In comparison with women who stopped smoking during early pregnancy, those who continued to smoke had on average a significantly lower level of education, had smoked more cigarettes per day before pregnancy, and were more likely to use nicotine replacement therapy in addition to smoking during pregnancy. A higher number of cigarettes consumed per day before pregnancy and a lower level of education were the strongest predictors for continued smoking during pregnancy. CONCLUSION The majority of Icelandic women who smoke stop when they become pregnant, and the prevalence of smoking during pregnancy in Iceland is still about 5%. Our results indicate stronger nicotine dependence in women who do not stop smoking during pregnancy. Awareness of this can help general practitioners (GPs) and others providing antenatal care to approach these women with more insight and empathy, which might theoretically help them to quit.
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Affiliation(s)
- Asthildur Erlingsdottir
- Department of Family Medicine, University of Iceland, Gardabaer, Iceland
- Gardabaer Health Care Centre, Gardabaer, Iceland
| | - Emil L. Sigurdsson
- Department of Family Medicine, University of Iceland, Gardabaer, Iceland
- Solvangur Health Care Centre, Hafnarfjordur, Iceland
| | - Jon Steinar Jonsson
- Department of Family Medicine, University of Iceland, Gardabaer, Iceland
- Gardabaer Health Care Centre, Gardabaer, Iceland
| | - Hildur Kristjansdottir
- Department of Midwifery, Faculty of Nursing, University of Iceland
- Directorate of Health, Reykjavik, Iceland
| | - Johann A. Sigurdsson
- Department of Family Medicine, University of Iceland, Gardabaer, Iceland
- General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Suzuki K, Sato M, Zheng W, Shinohara R, Yokomichi H, Yamagata Z. Effect of maternal smoking cessation before and during early pregnancy on fetal and childhood growth. J Epidemiol 2013; 24:60-6. [PMID: 24335086 PMCID: PMC3872526 DOI: 10.2188/jea.je20130083] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Maternal smoking during pregnancy is a major cause of intrauterine growth restriction and childhood obesity, but only a few studies have examined the association of smoking cessation before and during pregnancy with fetal and childhood growth. We examined this association in a prospective cohort study in Japan. Methods Our study included children born between 1991 and 2006 and their mothers. Using a questionnaire, maternal smoking status was recorded at pregnancy. The anthropometric data of the children were collected during a medical check-up at age 3 years. Multiple linear and logistic regression models were used for data analysis stratified by sex. Results In total, 2663 mothers reported their smoking status during early pregnancy, and data were collected from 2230 (83.7%) children at age 3 years. Maternal smoking during pregnancy was associated with a significant reduction in birth weight (approximately 120–150 g). Body mass index at age 3 years was significantly higher among boys born to smoking mothers than among boys born to nonsmoking mothers. Maternal smoking during pregnancy was associated with overweight at age 3 years among boys (adjusted odds ratio, 2.4; 95% CI, 1.03–5.4). However, among women who stopped smoking in early pregnancy, there was no increase in the risks of a small for gestational age birth or childhood overweight at age 3 years. Conclusions Children born to mothers who stopped smoking before or during early pregnancy had appropriate fetal and childhood growth.
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Affiliation(s)
- Kohta Suzuki
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
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Wang CY, Li HT, Hsu CH, Lin YL, Kuo SC. The experiences of women who quit smoking during pregnancy and how they dealt with their spouses' continued smoking. Midwifery 2013; 30:e64-71. [PMID: 24290196 DOI: 10.1016/j.midw.2013.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 09/03/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE to explore how pregnant women in Taiwan dealt with their spouses who continued to smoke and with passive smoking during their own process of quitting and abstaining. DESIGN a qualitative study using an oral history approach. Data were collected via tape-recorded open-ended interviews. All interviews were transcribed verbatim. Data were analysed using narrative analysis. SETTING the homes of the participant women living in the district of a regional hospital of eastern Taiwan. PARTICIPANTS a purposive sample of 10 Taiwanese women who had quit smoking while pregnant was recruited at 1-3 months following the birth of their infants. FINDINGS five major themes emerged: (1) the women coping with tobacco addiction on their own, (2) creating a non-smoking section or environment at home, (3) dealing with passive smoking, (4) conflict over the wife's sensitivity to her spouse's residual tobacco smell, and (5) allowing the husband to continue smoking to avoid conflicts. KEY CONCLUSIONS the pregnant women were expected by their spouses to quit smoking, yet the husbands continued to smoke. Women had to struggle to quit smoking on their own. The findings from this study support the need to listen to pregnant women's stories, as this is paramount to understanding their experiences of tobacco-use reduction and cessation, and for developing gender appropriate interventions to support their efforts. IMPLICATIONS FOR PRACTICE health care providers should encourage and help pregnant women who are willing to quit smoking. This help could be more family-centred instead of focusing on the pregnant women alone, and therefore involve educating the spouse to support his wife.
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Affiliation(s)
- Chia Yin Wang
- Outpatient Department at Mennonite Christian Hospital, Hualien County, 44 Min-Chuan Road, Hualien 970, Taiwan.
| | - Hsin-Tzu Li
- Changhua Christian Hospital, Changhua County, 135 Nanxial St., Changhua 500, Taiwan.
| | - Chi-Ho Hsu
- Department of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Taipei 112, Taiwan.
| | - Yu-Lan Lin
- Taipei Veterans General Hospital, 201, Sec 2, Shipai Rd., Taipei 11217, Taiwan.
| | - Su-Chen Kuo
- College of Nursing, National Taipei University of Nursing and Health Sciences, No. 365 Ming-Te Road, Taipei 11219, Taiwan.
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Cornelius MD. People with schizophrenia are more likely to have a mother who smoked during pregnancy than people without the condition. Evid Based Nurs 2013; 17:80. [PMID: 24257911 DOI: 10.1136/eb-2013-101549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Marie D Cornelius
- Department of Psychiatry and Epidemiology, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Chamberlain C, O’Mara-Eves A, Oliver S, Caird JR, Perlen SM, Eades SJ, Thomas J. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2013; 10:CD001055. [PMID: 24154953 PMCID: PMC4022453 DOI: 10.1002/14651858.cd001055.pub4] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, stillbirth, low birthweight and preterm birth and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and increasing in low- to middle-income countries. OBJECTIVES To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. SEARCH METHODS In this fifth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2013), checked reference lists of retrieved studies and contacted trial authors to locate additional unpublished data. SELECTION CRITERIA Randomised controlled trials, cluster-randomised trials, randomised cross-over trials, and quasi-randomised controlled trials (with allocation by maternal birth date or hospital record number) of psychosocial smoking cessation interventions during pregnancy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, and subgroup analyses and sensitivity analysis were conducted in SPSS. MAIN RESULTS Eighty-six trials were included in this updated review, with 77 trials (involving over 29,000 women) providing data on smoking abstinence in late pregnancy.In separate comparisons, counselling interventions demonstrated a significant effect compared with usual care (27 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.75), and a borderline effect compared with less intensive interventions (16 studies; average RR 1.35, 95% CI 1.00 to 1.82). However, a significant effect was only seen in subsets where counselling was provided in conjunction with other strategies. It was unclear whether any type of counselling strategy is more effective than others (one study; RR 1.15, 95% CI 0.86 to 1.53). In studies comparing counselling and usual care (the largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy (eight studies; average RR 1.06, 95% CI 0.93 to 1.21). However, a clear effect was seen in smoking abstinence at zero to five months postpartum (10 studies; average RR 1.76, 95% CI 1.05 to 2.95), a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77), and a significant effect at 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), but not in the longer term. In other comparisons, the effect was not significantly different from the null effect for most secondary outcomes, but sample sizes were small.Incentive-based interventions had the largest effect size compared with a less intensive intervention (one study; RR 3.64, 95% CI 1.84 to 7.23) and an alternative intervention (one study; RR 4.05, 95% CI 1.48 to 11.11).Feedback interventions demonstrated a significant effect only when compared with usual care and provided in conjunction with other strategies, such as counselling (two studies; average RR 4.39, 95% CI 1.89 to 10.21), but the effect was unclear when compared with a less intensive intervention (two studies; average RR 1.19, 95% CI 0.45 to 3.12).The effect of health education was unclear when compared with usual care (three studies; average RR 1.51, 95% CI 0.64 to 3.59) or less intensive interventions (two studies; average RR 1.50, 95% CI 0.97 to 2.31).Social support interventions appeared effective when provided by peers (five studies; average RR 1.49, 95% CI 1.01 to 2.19), but the effect was unclear in a single trial of support provided by partners.The effects were mixed where the smoking interventions were provided as part of broader interventions to improve maternal health, rather than targeted smoking cessation interventions.Subgroup analyses on primary outcome for all studies showed the intensity of interventions and comparisons has increased over time, with higher intensity interventions more likely to have higher intensity comparisons. While there was no significant difference, trials where the comparison group received usual care had the largest pooled effect size (37 studies; average RR 1.34, 95% CI 1.25 to 1.44), with lower effect sizes when the comparison group received less intensive interventions (30 studies; average RR 1.20, 95% CI 1.08 to 1.31), or alternative interventions (two studies; average RR 1.26, 95% CI 0.98 to 1.53). More recent studies included in this update had a lower effect size (20 studies; average RR 1.26, 95% CI 1.00 to 1.59), I(2)= 3%, compared to those in the previous version of the review (50 studies; average RR 1.50, 95% CI 1.30 to 1.73). There were similar effect sizes in trials with biochemically validated smoking abstinence (49 studies; average RR 1.43, 95% CI 1.22 to 1.67) and those with self-reported abstinence (20 studies; average RR 1.48, 95% CI 1.17 to 1.87). There was no significant difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however the effect was unclear in three dissemination trials of counselling interventions where the focus on the intervention was at an organisational level (average RR 0.96, 95% CI 0.37 to 2.50). The pooled effects were similar in interventions provided for women with predominantly low socio-economic status (44 studies; average RR 1.41, 95% CI 1.19 to 1.66), compared to other women (26 studies; average RR 1.47, 95% CI 1.21 to 1.79); though the effect was unclear in interventions among women from ethnic minority groups (five studies; average RR 1.08, 95% CI 0.83 to 1.40) and aboriginal women (two studies; average RR 0.40, 95% CI 0.06 to 2.67). Importantly, pooled results demonstrated that women who received psychosocial interventions had an 18% reduction in preterm births (14 studies; average RR 0.82, 95% CI 0.70 to 0.96), and infants born with low birthweight (14 studies; average RR 0.82, 95% CI 0.71 to 0.94). There did not appear to be any adverse effects from the psychosocial interventions, and three studies measured an improvement in women's psychological wellbeing. AUTHORS' CONCLUSIONS Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy, and reduce low birthweight and preterm births.
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Affiliation(s)
- Catherine Chamberlain
- Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alison O’Mara-Eves
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Sandy Oliver
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Jenny R Caird
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Susan M Perlen
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Sandra J Eades
- School of Public Health, Sydney School of Medicine, University of Sydney, Sydney, Australia
| | - James Thomas
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
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Abstract
The connection between housing and health is well established. Physical, chemical, and biological aspects of the child's home, such as cleanliness, moisture, pests, noise, accessibility, injury risks, and other forms of housing environmental quality, all have the potential to influence multiple aspects of the health and development of children. Basic sanitation, reduced household crowding, other improvements in housing and expanded, and improved housing regulations have led to advances in children's health. For example, lead poisoning prevention policies have profoundly reduced childhood lead exposure in the United States. This and many other successes highlight the health benefits for families, particularly children, by targeting interventions that reduce or eliminate harmful exposures in the home. Additionally, parental mental health problems, food insecurity, domestic violence, and the presence of guns in children's homes all are largely experienced by children in their homes, which are not as yet considered part of the Healthy Homes agenda. There is a large movement and now a regulatory structure being put in place for healthy housing, which is becoming closely wedded with environmental health, public health, and the practice of pediatrics. The importance of homes in children's lives, history of healthy homes, asthma, and exposures to lead, carbon monoxide, secondhand/thirdhand smoke, radon, allergy triggers is discussed, as well as how changes in ambient temperature, increased humidity, poor ventilation, water quality, infectious diseases, housing structure, guns, electronic media, family structure, and domestic violence all affect children's health.
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Miyake Y, Tanaka K, Arakawa M. Active and passive maternal smoking during pregnancy and birth outcomes: the Kyushu Okinawa maternal and child health study. BMC Pregnancy Childbirth 2013; 13:157. [PMID: 23919433 PMCID: PMC3750375 DOI: 10.1186/1471-2393-13-157] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 07/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Western countries, active maternal smoking during pregnancy is recognized as the most important preventable risk factor for adverse birth outcomes. However, the effect of passive maternal smoking is less clear and has not been extensively studied. In Japan, there has been only one epidemiological study which examined the effects of active smoking during early pregnancy on birth outcomes although the effects of passive smoking were not assessed. METHODS Study subjects were 1565 mothers with singleton pregnancies and the babies born from these pregnancies. Data on active maternal smoking status in the first, second, and third trimesters and maternal environmental tobacco smoke (ETS) exposure at home and work were collected with self-administered questionnaires. RESULTS Compared with children born to mothers who had never smoked during pregnancy, children born to mothers who had smoked throughout their pregnancy had a significantly increased risk of small-for-gestational-age (SGA) (adjusted odd ratio [OR] = 2.87; 95% confidence interval: 1.11 - 6.56). However, active maternal smoking only in the first trimester and active maternal smoking in the second and/or third trimesters but not throughout pregnancy were not significantly associated with SGA. With regard to the risk of preterm birth, the adjusted ORs for the above-mentioned three categories were not significant; however, the positive linear trend was significant (P for trend = 0.048). No significant association was found between active maternal smoking during pregnancy and the risk of low birth weight. There was a significant inverse relationship between active maternal smoking during pregnancy and birth weight; newborns of mothers who had smoked throughout pregnancy had an adjusted mean birth weight reduction of 169.6 g. When classifying babies by gender, a significant positive association between active maternal smoking throughout pregnancy and the risk of SGA was found only in male newborns, however, the interaction was not significant. Maternal ETS exposure at home or work was not significantly associated with any birth outcomes. CONCLUSIONS This is the first study in Japan to show that active maternal smoking throughout pregnancy, but not during the first trimester, is significantly associated with an increased risk of SGA and a decrease in birth weight. Thus, women who smoke should quit smoking as soon as possible after conception.
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Feng J, Kramer MR, Dever BV, Dunlop AL, Williams B, Jain L. Maternal smoking during pregnancy and failure of the georgia first grade criterion-referenced competency test. Paediatr Perinat Epidemiol 2013; 27:275-82. [PMID: 23574416 DOI: 10.1111/ppe.12044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy (MSDP) has been reported to be associated with impaired measures of cognitive function, but it remains unclear whether exposure to MSDP has an impact upon offspring school performance. We examined the association between MSDP and failure of the Criterion-Referenced Competency Tests (CRCT) among Georgia first grade students. METHODS A retrospective cohort was created by deterministically linking 331 531 children born in Georgia from 1998 to 2002 (inclusive) to their individual CRCT education records from 2005 to 2009. We evaluated the association between MSDP (yes/no) and failure of the CRCT Reading, English/Language Arts (ELA), and Mathematics tests, with adjustment for maternal and child sociodemographic characteristics and birth outcomes. Log-binomial models estimated the risk ratios and 95% confidence intervals. Conditional models were fitted to paired sibling data. RESULTS MSDP was associated with CRCT failure with an adjusted risk ratios for Reading: 1.16 [95% CI 1.12, 1.21]; ELA: 1.12 [95%CI 1.10, 1.15]; and Mathematics: 1.13 [95%CI 1.10, 1.16]. The association remained significant in paired sibling analyses. CONCLUSIONS MSDP may have independent long-term effects on offspring school performance, which does not appear to be through smoking-related adverse birth outcomes.
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Affiliation(s)
- Jia Feng
- School of Public Health, Emory University, Atlanta, GA 30322, USA
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Benjamin-Garner R, Stotts A. Impact of smoking exposure change on infant birth weight among a cohort of women in a prenatal smoking cessation study. Nicotine Tob Res 2013; 15:685-92. [PMID: 22990216 PMCID: PMC3611991 DOI: 10.1093/ntr/nts184] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 07/03/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite the known harmful effects of smoking during pregnancy, the highly addicted find it difficult to quit. Decreased smoking may be regarded as a means of harm reduction. There is limited information on the benefits of smoking reduction short of quitting. This study used salivary cotinine to assess the impact of change in smoking exposure on birth weight in full-term infants. METHODS In a prenatal smoking cessation study, smoking status was validated by saliva cotinine at baseline and end of pregnancy (EOP). Salivary cotinine ≥15 ng/ml defined active smoking. Based on salivary cotinine, women were grouped as nonsmoking/quit, light exposure (<150 ng/ml), and heavy exposure (≥150 ng/ml) at baseline and EOP. EOP and baseline smoking status were stratified to form smoking exposure change groups. Mean birth weight was compared among those who quit, reduced, maintained, and increased. RESULTS Smoking cessation was associated with a 299 g increase in birth weight compared with sustained heavy smoking, p = .021. Reduced exposure from heavy to light was associated with a 199 g increase in birth weight compared with sustained heavy exposure, a 103 g increase compared with increased exposure, and a 63 g increase compared with sustained light exposure. Differences among continuing smokers were not statistically significant. CONCLUSIONS Although not statistically significant, the increase in infant birth weight associated with reduction from heavy to light exposure suggests potential for benefit. The only statistically significant comparison was between quitters and sustained heavy smokers, confirming that smoking cessation should remain the goal for pregnant women.
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Affiliation(s)
- Ruby Benjamin-Garner
- Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
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Vilahur N, Allin MPG, Walshe M, Nosarti C, Rifkin L, Murray RM, Rosa A. Ectodermal markers of early developmental impairment in very preterm individuals. Psychiatry Res 2012; 200:715-8. [PMID: 22963911 DOI: 10.1016/j.psychres.2012.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 06/01/2012] [Accepted: 07/19/2012] [Indexed: 10/27/2022]
Abstract
Individuals born very preterm (before 33 weeks' gestation; VPT) are at risk of life-long, neurological impairments, behavioural and other health problems. It is not clear whether these neurodevelomental abnormalities originate prenatally, postnatally or a combination of both. Dermatoglyphics are stable ectodermal markers of neurodevelopmental disruption in the early prenatal period, as it has previously been reported in neuropsychiatric disorders such as schizophrenia or bipolar disorder. We have analyzed the dermatoglyphic variable total a-b ridge count (TABRC), which is a sensitive marker of ectodermal disruption during the first 24 weeks of foetal development, in 142 very preterm (VPT) individuals and 64 term born young adults. The VPT group showed significantly lower TABRC than the term group, especially those individuals presenting very low birth weight (VLBW), considered a proxy for more extreme prenatal stress, as shown by a two-way Anova analysis. These individuals, at risk of brain abnormalities and behavioural impairments, may have undergone disturbances before preterm birth occurs and prior to the 24th week of gestation. Our results support that dermatoglyphics represent a suitable marker to detect ectodermal alterations which have occurred very early in the course of development, and point out the vulnerability of the immature brain during the first half of gestation which may have adverse health consequences later in life.
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Affiliation(s)
- Nadia Vilahur
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia, Universitat de Barcelona, 08028 Barcelona, Spain
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Abstract
AbstractMany women suffer from new or worsening anxiety during pregnancy. In this pilot study, we investigated the effect of timing and severity of prenatal state anxiety symptoms on reduced birth weight. We hypothesized that: (1) Women with state anxiety symptoms during mid-gestation would deliver newborns with lower birth weight in comparison to participants with symptoms in early gestation and (2) compared to women with lower anxiety symptoms (< 50th percentile), women with medium-to-high state anxiety symptoms (> 50th percentile) would have lower birth weight offspring. The sample consisted of the first 30 pregnant women who agreed to participate in this pilot study. We assessed anxiety symptoms, using the State-Trait Anxiety Inventory during early and mid-gestation. We obtained birth weight from clinical charts. A hierarchical multiple regression showed that, after controlling for covariates, state anxiety symptoms in mid-gestation were associated with lower infant birth weight [F(9, 7) = 20.30, p<.001]. However, birth weight did not differ as a function of the severity of maternal state anxiety [F(1, 23)=.14, p=.71 and F(1, 24)=1.76, p=.20., respectively]. Clearly, our pilot data need replication. Once statistical significance is established with larger samples, it will be informative to examine the clinical significance of those findings.
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Street drug use during pregnancy: potential programming effects on preschool wheeze. J Dev Orig Health Dis 2012; 4:191-9. [DOI: 10.1017/s2040174412000670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Street drug use during pregnancy is detrimental to fetal development. Although the prevalence of wheeze is high in offspring of substance-abusing mothers, nothing is known about the role of street drug use during pregnancy in its development. We investigated the impact of maternal street drug use and distress during pregnancy on the development of wheeze and allergy in preschool children. Questionnaire data were accessed from the Community Perinatal Care trial of 791 mother–child pairs in Calgary, Alberta. Using logistic regression, the association between maternal substance use and distress during pregnancy, and wheeze and allergy at age 3 years was determined in boys and girls. After adjusting for alcohol use during pregnancy, pre- and postnatal tobacco use, preterm birth, duration of exclusive breastfeeding, daycare attendance and maternal socioeconomic status, maternal street drug use during pregnancy [odds ratio (OR): 5.02, 95% confidence interval (CI): 1.30–19.4] and severe maternal distress during pregnancy (OR: 5.79, 95% CI: 1.25–26.8) were associated with wheeze in girls. In boys, an independent association was found between severe distress during pregnancy (OR: 3.85, 95% CI: 1.11–13.3) and allergies, but there was no association with maternal street drug use. In conclusion, we found an association between maternal street drug use and wheeze in preschool girls that could not be accounted for by maternal distress, smoking or alcohol use during pregnancy. Prenatal programming effects of street drugs may explain this association.
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Neighborhood safety as a correlate of tobacco use in a sample of urban, pregnant women. Addict Behav 2012; 37:1132-7. [PMID: 22688344 DOI: 10.1016/j.addbeh.2012.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/02/2012] [Accepted: 05/21/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Environmental context has been increasingly recognized as an important determinant of health behavior. This study examined the effects of self-reported neighborhood violence and perceived safety on tobacco use in a sample of low-income, pregnant women. METHODS Pregnant women (N=1521) being treated at an urban emergency room completed a baseline interview where neighborhood safety (self-reported neighborhood violence and perceived safety) as well as individual (demographics, depression symptoms, stress, tobacco use, substance abuse) and social variables (prenatal social environment and number of close friends) were evaluated cross-sectionally. Tobacco use was measured again in a telephone interview at 22 weeks gestation. RESULTS In a logistic regression model of baseline smoking status, self-reported neighborhood violence was significantly associated with being a smoker independent of age, education status, attendance to prenatal care, gestational age and lifetime use of cocaine and marijuana. In a regression model estimating the relationship between these baseline variables and continued prenatal smoking, baseline smoking emerged as the strongest correlate of continued smoking during pregnancy. CONCLUSIONS These findings suggest that self-reported neighborhood violence had a stronger association with early pregnancy cigarette use compared to ongoing cigarette use in a sample of low-income, pregnant women. Prospective trials are needed to fully elucidate the relationship between individual and social-environmental determinants of tobacco use in this high-risk population.
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Zaballa K, Liu A, Peek MJ, Mongelli M, Nanan R. Association between World Health Organization categories of body mass index and relative risks for weight-related pregnancy outcomes: a retrospective cohort study. Obstet Med 2012; 5:112-8. [PMID: 27582867 DOI: 10.1258/om.2012.110091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To analyse the dose-dependent effect of body mass index (BMI) categories for common pregnancy outcomes. METHODS A retrospective cohort study of all deliveries that occurred between 1 January 2005 and 31 December 2009 in a tertiary maternity centre, in Sydney Australia. Common pregnancy outcomes were analysed against World Health Organization (WHO) BMI categories using multiple logistic regression analysis. RESULTS From a total of 18,304 pregnancies, 9087 singleton pregnancies with complete data-sets were identified. Of these pregnancies, 4000 (44%) had a normal BMI, 470 (5.2%) were underweight, 2293 (25.2%) were overweight, 1316 (14.5%) were obese class I, 630 (6.9%) were obese class II and 378 (4.2%) were obese class III. Using the normal BMI category as the reference, there was a clear dose effect of BMI categories for hypertension (P < 0.001), pre-eclampsia (P < 0.001), caesarean section (P < 0.001), macrosomia (P < 0.001), large for gestational age (P < 0.001), small for gestational age (P < 0.001) and neonatal respiratory distress (P = 0.039). In contrast, despite a significant association with BMI (P < 0.001), a dose-dependent effect was not found for gestational diabetes. CONCLUSION The results of our study have important clinical significance as the data, using WHO BMI categories, more accurately help stratify risk assessment in a clinically relevant dose-dependent relationship.
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Affiliation(s)
| | | | - Michael John Peek
- Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medical School Nepean, The University of Sydney, Nepean Hospital Penrith , NSW 2751 , Australia
| | - Max Mongelli
- Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medical School Nepean, The University of Sydney, Nepean Hospital Penrith , NSW 2751 , Australia
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Maternal personality traits and risk of preterm birth and fetal growth restriction. Eur Psychiatry 2012; 28:213-8. [DOI: 10.1016/j.eurpsy.2011.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 10/26/2011] [Accepted: 11/11/2011] [Indexed: 11/17/2022] Open
Abstract
AbstractBackground/AimsMaternal personality may increase vulnerability to stress, which could lead to an unfavourable intrauterine environment to the fetus. We sought to investigate the impact of maternal personality traits on adverse birth outcomes such as preterm birth, and fetal growth restriction in the mother-child cohort study (RHEA Study) in Crete, Greece 2007–2009.MethodsFive hundred and eighty pregnant women participating in “Rhea” cohort study completed the Eysenck Personality Questionnaire-Revised (EPQ-R) at 28–32 weeks of gestation. Information on anthropometric measures at birth was obtained from the hospital delivery logs and medical records. Fetal growth restriction was based on a customized model, and multivariate logistic regression models were used adjusting for confounders.ResultsA per unit increase in the EPQ Neuroticism scale increased the risk for fetal weight growth restriction by 9% [Odds Ratio (OR) = 1.09, 95 percent CI: 1.01, 1.19)], and for fetal head circumference growth restriction by 6% [OR = 1.06, 95 percent CI: 1.01, 1.18] after adjusting for maternal age, education, origin, marital status, working status, pre-pregnancy BMI, delivery type, parity, smoking, and alcohol intake during pregnancy.ConclusionsMaternal neuroticism, which predisposes to negative mood, may be a risk factor for fetal growth restriction.
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Cents RAM, Tiemeier H, Velders FP, Jaddoe VWV, Hofman A, Verhulst FC, Lambregtse-van den Berg MP, Hudziak JJ. Maternal smoking during pregnancy and child emotional problems: the relevance of maternal and child 5-HTTLPR genotype. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:289-97. [PMID: 22259195 DOI: 10.1002/ajmg.b.32026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 01/03/2012] [Indexed: 11/09/2022]
Abstract
Serotonin is involved in the development of neural circuits modulating emotional behavior. The short allele (s) of a polymorphism (5-HTTLPR) of the serotonin transporter gene is a risk factor for psychopathology in the presence of environmental stressors. Maternal smoking is associated with growth restriction of the human fetal brain and adverse effects of nicotine on the developing serotonin system have been documented. We hypothesized that maternal smoking interacts with both child and mother 5-HTTLPR genotype as a risk factor for later child emotional problems. In a sample of n = 1,529 mother-child dyads, smoking habits were assessed by questionnaires during pregnancy. Child emotional problems were measured by the Child Behavior Checklist at the child's age of 3 years. Maternal smoking during pregnancy significantly increased the risk for emotional problems in children carrying the s-allele; β = 0.24, P = 0.03 (mother-report), and β = 0.46, P = 0.001 (father-report). In children heterozygous at 5-HTTLPR and exposed to maternal prenatal smoking (n = 79) risk of emotional problems increased with each additional s-allele the mother carried. The associations between 5-HTTLPR and child emotional problems were not moderated by paternal prenatal smoking. These findings imply that the vulnerability for emotional problems in s-allele carriers may already originate in fetal life.
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Affiliation(s)
- Rolieke A M Cents
- The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
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79
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Baba S, Wikström AK, Stephansson O, Cnattingius S. Influence of smoking and snuff cessation on risk of preterm birth. Eur J Epidemiol 2012; 27:297-304. [PMID: 22430122 DOI: 10.1007/s10654-012-9676-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 03/06/2012] [Indexed: 11/24/2022]
Abstract
The mechanisms by which antenatal smoking exposure increases the risk of preterm birth remain unknown. Swedish oral moist snuff contains quantities of nicotine comparable to those typically absorbed from cigarette smoking, but does not result in exposure to the products of combustion, for example carbon monoxide. In a nation-wide study of 776,836 live singleton births in Sweden from 1999 to 2009, the authors used multiple logistic regression models to examine associations between cessation of smoking and Swedish snuff use early in pregnancy and risk of preterm birth (before 37 weeks). Compared with non-tobacco users both before and in early pregnancy, the adjusted odds ratios (OR), 95% confidence interval (CI) were OR=0.92, 95% CI 0.84-1.01, for women who stopped using snuff, and OR=0.90, 95% CI 0.87-0.94, for women who stopped smoking. In contrast, continued snuff use and smoking were associated with increased risks of preterm birth (adjusted OR=1.29, 95% CI 1.17-1.43, adjusted OR=1.30, 95% CI 1.25-1.36, respectively). The snuff and smoking-related risks were, if anything, higher for very (before 32 weeks) than moderately (32-36 weeks) preterm birth, and also higher for spontaneous than induced preterm birth. These findings suggest that antenatal exposure to nicotine is involved in the mechanism by which tobacco use increase the risk of preterm birth.
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Affiliation(s)
- Sachiko Baba
- Department of Medicine, Karolinska Institutet, Clinical Epidemiology Unit, Solna, Stockholm, Sweden.
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80
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Geerts CC, Bots ML, van der Ent CK, Grobbee DE, Uiterwaal CSPM. Parental smoking and vascular damage in their 5-year-old children. Pediatrics 2012; 129:45-54. [PMID: 22201150 DOI: 10.1542/peds.2011-0249] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The relation between smoke exposure in early life, the prenatal period in particular, and the vascular development of young children is largely unknown. METHODS Data from the birth cohort participating in the WHISTLER-Cardio study were used to relate the smoking of parents during pregnancy to subsequent vascular properties in their children. In 259 participating children who turned 5 years of age, parental smoking data were updated and children's carotid artery intima-media thickness (CIMT) and arterial wall distensibility were measured by using ultrasonography. RESULTS Children of mothers who had smoked throughout pregnancy had 18.8 μm thicker CIMT (95% confidence interval [CI] 1.1, 36.5, P = .04) and 15% lower distensibility (95% CI -0.3, -0.02, P = .02) after adjustment for child's age, maternal age, gender, and breastfeeding. The associations were not found in children of mothers who had not smoked in pregnancy but had smoked thereafter. The associations were strongest if both parents had smoked during pregnancy, with 27.7 μm thicker CIMT (95% CI 0.2, 55.3) and 21% lower distensibility (95% CI -0.4, -0.03). CONCLUSION Exposure of children to parental tobacco smoke during pregnancy affects their arterial structure and function in early life.
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Affiliation(s)
- Caroline C Geerts
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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[The Fetal Tobacco Syndrome - A statement of the Austrian Societies for General- and Family Medicine (ÖGAM), Gynecology and Obstetrics (ÖGGG), Hygiene, Microbiology and Preventive Medicine (ÖGHMP), Pediatrics and Adolescence Medicine (ÖGKJ) as well as Pneumology (ÖGP)]. Wien Klin Wochenschr 2011; 124:129-45. [PMID: 22189489 DOI: 10.1007/s00508-011-0106-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 11/13/2011] [Indexed: 10/14/2022]
Abstract
Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborn's health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.
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Kritsotakis G, Vassilaki M, Chatzi L, Georgiou V, Philalithis AE, Kogevinas M, Koutis A. Maternal social capital and birth outcomes in the mother–child cohort in Crete, Greece (Rhea study). Soc Sci Med 2011; 73:1653-60. [DOI: 10.1016/j.socscimed.2011.09.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 07/28/2011] [Accepted: 09/20/2011] [Indexed: 11/26/2022]
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Lenz B, Müller CP, Stoessel C, Sperling W, Biermann T, Hillemacher T, Bleich S, Kornhuber J. Sex hormone activity in alcohol addiction: integrating organizational and activational effects. Prog Neurobiol 2011; 96:136-63. [PMID: 22115850 DOI: 10.1016/j.pneurobio.2011.11.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 11/03/2011] [Accepted: 11/08/2011] [Indexed: 01/06/2023]
Abstract
There are well-known sex differences in the epidemiology and etiopathology of alcohol dependence. Male gender is a crucial risk factor for the onset of alcohol addiction. A directly modifying role of testosterone in alcohol addiction-related behavior is well established. Sex hormones exert both permanent (organizational) and transient (activational) effects on the human brain. The sensitive period for these effects lasts throughout life. In this article, we present a novel early sex hormone activity model of alcohol addiction. We propose that early exposure to sex hormones triggers structural (organizational) neuroadaptations. These neuroadaptations affect cellular and behavioral responses to adult sex hormones, sensitize the brain's reward system to the reinforcing properties of alcohol and modulate alcohol addictive behavior later in life. This review outlines clinical findings related to the early sex hormone activity model of alcohol addiction (handedness, the second-to-fourth-finger length ratio, and the androgen receptor and aromatase) and includes clinical and preclinical literature regarding the activational effects of sex hormones in alcohol drinking behavior. Furthermore, we discuss the role of the hypothalamic-pituitary-adrenal and -gonadal axes and the opioid system in mediating the relationship between sex hormone activity and alcohol dependence. We conclude that a combination of exposure to sex hormones in utero and during early development contributes to the risk of alcohol addiction later in life. The early sex hormone activity model of alcohol addiction may prove to be a valuable tool in the development of preventive and therapeutic strategies.
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Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany.
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Chen H, Iglesias MA, Caruso V, Morris MJ. Maternal cigarette smoke exposure contributes to glucose intolerance and decreased brain insulin action in mice offspring independent of maternal diet. PLoS One 2011; 6:e27260. [PMID: 22076142 PMCID: PMC3208635 DOI: 10.1371/journal.pone.0027260] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Accepted: 10/12/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Maternal smoking leads to intrauterine undernutrition and is associated with low birthweight and higher risk of offspring obesity. Intrauterine smoke exposure (SE) may alter neuroendocrine mediators regulating energy homeostasis as chemicals in cigarette smoke can reach the fetus. Maternal high-fat diet (HFD) consumption causes fetal overnutrition; however, combined effects of HFD and SE are unknown. Thus we investigated the impact of combined maternal HFD and SE on adiposity and energy metabolism in offspring. METHOD Female Balb/c mice had SE (2 cigarettes/day, 5 days/week) or were sham exposed for 5 weeks before mating. Half of each group was fed HFD (33% fat) versus chow as control. The same treatment continued throughout gestation and lactation. Female offspring were fed chow after weaning and sacrificed at 12 weeks. RESULTS Birthweights were similar across maternal groups. Faster growth was evident in pups from SE and/or HFD dams before weaning. At 12 weeks, offspring from HFD-fed dams were significantly heavier than those from chow-fed dams (chow-sham 17.6±0.3 g; chow-SE 17.8±0.2 g; HFD-sham 18.7±0.3 g; HFD-SE 18.8±0.4 g, P<0.05 maternal diet effect); fat mass was significantly greater in offspring from chow+SE, HFD+SE and HFD+sham dams. Both maternal HFD and SE affected brain lactate transport. Glucose intolerance and impaired brain response to insulin were observed in SE offspring, and this was aggravated by maternal HFD consumption. CONCLUSION While maternal HFD led to increased body weight in offspring, maternal SE independently programmed adverse health outcomes in offspring. A smoke free environment and healthy diet during pregnancy is desirable to optimize offspring health.
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Affiliation(s)
- Hui Chen
- School of Medical and Molecular Bioscience, Faculty of Science, University of Technology, Sydney, Sydney, New South Wales, Australia.
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85
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Bizoń A, Milnerowicz-Nabzdyk E, Zalewska M, Zimmer M, Milnerowicz H. Changes in pro/antioxidant balance in smoking and non-smoking pregnant women with intrauterine growth restriction. Reprod Toxicol 2011; 32:360-7. [DOI: 10.1016/j.reprotox.2011.08.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 07/27/2011] [Accepted: 08/20/2011] [Indexed: 11/28/2022]
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Blalock JA, Nayak N, Wetter DW, Schreindorfer L, Minnix JA, Canul J, Cinciripini PM. The relationship of childhood trauma to nicotine dependence in pregnant smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2011; 25:652-63. [PMID: 21928869 DOI: 10.1037/a0025529] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pregnant women with high levels of nicotine dependence are the least likely to quit smoking spontaneously during pregnancy or to benefit from smoking cessation interventions. In the general population, there is increasing evidence of a relationship between smoking, nicotine dependence, and exposure to childhood trauma. We examined the relationship of childhood trauma to several measures of nicotine dependence and evaluated whether this relationship was mediated by major depressive disorder or depressive symptom severity in pregnant smokers. Moderate to extreme levels of childhood trauma were significantly related to smoking within 5 minutes or less of waking, and to the Behavioral Choice-Melioration, Negative Reinforcement, and Tolerance subscales of the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68) scale. The relationships between childhood emotional abuse and the WISDM-68 Total and Negative Reinforcement subscale were partially mediated by depressive symptoms. Results suggest that childhood trauma may be a risk factor underlying nicotine dependence in pregnant smokers. Increased understanding of the relationship of affect regulation to smoking in individuals with childhood trauma histories may aid in the development of more effective treatments of nicotine dependence for this population of smokers.
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Affiliation(s)
- Janice A Blalock
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX 77230-1439, USA.
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Albrecht S, Kelly‐Thomas K, Osborne JW, Ogbagaber S. The SUCCESS Program for Smoking Cessation for Pregnant Women. J Obstet Gynecol Neonatal Nurs 2011; 40:520-31. [DOI: 10.1111/j.1552-6909.2011.01280.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Mediterranean diet adherence during pregnancy and fetal growth: INMA (Spain) and RHEA (Greece) mother-child cohort studies. Br J Nutr 2011; 107:135-45. [PMID: 21733314 DOI: 10.1017/s0007114511002625] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Dietary intake of specific nutrients or food groups during pregnancy could influence fetal growth, but scant evidence is available on effects of dietary patterns. The aim of this study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on fetal growth in two population-based mother-child cohorts in Spain and Greece. We studied 2461 mother-newborn pairs from the Spanish multi-centre 'INMA' study (Atlantic area: INMA-Atlantic; Mediterranean area: INMA-Mediterranean), and 889 pairs from the 'RHEA' study in Crete, Greece. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Fetal growth restriction was based on a customised model, and multivariate log-binomial and linear regression models were used to adjust for several confounders. MD scores differ significantly between the cohorts with women in INMA-Atlantic reporting higher intakes of fish and dairy products, while women in the Mediterranean area reported higher intakes of cereals, vegetables and fruits. Women with high MD adherence had a significantly lower risk of delivering a fetal growth-restricted infant for weight (risk ratios: 0·5; 95 % CI 0·3, 0·9) in the INMA-Mediterranean cohort. Stratified analysis by smoking revealed that higher MD adherence increased birth weight and birth length in smoking mothers, whereas this effect was not apparent in non-smoking mothers. The results of the present study show that several types of MD exist across European Mediterranean regions. High MD adherence may modify the detrimental effect of smoking on birth size, but overall effects of diet were not universal for the studies in this analysis.
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Robinson CJ, Wagner CL, Hollis BW, Baatz JE, Johnson DD. Maternal vitamin D and fetal growth in early-onset severe preeclampsia. Am J Obstet Gynecol 2011; 204:556.e1-4. [PMID: 21507371 DOI: 10.1016/j.ajog.2011.03.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 02/13/2011] [Accepted: 03/09/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Recently, vitamin D deficiency has been associated with increased risks for preeclampsia and diagnosis of early-onset, severe preeclampsia (EOSPE). The purpose of this investigation was to examine the association between vitamin D levels and small-for-gestational age (SGA) in patients with EOSPE. STUDY DESIGN Patients with EOSPE were recruited, and demographics, outcomes, and plasma were collected. We assessed 25-hydroxyvitamin D (25[OH]D) by radioimmunoassay and reported our findings in nanograms per milliliter. Results were analyzed by Mann-Whitney U test and Spearman correlation and were reported as median (Q1-Q3). RESULTS In patients with EOSPE (n = 56), 25(OH)D was lower in patients with SGA (16.8 ng/mL; range, 8.9-23 ng/mL) vs normal fetal growth (25.3 ng/mL; range, 16-33 ng/mL; P = .02). 25(OH)D was correlated significantly with percentile growth at delivery (ρ = 0.31; P = .02). CONCLUSION Vitamin D is lower among patients with SGA in EOSPE than those without growth retardation. We suspect that vitamin D may impact fetal growth through placental mechanisms.
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Abstract
PURPOSE OF REVIEW Second-hand smoke (SHS) is a major cause of morbidity and mortality on a global scale. Governments have increasingly sought to mitigate the effects of SHS by introducing legislation that restricts tobacco consumption in public places. There is emerging evidence that such legislation leads to direct and indirect health benefits. RECENT FINDINGS Exposure to SHS is now shown to be associated with development of cardiovascular disease, and poorer health outcomes in patients with established chronic obstructive pulmonary disease. Childhood (including in-utero) exposure to SHS has recently been linked with increased risk of cleft palate, demonstrable signs of atherosclerosis, and the development of emphysema and lung cancer in adulthood. Comprehensive bans on smoking in public lead to a reduction in overall exposure to SHS for both adults and children and have also been shown to immediately attenuate the incidence of myocardial infarction and paediatric hospital attendances with acute asthma. SUMMARY Banning smoking in public places is an effective tool for reducing tobacco-related morbidity across a multiplicity of diseases. Countries that have not already done so should introduce legislation to enforce effective legislation that prohibits smoking in public places.
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Yang J, Xie RH, Krewski D, Wang YJ, Walker M, Wen SW. Exposure to trimethoprim/sulfamethoxazole but not other FDA category C and D anti-infectives is associated with increased risks of preterm birth and low birth weight. Int J Infect Dis 2011; 15:e336-41. [DOI: 10.1016/j.ijid.2011.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 01/18/2011] [Accepted: 01/22/2011] [Indexed: 10/18/2022] Open
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Vardavas CI, Patelarou E, Grandér M, Chatzi L, Palm B, Fthenou E, Roumeliotaki T, Koutis A, Kafatos A, Vrijheid M, Connolly GN, Murphy S, Vahter M, Kogevinas M. The association between active/passive smoking and toxic metals among pregnant women in Greece. Xenobiotica 2011; 41:456-63. [PMID: 21381896 DOI: 10.3109/00498254.2011.559294] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Exposure to toxic metals during pregnancy may have detrimental effects on foetal development. We assessed the role of sociodemographic characteristics and active and passive smoking on blood concentrations of metals (As, Cd, Pb, Hg, Sb, U, Mn and Mo). Venous blood drawn from 50 pregnant women, randomly selected from the mother-child birth cohort 'Rhea'. Extensive questionnaire data on active and passive smoking were collected. Urinary cotinine was measured to validate self-reported exposure and non-smoking status. Smokers had higher concentrations of Cd (1.0 µg/L) as compared with non-smokers (0.29 µg/L, P < 0.001) and a tendency for higher As and Hg. Among non-smokers, blood As and Hg concentrations were also associated with exposure to passive smoking in public venues and the family home and to overall greater secondhand smoke (SHS) exposure (As: 0.97µg/L among heavy-exposed compared with 0.20 µg/L among the low-exposed, P < 0.05; Hg: 2.1 µg/L vs. 0.9 µg/L respectively, P < 0.05). Controlling for fish and seafood intake altered the statistical significance but not the direction of the above associations. Smoking was associated with higher Cd concentrations in pregnant women, although the association between passive smoking and elevated As and Hg concentrations was indicative, however inconclusive.
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Affiliation(s)
- Constantine I Vardavas
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
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Current world literature. Curr Opin Pulm Med 2011; 17:126-30. [PMID: 21285709 DOI: 10.1097/mcp.0b013e3283440e26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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