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Huang C, Ren X, Xu B, Liu P, Li T, Zhu Q, Huang J, Chen X, Wu D, Yang X, Zhu F, Liu J. Urinary nicotine metabolites are associated with cognitive impairment among the elderly in southern China. Tob Induc Dis 2023; 21:123. [PMID: 37799805 PMCID: PMC10548790 DOI: 10.18332/tid/170423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION This study comprehensively assessed the association between eight metabolites of urinary nicotine and cognitive impairment. METHODS This cross-sectional study was based on the data of Shenzhen Aging Related Disorder Cohort (SADC), including 51 elderly community data variables such as demographic characteristics, neuropsychological assessment and environmental factors, from July 2017 to November 2018. Participant's cognitive function was assessed by Mini-Mental State Examination (MMSE) scale and urinary nicotine metabolite [including cotinine N-β-D-glucuronide (CotGluc), rac 4-hydroxy-4-(3-pyridyl) butanoic acid dicyclohexylamine salt (HyPyBut), trans-3'-hydroxy cotinine O-β-D-glucuronide (OHCotGluc), and cotinine (Cot), etc.] concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Generalized linear models and restricted cubic spline models were used to explore the relationships between the urinary levels of nicotine metabolite and cognitive function. RESULTS A total of 296 individuals aged >60 years were included. Individuals in the third quartile of CotGluc had a 0.786 point (95% CI: -1.244 - -0.329) decrease or in the highest quartile of OHCotGluc had a 0.804 point (95% CI: -1.330 - -0.278) decreased in attention and calculation compared to those in the lowest quartile (all p for trend <0.05). Compared with those in the lowest quartile, individuals in the highest quartile of CotGluc, HyPyBut, OHCotGluc and Cot, respectively, corresponded to a 1.043 point (95% CI: -2.269-0.182), 1.101 points (95% CI: -2.391-0.188), 2.318 points (95% CI: -3.615 - -1.020), and 1.460 points (95% CI: -2.726 - -0.194) decreased in MMSE total score (all p for trend <0.05). A non-linear dose-response relationship between urinary levels of CotGluc, HyPyBut, OHCotGluc or Cot and cognitive function (all overall p<0.05, non-linear p<0.05). Subgroup analysis showed that urinary levels of CotGluc, OHCotGluc or Cot were significantly negatively associated with cognitive function (all p for trend <0.05) among females and non-smokers. CONCLUSIONS The findings highlight the public health implications of environmental tobacco smoke exposure, and effective interventions need to be performed for vulnerable populations.
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Affiliation(s)
- Chao Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiaohu Ren
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Benhong Xu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Peiyi Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Tian Li
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Qinqin Zhu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Jia Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiao Chen
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Desheng Wu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xifei Yang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, People’s Republic of China
| | - Jianjun Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
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Grippo A, Zhu K, Yeung EH, Bell EM, Bonner MR, Tian L, Mendola P, Mu L. Indoor air pollution exposure and early childhood development in the Upstate KIDS Study. ENVIRONMENTAL RESEARCH 2023; 234:116528. [PMID: 37419197 PMCID: PMC11365522 DOI: 10.1016/j.envres.2023.116528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Limited human studies have investigated the impact of indoor air pollution on early childhood neurodevelopment among the US population. We aimed to examine the associations between prenatal and postnatal indoor air pollution exposure and early childhood development in a population-based birth cohort. METHODS This analysis included 4735 mother-child pairs enrolled between 2008 and 2010 in the Upstate KIDS Study. Indoor air pollution exposure from cooking fuels, heating fuels, and passive smoke during pregnancy, and at 12 and 36 months after birth were assessed by questionnaires. Five domains of child development were assessed by the Ages and Stages Questionnaire at 4, 8, 12, 18, 24, 30, and 36 months. Generalized estimating equations were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS Exposure to unclean cooking fuels (natural gas, propane, or wood) throughout the study period was associated with increased odds of failing any development domain (OR = 1.28, 95% CI 1.07, 1.53), the gross motor domain (OR = 1.52, 95% CI: 1.09, 2.13), and the personal-social domain (OR = 1.36, 95% CI: 1.00, 1.85), respectively. Passive smoke exposure throughout the study period increased the odds of failing the problem-solving domain by 71% (OR = 1.71, 95% CI 1.01, 2.91) among children of non-smoking mothers. No association was found between heating fuel use and failing any or specific domains. CONCLUSION Unclean cooking fuel use and passive smoke exposure during pregnancy and early life were associated with developmental delays in this large prospective birth cohort.
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Affiliation(s)
- Alexandra Grippo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Edwina H Yeung
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Erin M Bell
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Matthew R Bonner
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lili Tian
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Zhang Y, Wan Y, Liu H, Qian X, Ma J, Xu S, Xia W, Li Y. Low level of urinary cotinine in pregnant women also matters: variability, exposure characteristics, and association with oxidative stress markers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27624-8. [PMID: 37328725 DOI: 10.1007/s11356-023-27624-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/10/2023] [Indexed: 06/18/2023]
Abstract
China has relatively high indoor contamination of nicotine, according to recent publications. Therefore, nicotine exposure risks for sensitive populations such as pregnant women in China are of concern. The variability of its internal exposure levels across three trimesters among pregnant women is not well documented. Factors related with nicotine exposure across pregnancy and its associations with oxidative stress markers are also understudied. Based on a birth cohort, we measured concentrations of cotinine (a major metabolite of nicotine) and oxidative stress markers including 8-OHdG, 8-OHG, and HNE-MA in urine samples collected at three trimesters from 1,155 pregnant women enrolled between January 2014 and June 2017 in Wuhan, China. The variability of urinary cotinine across the trimesters, potential factors associated with it, as well as the relationships between urinary cotinine and oxidative stress markers were assessed in pregnant women with cotinine concentrations of < 50 ng/mL (the cutoff value to distinguish smokers and non-smokers). Urinary specific gravity adjusted median concentrations of cotinine (ng/mL) in the entire pregnancy, first, second, and third trimester were 3.04, 3.32, 3.36, and 2.50, respectively, which exhibited fair reliability (intraclass correlation coefficient: 0.47) across pregnancy. Most participants had an estimated daily intake of nicotine higher than the acceptable value (100 ng/kg-bw/day) recommended by the UK and the USA. Maternal age, education level, pre-pregnancy body mass index, and sampling seasons were related to urinary concentrations of cotinine. After adjusting for confounding factors, significant positive relationships (β; 95% confidence interval) were observed between urinary cotinine concentrations and 8-OHdG (0.28; 0.25, 0.30), 8-OHG (0.27; 0.25, 0.29), and HNE-MA (0.27; 0.21, 0.32), respectively (p < 0.01). These results lend insight into the major factors associated with nicotine exposure of pregnant women at environmentally relevant levels and its potential effect on oxidative stress with a large sample size, and warrant the necessity of reducing the exposure in sensitive populations.
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Affiliation(s)
- Yiqiong Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Prevention & Control, Wuhan, Hubei, 430024, People's Republic of China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xi Qian
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Jiaolong Ma
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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Switching from tobacco cigarettes in very early pregnancy: The effects of in utero e-cigarette exposure on mouse offspring neurodevelopment and behaviour. Physiol Behav 2023; 263:114118. [PMID: 36796533 DOI: 10.1016/j.physbeh.2023.114118] [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: 10/28/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are often perceived to be safer than smoking, which has led to some women switching to e-cigarettes during pregnancy. However, the effects of switching from smoking to e-cigarettes on both pregnancy outcomes and the foetus are largely unknown. This study aimed to investigate the effects of switching from tobacco smoking to e-cigarette use in very early pregnancy on birth outcomes, neurodevelopment and behaviour of the offspring. METHODS Female BALB/c mice were exposed to cigarette smoke for up to two weeks before being mated. Mated dams were then allocated to one of four treatment groups: (i) continued exposure to cigarette smoke (ii) exposure to e-cigarette aerosol with nicotine, (iii) or without nicotine, or (iv) medical air. Pregnant mice were exposed for 2 h per day for the duration of pregnancy. Gestational outcomes including litter size and sex ratio were assessed, in addition to early-life markers of physical- and neuro- development. At 8 weeks of age, motor coordination, anxiety, locomotion, memory and learning of the adult offspring were assessed. RESULTS Gestational outcomes and early markers of physical- and neuro- development were unaffected by in utero exposure, as well as locomotion, anxiety-like behaviour, and object recognition memory during adulthood. However, both e-cigarette groups displayed increased spatial recognition memory compared to air exposed controls. Maternal exposure to nicotine containing e-cigarette aerosol was found to increase offspring bodyweight and impair motor skill learning. CONCLUSIONS These results suggest there may be some benefits as well as negative effects of switching to e-cigarettes in early pregnancy.
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Zoia S, Biancotto M, Caravale B, Valletti A, Montelisciani L, Croci I, Voller F, Rusconi F, Carrozzi M, Chiandotto V, Di Lallo D, Vicari S, Cuttini M. Early factors associated with risk of developmental coordination disorder in very preterm children: A prospective area-based cohort study in Italy. Paediatr Perinat Epidemiol 2022; 36:683-695. [PMID: 35437802 PMCID: PMC9546412 DOI: 10.1111/ppe.12878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Developmental coordination disorder (DCD) is a motor disorder of unknown aetiology that may have long-term consequences on daily activities, and psychological and physical health. Studies investigating risk factors for DCD have so far provided inconsistent results. OBJECTIVES To assess, using a parent-report screening tool, risk of DCD in school-age very preterm children born in Italy, and investigate the associated early biomedical and sociodemographic factors. METHODS A prospective area-based cohort (804 children, response rate 73.4%) was assessed at 8-11 years of age in three Italian regions. Perinatal data were abstracted from medical records. DCD risk was measured using the Italian-validated version of the Developmental Coordination Disorder Questionnaire (DCDQ-IT). For this study, children with cognitive deficit (i.e. intelligence quotient <70), cerebral palsy, severe vision and hearing disabilities, and other impairments affecting movement were excluded. A total of 629 children were analysed. We used inverse probability weighting to account for loss to follow-up, and multilevel, multivariable modified Poisson models to obtain adjusted risk ratio (aRR) and 95% confidence interval (CI). Missing values in the covariates were imputed. RESULTS 195 children (weighted proportion 31.8%, 95% CI 28.2, 35.6) scored positive on the DCDQ-IT, corresponding to the 15th centile of the reference Movement-ABC test. Factors associated with overall DCD risk were male sex (aRR 1.35, 95% CI 1.05, 1.73), intrauterine growth restriction (aRR 1.45, 95% CI 1.14, 1.85), retinopathy of prematurity (aRR 1.62, 95% CI 1.07, 2.45), and older maternal age at delivery (aRR 1.39, 95% CI 1.09, 1.77). Complete maternal milk feeding at discharge from the neonatal unit and higher parental socio-economic status were associated with decreased risk. CONCLUSIONS Both biomedical and sociodemographic factors increase DCD risk. These findings can contribute to elucidating the origins of this disorder, and assist in the identification of children at risk for early referral and intervention.
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Affiliation(s)
- Stefania Zoia
- Struttura Complessa Tutela Salute Bambini Adolescenti Donne FamigliaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Marina Biancotto
- Struttura Complessa Tutela Salute Bambini Adolescenti Donne FamigliaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Barbara Caravale
- Department of Developmental and Social PsychologyLa Sapienza UniversityRomeItaly
| | - Alessandra Valletti
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Laura Montelisciani
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Ileana Croci
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Fabio Voller
- Unit of EpidemiologyRegional Health Agency of TuscanyFlorenceItaly
| | - Franca Rusconi
- Unit of EpidemiologyMeyer Children's University HospitalFlorenceItaly,Present address:
Department of Mother and Child HealthAzienda USL Toscana Nord OvestPisaItaly
| | - Marco Carrozzi
- Department of NeuroscienceBurlo Garofolo Maternal and Child Health HospitalIRCCSTriesteItaly
| | - Valeria Chiandotto
- Neonatal Intensive Care Unit, S. Maria della Misericordia University HospitalUdineItaly
| | - Domenico Di Lallo
- Hospital Network Planning and Research AreaLazio Regional Health AuthorityRomeItaly
| | - Stefano Vicari
- Department of Life Sciences and Public HealthCatholic University, and Department of NeuroscienceChild & Adolescent Psychiatry UnitBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Marina Cuttini
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
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Villalobos-García D, Ali HEA, Alarabi AB, El-Halawany MS, Alshbool FZ, Khasawneh FT. Exposure of Mice to Thirdhand Smoke Modulates In Vitro and In Vivo Platelet Responses. Int J Mol Sci 2022; 23:ijms23105595. [PMID: 35628405 PMCID: PMC9144272 DOI: 10.3390/ijms23105595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Smoking is a risk factor for a variety of deleterious conditions, such as cancer, respiratory disease and cardiovascular disease. Thrombosis is an important and common aspect of several cardiovascular disease states, whose risk is known to be increased by both first- and secondhand smoke. More recently, the residual cigarette smoke that persists after someone has smoked (referred to as thirdhand smoke or THS) has been gaining more attention, since it has been shown that it also negatively affects health. Indeed, we have previously shown that 6-month exposure to THS increases the risk of thrombogenesis. However, neither the time-dependence of THS-induced thrombus formation, nor its sex dependence have been investigated. Thus, in the present study, we investigated these issues in the context of a shorter exposure to THS, specifically 3 months, in male and female mice. We show that the platelets from 3-month THS-exposed mice exhibited enhanced activation by agonists. Moreover, we also show that mice of both sexes exposed to THS have decreased tail bleeding as well as decreased thrombus occlusion time. In terms of the role of sex, intersex disparities in thrombus development and hemostasis as well as in platelet aggregation were, interestingly, observed. Together, our findings show that exposing mice to THS for 3 months is sufficient to predispose them to thrombosis; which seems to be driven, at least in part, by an increased activity in platelets, and that it does not manifest equally in both sexes.
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Affiliation(s)
- Daniel Villalobos-García
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Hamdy E. A. Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Ahmed B. Alarabi
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (A.B.A.); (F.Z.A.)
| | - Medhat S. El-Halawany
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Fatima Z. Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (A.B.A.); (F.Z.A.)
| | - Fadi T. Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
- Correspondence: ; Tel.: +1-361-221-0755
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Wei CF, Lin CC, Tsai MS, Guo YL, Lin SJ, Liao HF, Hsieh WS, Chen MH, Chen PC. Associations Between Infant Developmental Delays and Secondhand Smoke Exposure Modified by Maternal Prepregnancy Overweight and Obesity Status. Nicotine Tob Res 2021; 23:1475-1483. [PMID: 33556174 DOI: 10.1093/ntr/ntab024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/03/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Secondhand smoke exposure during pregnancy has long been associated with adverse health outcomes in children, but only a few studies have examined its effect modifiers. In this study, we applied effect modification analysis for maternal prepregnancy weight status on detrimental neurodevelopmental effect of secondhand smoke exposure during pregnancy and infancy in a nationwide representative population. AIMS AND METHODS Term singleton mother-infant pairs with nonsmoking mothers were included for main analysis (N = 15 987) from the Taiwan Birth Cohort Study (TBCS), and were further matched with propensity score (n = 5434). We extracted secondhand smoke exposure during pregnancy and infancy, and eight neurodevelopmental milestones from the responses in the baseline visit at 6 months, and 18-month follow-up of TBCS. The associations between secondhand smoke exposure and neurodevelopmental achievement were analyzed with multivariable logistic regression and Cox model. Propensity score weighting and matching were applied for high-versus-low analysis, and relative excess risk due to interaction were used to estimate effect modification. RESULTS Higher secondhand smoke exposure was associated with increased likelihood of delayed milestone achievement across gross motor, fine motor, language-related, and social-related domains. The associations in fine motor domains remained observable in propensity score-weighted and -matched models. We identified additive interaction with self-reported maternal overweight and obesity status before pregnancy in milestone development for walking with support, scribbling, and waving goodbye. CONCLUSIONS Secondhand smoke exposure during pregnancy and infancy were associated with delayed neurodevelopmental milestone achievement at 18 months, and the associations were modified by maternal prepregnancy overweight and obesity status. IMPLICATIONS The study results suggested the association between maternal secondhand smoke exposure during pregnancy and infancy and delayed fine motor and language-related milestone achievement at 18 months in multivariable, propensity score weighting, and matching populations. The results of positive effect modifications for maternal prepregnancy overweight and obesity status suggested the importance of concurrent interventions on smoke-free environment and maternal health during pregnancy.
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Affiliation(s)
- Chih-Fu Wei
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Ching-Chun Lin
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Meng-Shan Tsai
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yueliang Leon Guo
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hua-Fang Liao
- School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.,Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Mei-Huei Chen
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan.,Innovation and Policy Center for Population Health and Sustainable Environment, National Taiwan University College of Public Health, Taipei, Taiwan
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Venkatesh KK, Leviton A, Fichorova RN, Joseph RM, Douglass LM, Frazier JA, Kuban K, Santos HP, Fry RC, O'Shea TM. Prenatal tobacco smoke exposure and neurological impairment at 10 years of age among children born extremely preterm: a prospective cohort. BJOG 2021; 128:1586-1597. [PMID: 33682301 DOI: 10.1111/1471-0528.16690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the association between prenatal tobacco smoke exposure and neurological impairment at 10 years of age among children born extremely preterm (<28 weeks of gestation). DESIGN The Extremely Low Gestational Age Newborn (ELGAN) Study, a prospective cohort. SETTING Ten-year follow-up of extremely preterm infants born at 14 US hospitals between 2002 and 2004. METHODS Prenatal tobacco smoke exposure was defined as a mother's report at enrolment of active (i.e. maternal) and passive smoking during pregnancy. Poisson regression with generalized estimating equations was used. Models adjusted for mother's age, race/ethnicity, education, insurance, pre-pregnancy body mass index, US region, multiple gestation and infant's sex; and in sensitivity analysis, gestational age at delivery and clinical subtype of preterm birth, given their classification as intermediate and non-confounding variables. MAIN OUTCOMES Neurological impairment at 10 years, epilepsy, cerebral palsy and cognitive impairment. RESULTS Of 1200 ELGAN study survivors, 856 were assessed at 10 years of age with neurological outcomes, of whom 14% (118/856) had active tobacco exposure during pregnancy and 24% (207/852) had passive tobacco exposure. Compared with children who were not exposed prenatally to tobacco, children exposed to active tobacco use during pregnancy had a higher risk of epilepsy (14% versus 5%; adjusted relative risk: 1.68, 95% CI 1.45-1.92). This risk remained after adjustment for gestational age at delivery and clinical subtype of preterm birth. Prenatal tobacco smoke exposure was not associated with other assessed neurological outcomes, including cerebral palsy and multiple measures of cognitive impairment. CONCLUSIONS Among children born extremely preterm, prenatal active tobacco smoke exposure was associated with an increased risk of epilepsy at 10 years of life. TWEETABLE ABSTRACT Among infants born before 28 weeks of gestation, prenatal active tobacco smoke exposure was associated with an increased risk of epilepsy at 10 years of life.
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Affiliation(s)
- K K Venkatesh
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA
| | - A Leviton
- Department of Neurology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - R N Fichorova
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R M Joseph
- Department of Anatomy & Neurobiology, Boston University, Boston, MA, USA
| | - L M Douglass
- Department of Pediatrics, Boston University, Boston, MA, USA
| | - J A Frazier
- Department of Psychiatry, University of Massachusetts Medical School, Worchester, MA, USA
| | - Kck Kuban
- Department of Pediatrics, Boston University, Boston, MA, USA
| | - H P Santos
- Biovehavioral Laboratory, School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - T M O'Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
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9
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Kaarid KP, Vu N, Bartlett K, Patel T, Sharma S, Honor RD, Shea AK. Assessing the prevalence and correlates of prenatal cannabis consumption in an urban Canadian population: a cross-sectional survey. CMAJ Open 2021; 9:E703-E710. [PMID: 34162662 PMCID: PMC8248560 DOI: 10.9778/cmajo.20200181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recreational cannabis use was legalized in Canada in October 2018. We aimed to determine the prevalence and correlates of cannabis consumption among pregnant individuals in a single Canadian city following national legalization. METHODS Over the period May to October 2019, we distributed an anonymous cross-sectional survey to pregnant patients attending family practice, midwifery, and low-risk and high-risk obstetrics clinics in Hamilton, Ontario. Eligibility was based on English literacy and current pregnancy. The survey included questions regarding lifetime and in-pregnancy cannabis use, intent for postpartum use and patterns of use. We also collected demographic information. We calculated descriptive statistics and performed logistic regression analyses to explore the relations between cannabis consumption and demographic characteristics. RESULTS Of 531 pregnant individuals approached, 478 agreed and were able to participate, for a 90% participation rate. Among these 478 respondents, 54 (11%) reported consuming cannabis at some point during the pregnancy and 20 (4%) reported currently consuming cannabis. Among the 460 respondents who intended to breastfeed, 23 (5%) planned to consume cannabis during the postpartum period. Of 20 current users, 13 (65%) reported consuming cannabis at least weekly and 19 (95%) reported nausea, sleep problems or anxiety as reasons for use. Respondents without postsecondary education had 10.0-fold (95% confidence interval [CI] 4.6-23.5) greater odds of prenatal cannabis consumption than university-educated respondents. In addition, respondents who reported that their partners used cannabis had 3.9-fold (95% CI 2.2-7.3) greater odds of prenatal cannabis consumption than those who reported that their partners did not use cannabis. INTERPRETATION Lower educational attainment and partners' cannabis consumption were associated with greater odds of inpregnancy cannabis use. These results may help to inform early intervention strategies to decrease cannabis consumption during this vulnerable period of fetal and neonatal development.
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Affiliation(s)
- Kaija P Kaarid
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Nancy Vu
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Katelyn Bartlett
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Tejal Patel
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Sapna Sharma
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Richard D Honor
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont
| | - Alison K Shea
- Department of Obstetrics and Gynecology (Kaarid, Vu, Bartlett, Patel, Sharma, Shea), McMaster University, Hamilton, Ont.; Department of Biology (Honor), Queen's University, Kingston, Ont.
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10
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Suyama S, Yagyu K, Araki A, Miyashita C, Itoh S, Minatoya M, Yamazaki K, Tamura N, Nakai A, Saito T, Kishi R. Risk factors for motor coordination problems in preschool-age children. Pediatr Int 2020; 62:1177-1183. [PMID: 32353913 DOI: 10.1111/ped.14275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/14/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Motor coordination problems (MCP) in children can sometimes be diagnosed as developmental coordination disorder. Early intervention for developmental coordination disorder is necessary because it often continues into adolescence, causing mental and physical complications. Few studies have investigated the prevalence of childhood MCP in the Japanese population, examining the risk factors for MCP. We therefore investigated the prenatal factors associated with MCP in preschool-age children. METHODS This study was based on a prospective cohort study, the Hokkaido Study on Environment and Children's Health. Mothers of 4,851 children who reached the age of 5 years within the study-period received questionnaires, including the Japanese version of the Developmental Coordination Disorder Questionnaire (DCDQ-J). We examined the risk factors associated with MCP using logistic regression analysis. RESULTS Of 3,402 returned DCDQ-J questionnaires, 3,369 were answered completely. From the 3,369 children, we categorized having MCP by using two cut-off scores: that of the DCDQ'07 and the cut-off at the 5th percentile of a total DCDQ-J score. Comparing children with and without MCP, we found significant differences in the education level of the mothers, annual household income during pregnancy, maternal alcohol consumption and smoking during pregnancy, and sex and age of the children at the time of completing the DCDQ-J by both categorizations. Adjusted logistic regression analysis revealed that maternal smoking during the first trimester of pregnancy and male sex were significantly associated with MCP. CONCLUSIONS Our results suggest that maternal smoking during pregnancy is the main factor associated with MCP in preschool-age children.
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Affiliation(s)
- Satoshi Suyama
- Funded Research Division of Child and Adolescent Psychiatry, Hokkaido University Hospital, Sapporo, Japan
| | - Kazuyori Yagyu
- Funded Research Division of Child and Adolescent Psychiatry, Hokkaido University Hospital, Sapporo, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.,Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.,Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tachikawa, Japan
| | - Akio Nakai
- Graduate School of Clinical Education & The Center for the Study of Child Development, Institute for Education, Mukogawa Women's University, Nishinomiya, Japan
| | - Takuya Saito
- Funded Research Division of Child and Adolescent Psychiatry, Hokkaido University Hospital, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
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11
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Moore BF, Shapiro AL, Wilkening G, Magzamen S, Starling AP, Allshouse WB, Adgate JL, Dabelea D. Prenatal Exposure to Tobacco and Offspring Neurocognitive Development in the Healthy Start Study. J Pediatr 2020; 218:28-34.e2. [PMID: 31759580 PMCID: PMC7042047 DOI: 10.1016/j.jpeds.2019.10.056] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/23/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore the associations between prenatal exposure to tobacco and neurocognitive development, in the absence of prematurity or low birth weight. STUDY DESIGN We followed mother-child pairs within Healthy Start through 6 years of age. Children were born at ≥37 weeks of gestation with a birth weight of ≥2500 g. Parents completed the Third Edition Ages and Stages Questionnaire (n = 246) and children completed a subset of the National Institutes of Health Toolbox Cognition Battery (n = 200). The Ages and Stages Questionnaire domains were dichotomized as fail/monitor and pass. Maternal urinary cotinine was measured at approximately 27 weeks of gestation. Separate logistic regression models estimated associations between prenatal exposure to tobacco (cotinine below vs above the limit of detection) and the Ages and Stages Questionnaire domains. Separate linear regression models estimated associations between prenatal exposure to tobacco and fully corrected T-scores for inhibitory control, cognitive flexibility, and receptive language, as assessed by the National Institutes of Health Toolbox. A priori covariates included sex, maternal age, maternal education, daily caloric intake during pregnancy, race/ethnicity, household income, maternal psychiatric disorders, and, in secondary models, postnatal exposure to tobacco. RESULTS Compared with unexposed offspring, exposed offspring were more likely to receive a fail/monitor score for fine motor skills (OR, 3.9; 95% CI, 1.5-10.3) and decreased inhibitory control (B: -3.0; 95% CI, -6.1 to -0.7). After adjusting for postnatal exposure, only the association with fine motor skills persisted. CONCLUSIONS Prenatal and postnatal exposures to tobacco may influence neurocognitive development, in the absence of preterm delivery or low birth weight. Increased developmental screening may be warranted for exposed children.
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Affiliation(s)
- Brianna F. Moore
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora CO, USA
| | - Allison L. Shapiro
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO, USA
| | - Greta Wilkening
- Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora CO, USA
| | - William B. Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora CO, USA
| | - John L. Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora CO, USA,Department of Pediatrics, University of Colorado School of Medicine, Aurora CO, USA
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12
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Delgado DA, Michelon RC, Gerzson LR, Almeida CSD, Alexandre MDG. Avaliação do desenvolvimento motor infantil e sua associação com a vulnerabilidade social. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/18047027012020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar o desenvolvimento motor de crianças de quatro a 17 meses e investigar sua associação com fatores de risco sociodemográficos. Estudo transversal, descritivo, composto por crianças de quatro a 17 meses provenientes da unidade de internação pediátrica de um hospital público de Porto Alegre (RS), clinicamente estáveis e com alta breve prevista. Para a avaliação dos fatores de risco sociodemográficos foi utilizado um questionário elaborado pelas pesquisadoras, que abordou fatores biológicos, sociais e ambientais. Para a avaliação do desenvolvimento motor foi utilizada a Alberta Infant Motor Scale na versão traduzida, adaptada e validada para a população brasileira. Para a análise estatística foi utilizado o teste t de Student e o teste qui-quadrado, com nível de significância de 5% (p≤0,05). De um total de 110 crianças avaliadas, o desempenho motor se mostrou aquém do esperado em mais da metade delas (63,6%, n=70). Houve associação estatisticamente significativa entre o desenvolvimento motor e vacinas atrasadas (p=0,005), convivência com tabagistas em casa (p=0,047) e recebimento de benefício socioeconômico (p=0,036). Conclui-se que esses fatores sociais podem estar associados a fatores de risco ao desenvolvimento motor de crianças de quatro a 17 meses.
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13
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Lee M, Ha M, Hong YC, Park H, Kim Y, Kim EJ, Kim Y, Ha E. Exposure to prenatal secondhand smoke and early neurodevelopment: Mothers and Children's Environmental Health (MOCEH) study. Environ Health 2019; 18:22. [PMID: 30894196 PMCID: PMC6425627 DOI: 10.1186/s12940-019-0463-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/05/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND The association between exposure to secondhand smoke (SHS) during pregnancy and a child's neurodevelopment has not been established yet. We explored the association between prenatal exposure to SHS and neurodevelopment at 24 months of age considering genetic polymorphism and breastfeeding in 720 mothers and their offspring enrolled in the Korean multicenter birth cohort study (Mothers and Children Environmental Health, MOCEH). METHODS We quantified urine cotinine concentrations in mothers once from 12th to 20th gestational weeks and excluded those whose urine cotinine levels exceeded 42.7 ng/ml to represent SHS exposure in early pregnancy. Mental developmental index (MDI) and psychomotor developmental index (PDI) values were measured using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II) at 24 months of age. A general linear model was used to assess the relationship between maternal urinary cotinine level and neurodevelopment. RESULTS MDI scores were inversely associated with cotinine [β = - 2.73; 95% confidence interval (CI): - 5.32 to - 0.15] in children whose mothers had early pregnancy urinary cotinine levels >1.90 ng/ml. No association was evident in children whose mothers had cotinine levels ≤1.90 ng/ml. This negative association was more pronounced in children whose mothers had both Glutathione S-transferases mu 1 (GSTM1) and theta 1 (GSTT1) null type [β = - 5.78; 95% CI: -10.69 to - 0.87], but not in children whose mothers had any present type of GSTM1/GSTT1 [β = - 1.64; 95% CI: -4.79 to 1.52]. The association was no longer significant when children received breast milk exclusively for up to 6 months [β = - 0.24; 95% CI: -4.69 to 4.20] compared to others [β = - 3.75; 95% CI: -7.51 to 0.00]. No significant association was found for PDI. CONCLUSIONS Maternal exposure to SHS during pregnancy may result in delayed MDI in early childhood. This effect might be modified by genetic polymorphism and breastfeeding behavior.
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Affiliation(s)
- Myeongjee Lee
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Eui-Jung Kim
- Department of Psychiatry, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
- Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
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14
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Mahlberg N, James ME, Bulten R, Rodriguez C, Kwan M, Cairney J. Investigating the Association Between Exposure to Second Hand Smoke in utero and Developmental Coordination Disorder. Front Pediatr 2019; 7:438. [PMID: 31828051 PMCID: PMC6849499 DOI: 10.3389/fped.2019.00438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are highly comorbid in children. There is evidence linking second hand smoke (SHS) exposure in utero to ADHD; however, it's relation to DCD is unknown. The purpose of this study was to examine the effect of SHS exposure in utero in children with and without DCD. Methods: This study was a cross-sectional examination of 122 children from the District School Board of Niagara (72 males, 50 females, M age = 12.9 years) who were part of a larger, prospective cohort study. Participants were assessed for motor proficiency and intelligence and were screened for symptoms of ADHD using the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, the Kaufman Brief Intelligence Inventory, 2nd edition, and the Conners' Parent Rating Scales-Revised: Short Form, respectively. Parent questionnaires were used to determine SHS exposure in utero as either yes or no. Multinomial logistic regression was used to examine the relationship between SHS exposure and DCD risk. Results: Children exposed to SHS in utero were significantly more likely to be at high risk for DCD than children who were not (OR = 3.33, p = 0.004), and children exposed to SHS in utero were more likely to be at moderate risk for DCD in the presence (OR = 3.57, p = 0.025) or absence of ADHD (OR = 2.38, p = 0.042). However, statistical adjustment for birth weight, socioeconomic status, age, and sex reduced this effect to non-significance in the moderate risk group. Conclusion: Results suggest exposure to SHS during pregnancy increases the chances of a child developing high risk DCD. While SHS exposure may increase DCD risk with and without ADHD, this effect may be explained by covariates and confounding factors. Further study is needed to examine the mechanisms linking SHS exposure in utero to motor coordination problems in children.
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Affiliation(s)
- Nadilein Mahlberg
- Infant and Child Health Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Maeghan E James
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Rheanna Bulten
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Christine Rodriguez
- Infant and Child Health Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Matthew Kwan
- Infant and Child Health Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - John Cairney
- Infant and Child Health Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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15
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Cauley M, Hall BJ, Abreu-Villaça Y, Junaid S, White H, Kiany A, Slotkin TA, Levin ED. Critical developmental periods for effects of low-level tobacco smoke exposure on behavioral performance. Neurotoxicology 2018; 68:81-87. [PMID: 30036564 PMCID: PMC6153040 DOI: 10.1016/j.neuro.2018.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 12/27/2022]
Abstract
Tobacco exposure during development leads to neurobehavioral dysfunction in children, even when exposure is limited to secondhand smoke. We have previously shown in rats that developmental exposure to tobacco smoke extract (TSE), at levels mimicking secondhand smoke, starting preconception and extending throughout gestation, evoked subsequent locomotor hyperactivity and cognitive impairment. These effects were greater than those caused by equivalent exposures to nicotine alone, implying that other agents in tobacco smoke contributed to the adverse behavioral effects. In the present study, we examined the critical developmental windows of vulnerability for these effects, restricting TSE administration (0.2 mg/kg/day nicotine equivalent, or DMSO vehicle, delivered by subcutaneously-implanted pumps) to three distinct 10 day periods: the 10 days preceding mating, the first 10 days of gestation (early gestation), or the second 10 days of gestation (late gestation). The principal behavioral effects revealed a critical developmental window of vulnerability, as well as sex selectivity. Late gestational TSE exposure significantly increased errors in the initial training on the radial-arm maze in female offspring, whereas no effects were seen in males exposed during late gestation, or with either sex in the other exposure windows. In attentional testing with the visual signal detection test, male offspring exposed to TSE during early or late gestation showed hypervigilance during low-motivating conditions. These results demonstrate that gestational TSE exposure causes persistent behavioral effects that are dependent on the developmental window in which exposure occurs. The fact that effects were seen at TSE levels modeling secondhand smoke, emphasizes the need for decreasing involuntary tobacco smoke exposure, particularly during pregnancy.
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Affiliation(s)
- Marty Cauley
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Brandon J Hall
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Yael Abreu-Villaça
- Departamento de Ciências Fisiologicas, Universidade do Estado do Rio de Janeiro (UERJ), RJ, Brazil
| | - Shaqif Junaid
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Hannah White
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Abtin Kiany
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - Theodore A Slotkin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA; Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Edward D Levin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA; Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, 27710, USA.
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16
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Jain RB. Rates of exposure to environmental tobacco smoke from various indoor environments among US children and nonsmoker adolescents and adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:17002-17011. [PMID: 29627962 DOI: 10.1007/s11356-018-1891-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/27/2018] [Indexed: 06/08/2023]
Abstract
Data from National Health and Nutrition Examination Survey for 2013-2014 were used to compute rates of exposure (ROE) to environmental tobacco smoke (ETS) from various indoor environments among US children and nonsmoking adolescents and adults. In a typical week in USA, 473,000 infants (ROE, 11%), 3.36 million children aged 1-5 years (ROE, 16.4%), and 4.59 million children aged 6-11 years (ROE, 18.6%) are exposed to ETS from indoor environments only. ROE among children was found to be highest by inhaling tobacco smoke inside home, riding in a car, and when visiting other people's homes. In a typical week, 4.1 million nonsmoking adolescents (ROE, 29.2%) were being exposed to ETS. For every one adolescent smoker, 2.4 nonsmoker adolescents were being subjected to ETS exposure. Both non-Hispanic White (NHW) and non-Hispanic Black (NHB) nonsmoking adolescents had higher ROE (p < 0.01) than Hispanics (HISP) and non-Hispanic Asians (NHAS). Also, in a typical week, 16.8 million nonsmoking adults (ROE, 29.2%) were being exposed to ETS. For every adult smoker, 0.7 nonsmoker adult was subjected to ETS exposure. Both NHW and NHB nonsmoking adults had higher ROE (p < 0.01) than HISP and NHAS and males had higher ROE than females (p < 0.01).
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17
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Salihu HM, Paothong A, Das R, King LM, Pradhan A, Riggs B, Naik E, Siegel EM, Whiteman VE. Evidence of altered brain regulatory gene expression in tobacco-exposed fetuses. J Perinat Med 2017; 45:1045-1053. [PMID: 28130959 DOI: 10.1515/jpm-2016-0279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/21/2016] [Indexed: 11/15/2022]
Abstract
AIM We sought to determine the association between prenatal smoking status and expression of fetal brain regulatory genes. METHODS At delivery, we collected information from parturient women on prenatal smoking habits and analyzed salivary cotinine levels. We obtained neonatal umbilical cord blood and extracted total RNA. We then employed the quantitative polymerase chain reaction (QPCR) analyses and the comparative CT method to calculate the relative gene expression of selected fetal brain regulatory genes responsible for (1) brain growth (brain-derived neutrotrophic factor, BDNF), (2) myelination (proteolipidic protein 1, PLP1 and myelin basic protein, MBP), and (3) neuronal migration and cell-cell interactions during fetal brain development or RLN. The χ2-test, analysis of variance (ANOVA), and the Grubb test were used to evaluate the relationship between prenatal smoking status and relative gene expression levels. Further analysis using bootstrapping was performed to assess the precision of our estimates. RESULTS Of the 39 maternal-infant dyads included in this study, 25.6% were non-smokers, 43.6% were passive smokers and 30.8% were active smokers. The results showed down-regulation of the selected fetal brain regulatory genes among active smokers. CONCLUSIONS These findings represent preliminary evidence in humans that intrauterine tobacco exposure impacts fetal brain programming. Future studies are warranted to examine whether our findings represent potential mechanisms through which adverse childhood/adult-onset cognitive and behavioral outcomes that have been previously linked to intrauterine exposure occur.
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18
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Frandsen M, Thow M, Ferguson SG. Financial Incentives Alone Versus Incentivized Partner Support for Promoting Smoking Cessation During Pregnancy and Postpartum: Protocol for a Non-Randomized Single-Blinded Study. JMIR Res Protoc 2017; 6:e209. [PMID: 29089293 PMCID: PMC5686414 DOI: 10.2196/resprot.7907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/13/2017] [Accepted: 08/09/2017] [Indexed: 11/13/2022] Open
Abstract
Background Smoking tobacco remains the most significant modifiable cause of adverse pregnancy outcomes and contributor to ongoing maternal and infant ill-health. Pregnancy for many is a time of heightened health focus, with the primary motivation being the well-being of the unborn child. Yet, many women continue to smoke throughout their pregnancy. Despite this heightened motivation and known health risks, interventions to date have not effectively curbed the rate of smoking during pregnancy and they remain as high as rates among the general population. One promising strategy has been to incentivize these women to quit. However, incentives-based studies have not shown or reported long-term efficacy. Here, we present the protocol of a trial exploring the effect of incentivized partner support on pre- and postpartum smoking cessation. Objective The aim of this study is to determine whether providing incentives to both the expectant mother and her support person in promoting short- and long-term smoking cessation during pregnancy is more effective than incentives to the expectant mother alone. Methods This protocol is designed as a non-randomized, single-blinded trial to determine the efficacy of incentivized partner support, compared to participant incentive only, in promoting smoking cessation during pregnancy and postpartum. All eligible pregnant women receiving antenatal care via the Tasmanian Health Service (Australia) will be invited to participate. Participants will be eligible for monthly quit-contingent shopping vouchers if they verify, via carbon monoxide breath sample, as being abstinent from smoking. Participating women will be eligible for vouchers until 6-months postpartum and will be followed up at 12-months postpartum. Results The recruitment phase of this study has concluded. Results are expected to be published by the end of 2018. Conclusions This study protocol extends the current literature on incentivized smoking cessation interventions for pregnant women by assessing the influence of incentivizing a support partner on short- and long-term abstinence. Key ethical considerations are discussed including potential for receipt (or not) of quit-contingent vouchers impacting negatively on the participant’s relationship with their partner. The findings of the study may have important implications for the role support partners are assigned in smoking cessation programs targeting pregnant women. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12615001158550; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=367981 (Archived by WebCite at http://www.webcitation.org/6tGKO28uh)
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Affiliation(s)
- Mai Frandsen
- School of Health Science, Faculty of Health, University of Tasmania, Launceston, Australia
| | - Megan Thow
- School of Health Science, Faculty of Health, University of Tasmania, Launceston, Australia
| | - Stuart G Ferguson
- School of Medicine, Faculty of Health, University of Tasmania, Hobart, Australia
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Noël A, Xiao R, Perveen Z, Zaman H, Le Donne V, Penn A. Sex-specific lung functional changes in adult mice exposed only to second-hand smoke in utero. Respir Res 2017. [PMID: 28651580 PMCID: PMC5485620 DOI: 10.1186/s12931-017-0591-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background An increasing number of epidemiological and experimental studies have associated exposure to second-hand smoke (SHS) during pregnancy with adverse outcomes in newborns. As we have previously shown in mice, in utero exposure to SHS at critical stages of fetal development, results in altered lung responses and increased disease susceptibility upon re-exposure to irritants (SHS or ovalbumin) in adulthood. In this study, we asked whether the in utero SHS exposure alone is sufficient to alter lung structure and function in adult mice. Methods Pregnant BALB/c mice were exposed from days 6 to 19 of pregnancy to 10 mg/m3 of SHS or HEPA-filtered air. Male and female offspring (n = 13–15/group) were sacrificed at 15 weeks of age. We measured lung function with non-invasive and invasive methods, performed lung morphometric analysis on trichrome-stained lung tissue samples, and assessed lung gene expression via RNA sequencing and protein assays. Results In utero SHS exposure significantly increased mean linear intercept and decreased the surface area per unit volume of the lungs in both males and females, indicating perturbation in alveolar developmental processes. Tidal volume, minute volume and inspiratory capacity were significantly decreased compared with the controls only in male mice exposed in utero to SHS, suggesting that males are more sensitive than females to an SHS insult during lung development. This also suggests that in our model, lung structure changes may be necessary but are not sufficient to impair lung function. SERPINA1A, the mouse ortholog of human α1-antitrypsin, deficiency of which is a known genetic risk factor for emphysema, was down-regulated at the protein level in the in utero SHS-exposed mice. Additionally, DNMT3A protein expression was dysregulated, indicating that DNA methylation occurred in the lungs. Conclusions Our results indicate that in utero SHS exposure alone alters both lung function and structure well into adulthood (15 weeks) in male mice. Furthermore, lung function alterations in this model are sex-specific, with males being more susceptible to in utero SHS effects. Overall, our data suggest that in utero SHS exposure alone can predispose to adult lung diseases.
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Affiliation(s)
- Alexandra Noël
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, 70803, LA, USA
| | - Rui Xiao
- Department of Anesthesiology, Columbia University Medical Center, 622 West 168th Street, New York, 10032, NY, USA
| | - Zakia Perveen
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, 70803, LA, USA
| | - Hasan Zaman
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, 70803, LA, USA
| | - Viviana Le Donne
- Translational Medicine and Comparative Pathobiology, R&D Platform Technology and Science, GlaxoSmithKline, Park Road, Ware, SG12 ODP, UK
| | - Arthur Penn
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, 70803, LA, USA.
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20
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Chatzi L, Leventakou V, Vafeiadi M, Koutra K, Roumeliotaki T, Chalkiadaki G, Karachaliou M, Daraki V, Kyriklaki A, Kampouri M, Fthenou E, Sarri K, Vassilaki M, Fasoulaki M, Bitsios P, Koutis A, Stephanou EG, Kogevinas M. Cohort Profile: The Mother-Child Cohort in Crete, Greece (Rhea Study). Int J Epidemiol 2017; 46:1392-1393k. [DOI: 10.1093/ije/dyx084] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 12/20/2022] Open
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Goodwin RD, Cheslack-Postava K, Nelson DB, Smith PH, Hasin DS, Janevic T, Bakoyiannis N, Wall MM. Serious Psychological Distress and Smoking During Pregnancy in the United States: 2008-2014. Nicotine Tob Res 2017; 19:605-614. [PMID: 28403468 PMCID: PMC5441894 DOI: 10.1093/ntr/ntw323] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 12/14/2016] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among women with and without SPD, from 2008 to 2014. METHODS Data were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons aged 12 and over. SPD and smoking in the past 30 days among pregnant women, aged 18 and older, were examined using logistic regression models. Heterogeneity in this association by demographic characteristics, trends over time, and level of cigarette consumption was also examined. RESULTS Prenatal smoking was common. Almost 40% of pregnant women with acute SPD reported smoking, 23% of pregnant women with recent SPD smoked, and 11.7% of pregnant women without recent SPD smoked. No significant change was found in the prevalence of prenatal smoking from 2008 to 2014 in any of these groups. Robust relationships were found between acute (OR = 5.05 [3.64-6.99]) and recent SPD (OR = 2.37 [1.74-3.24]) and smoking; these findings remained after adjusting for demographics. CONCLUSIONS SPD and smoking during pregnancy are strongly associated; this relationship is present across all sociodemographic groups and the prevalence of smoking in pregnancy has remained relatively unchanged over the past decade both in the presence and absence of SPD. IMPLICATIONS SPD and smoking in pregnancy are robustly linked; the prevalence of smoking in pregnancy is extremely high in women with SPD. Screening women with mental health problems for prenatal smoking, as well as screening pregnant smokers for mental health problems, seems warranted and may assist more women in seeking and utilizing treatment options. Efforts to reduce the prevalence of smoking during pregnancy might specifically target women with SPD, where the potential for impact is substantial.
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Affiliation(s)
- Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Keely Cheslack-Postava
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Deborah B Nelson
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
- Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, PA
| | - Philip H Smith
- Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY School of Medicine, New York, NY
| | - Deborah S Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Teresa Janevic
- Department of Population Health Science and Health Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ
| | - Nina Bakoyiannis
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY
| | - Melanie M Wall
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- New York State Psychiatric Institute, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
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Ferguson A, Penney R, Solo-Gabriele H. A Review of the Field on Children's Exposure to Environmental Contaminants: A Risk Assessment Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E265. [PMID: 28273865 PMCID: PMC5369101 DOI: 10.3390/ijerph14030265] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/21/2017] [Accepted: 02/25/2017] [Indexed: 01/21/2023]
Abstract
Background: Children must be recognized as a sensitive population based on having biological systems and organs in various stages of development. The processes of absorption, distribution, metabolism and elimination of environmental contaminants within a child's body are considered less advanced than those of adults, making them more susceptible to disease outcomes following even small doses. Children's unique activities of crawling and practicing increased hand-to-mouth ingestion also make them vulnerable to greater exposures by certain contaminants within specific environments. Approach: There is a need to review the field of children's environmental exposures in order to understand trends and identify gaps in research, which may lead to better protection of this vulnerable and sensitive population. Therefore, explored here are previously published contemporary works in the broad area of children's environmental exposures and potential impact on health from around the world. A discussion of children's exposure to environmental contaminants is best organized under the last four steps of a risk assessment approach: hazard identification, dose-response assessment, exposure assessment (including children's activity patterns) and risk characterization. We first consider the many exposure hazards that exist in the indoor and outdoor environments, and emerging contaminants of concern that may help guide the risk assessment process in identifying focus areas for children. A section on special diseases of concern is also included. Conclusions: The field of children's exposures to environmental contaminants is broad. Although there are some well-studied areas offering much insight into children exposures, research is still needed to further our understanding of exposures to newer compounds, growing disease trends and the role of gene-environment interactions that modify adverse health outcomes. It is clear that behaviors of adults and children play a role in reducing or increasing a child's exposure, where strategies to better communicate and implement risk modifying behaviors are needed, and can be more effective than implementing changes in the physical environment.
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Affiliation(s)
- Alesia Ferguson
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 820, Little Rock, AR 72205, USA.
| | - Rosalind Penney
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 820, Little Rock, AR 72205, USA.
| | - Helena Solo-Gabriele
- Department of Civil, Architectural, and Environmental Engineering, College of Engineering, University of Miami, Florida, 1251 Memorial Drive, Coral Gables, FL 33146, USA.
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23
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Oei JL, Melhuish E, Uebel H, Azzam N, Breen C, Burns L, Hilder L, Bajuk B, Abdel-Latif ME, Ward M, Feller JM, Falconer J, Clews S, Eastwood J, Li A, Wright IM. Neonatal Abstinence Syndrome and High School Performance. Pediatrics 2017; 139:peds.2016-2651. [PMID: 28093465 DOI: 10.1542/peds.2016-2651] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. RESULTS Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001. CONCLUSIONS A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
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Affiliation(s)
- Ju Lee Oei
- School of Women's and Children's Health, .,Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia.,Ingham Research Centre, Liverpool, New South Wales, Australia
| | - Edward Melhuish
- Early Start Research Institute and.,Department of Education, University of Oxford, Oxford, United Kingdom.,Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | | | | | | | | | - Lisa Hilder
- National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mohamed E Abdel-Latif
- Department of Neonatology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.,Faculty of Medicine, the Australian National University, Deakin, Australian Capital Territory, Australia
| | - Meredith Ward
- School of Women's and Children's Health.,Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia
| | - John M Feller
- School of Women's and Children's Health.,Sydney Children's Hospital, Sydney Children's Hospital Network, Randwick, New South Wales, Australia
| | - Janet Falconer
- The Langton Centre, Surry Hills, New South Wales, Australia
| | - Sara Clews
- The Langton Centre, Surry Hills, New South Wales, Australia
| | - John Eastwood
- School of Women's and Children's Health.,Ingham Research Centre, Liverpool, New South Wales, Australia.,Community Health Services, Sydney Local Health District, Sydney, New South Wales, Australia.,School of Public Health, Menzies Centre for Health Policy, and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; and.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Annie Li
- School of Women's and Children's Health
| | - Ian M Wright
- Early Start Research Institute and.,Illawarra Health and Medical Research Institute and School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia.,Department of Paediatrics, The Wollongong Hospital, Wollongong, New South Wales, Australia
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Alemán A, Morello P, Colomar M, Llambi L, Berrueta M, Gibbons L, Buekens P, Althabe F. Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 14:ijerph14010028. [PMID: 28036075 PMCID: PMC5295279 DOI: 10.3390/ijerph14010028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/07/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS) exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate the effects of the intervention on the rates of self-reported SHS exposure at home and at work, and on attitudes recalled by non-smoker women enrolled in the intervention group compared with the control group. We randomly assigned (1:1) 20 antenatal care clusters in Argentina and Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling, which also included questions and counseling regarding SHS exposure, or to receive the standard of care. There was not a statistically significant difference between groups of the intervention’s effect (reduction of exposure to SHS) on any of the three exposure outcome measures (exposure at home, work or other indoor areas) or on the attitudes of women regarding exposure (avoiding breathing SHS and having rooms where smoking is forbidden). This analysis shows that we should not expect reductions in SHS exposure with this modest intervention alone. To achieve such reductions, strategies engaging partners and other household members may be more effective.
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Affiliation(s)
- Alicia Alemán
- Montevideo Clinical and Epidemiological Research Unit, Montevideo 11600, Uruguay.
| | - Paola Morello
- Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires C1414CPV, Argentina.
| | - Mercedes Colomar
- Montevideo Clinical and Epidemiological Research Unit, Montevideo 11600, Uruguay.
| | - Laura Llambi
- Hospital de Clínicas, Facultad de Medicina, Universidad de la Republica, Montevideo 11600, Uruguay.
| | - Mabel Berrueta
- Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires C1414CPV, Argentina.
| | - Luz Gibbons
- Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires C1414CPV, Argentina.
| | - Pierre Buekens
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Fernando Althabe
- Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires C1414CPV, Argentina.
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25
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Self-reported and laboratory evaluation of late pregnancy nicotine exposure and drugs of abuse. J Perinatol 2016; 36:814-8. [PMID: 27388942 DOI: 10.1038/jp.2016.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/20/2016] [Accepted: 06/03/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the prevalence of late pregnancy nicotine exposures, including secondhand smoke exposures, and to evaluate the associated risk of exposure to drugs of abuse. STUDY DESIGN The study was a retrospective single-center cohort analysis of more than 18 months. We compared self-reported smoking status from vital birth records with mass spectrometry laboratory results of maternal urine using a chi-square test. Logistic regression estimated adjusted odds for detection of drugs of abuse based on nicotine detection. RESULTS Compared with 8.6% self-reporting cigarette use, mass spectrometry detected high-level nicotine exposures for 16.5% of 708 women (P<0.001) and an additional 7.5% with low-level exposures. We identified an increased likelihood of exposure to drugs of abuse, presented as adjusted odds ratios, (95% confidence interval (CI), for both low-level (5.69, CI: 2.09 to 15.46) and high-level (13.93, CI: 7.06 to 27.49) nicotine exposures. CONCLUSION Improved measurement tactics are critically needed to capture late pregnancy primary and passive nicotine exposures from all potential sources.
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Hall BJ, Cauley M, Burke DA, Kiany A, Slotkin TA, Levin ED. Cognitive and Behavioral Impairments Evoked by Low-Level Exposure to Tobacco Smoke Components: Comparison with Nicotine Alone. Toxicol Sci 2016; 151:236-44. [PMID: 26919958 DOI: 10.1093/toxsci/kfw042] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Active maternal smoking has adverse effects on neurobehavioral development of the offspring, with nicotine (Nic) providing much of the underlying causative mechanism. To determine whether the lower exposures caused by second-hand smoke are deleterious, we administered tobacco smoke extract (TSE) to pregnant rats starting preconception and continued through the second postnatal week, corresponding to all 3 trimesters of fetal brain development. Dosing was adjusted to produce maternal plasma Nic concentrations encountered with second-hand smoke, an order of magnitude below those seen in active smokers. We then compared TSE effects to those of an equivalent dose of Nic alone, and to a 10-fold higher Nic dose. Gestational exposure to TSE and Nic significantly disrupted cognitive and behavioral function in behavioral tests given during adolescence and adulthood (postnatal weeks 4-40), producing hyperactivity, working memory deficits, and impairments in emotional processing, even at the low exposure levels corresponding to second-hand smoke. Although TSE effects were highly correlated with those of Nic, the effects of TSE were much larger than could be attributed to just the Nic in the mixture. Indeed, TSE effects more closely resembled those of the 10-fold higher Nic levels, but still exceeded their magnitude. In combination with our earlier findings, this study thus completes the chain of causation to prove that second-hand smoke exposure causes neurodevelopmental deficits, originating in disruption of neurodifferentiation, leading to miswiring of neuronal circuits, and as shown here, culminating in behavioral dysfunction. As low level exposure to Nic alone produced neurobehavioral teratology, 'harm reduction' Nic products do not abolish the potential for neurodevelopmental damage.
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Affiliation(s)
| | - Marty Cauley
- *Department of Psychiatry and Behavioral Sciences
| | | | - Abtin Kiany
- *Department of Psychiatry and Behavioral Sciences
| | - Theodore A Slotkin
- *Department of Psychiatry and Behavioral Sciences Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710
| | - Edward D Levin
- *Department of Psychiatry and Behavioral Sciences Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710
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Jain RB. Trends in exposure to second hand smoke at home among children and nonsmoker adolescents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 542:144-152. [PMID: 26519575 DOI: 10.1016/j.scitotenv.2015.10.076] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/14/2015] [Accepted: 10/15/2015] [Indexed: 06/05/2023]
Abstract
Data from National Health and Nutrition Examination Survey (NHANES) for the years 1999-2012 were used to evaluate trends in exposure to second hand smoke (SHS) at home among children aged 3-11 years and nonsmoker adolescents aged 12-19 years. A total of 12,815 children and 10,269 adolescents were included in the analyses. Serum cotinine was used as a biomarker for exposure to SHS at home. Regression models with log10 transformed values of serum cotinine as dependent variables and age, race/ethnicity, NHANES survey year, and family poverty income ratio as a surrogate measure of socioeconomic status were used in models for those with and without exposure to SHS at home. In addition, for those with exposure to SHS at home, number of smokers smoking inside home and number of cigarettes smoked at home every day were also used as independent variables. There was a biennial increase of 1.05 ng/L in adjusted serum cotinine levels for children with exposure to SHS at home over the period of 1999-2012. Serum cotinine levels among nonsmoker adolescents with exposure to SHS at home did not change over time. When there was no exposure to SHS at home, there was a statistically significant downward trend for serum cotinine levels for both children and nonsmoker adolescents. Serum cotinine levels attributable to SHS exposure increased with age among nonsmoker adolescents (p≤0.02) but decreased with age among children (p<0.01). For a unit decrease in family poverty income ratio, SHS exposure as measured by serum cotinine levels (Table 6) increased by 1.18 ng/L among children and by 1.30 ng/L among nonsmoker adolescents. In general, observed serum cotinine levels associated with SHS exposure at home were higher for children than they were for nonsmoker adolescents.
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Affiliation(s)
- Ram B Jain
- 2959 Estate View Ct, Dacula, GA 30019, United States.
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Affiliation(s)
- John C Duby
- Department of Pediatrics, Northeast Ohio Medical University, Akron Children's Hospital, Akron, Ohio.
| | - Diane L Langkamp
- Department of Pediatrics, Northeast Ohio Medical University, Akron Children's Hospital, Akron, Ohio
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