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Bailey BA, Azar M, Nadolski K, Dodge P. Fetal Growth Following Electronic Cigarette Use in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1179. [PMID: 39338062 PMCID: PMC11431261 DOI: 10.3390/ijerph21091179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/30/2024] [Accepted: 09/01/2024] [Indexed: 09/30/2024]
Abstract
Electronic cigarette (e-cig) use in pregnancy is common, but potential effects on fetal development are largely unknown. This study's goal was to examine the association between e-cig exposure and fetal growth. Data were extracted from medical charts in this single-site retrospective study. The sample, excluding those with known tobacco, alcohol, illicit drug, opioid, and benzodiazepine use, contained women who used e-cigs throughout pregnancy and non-e-cig user controls. Fetal size measurements from second- and third-trimester ultrasounds and at birth were expressed as percentiles for gestational age. Following adjustment for confounding factors, in the second trimester, only femur length was significant, with an adjusted deficit of 11.5 percentile points for e-cig exposure compared to controls. By the third trimester, the femur length difference was 28.5 points, with the fetal weight difference also significant (17.2 points). At birth, all three size parameter differences between groups were significant. Significant size deficits were predicted by prenatal e-cig exposure, becoming larger and impacting more parameters with increasing gestation. While additional studies are warranted to confirm and expand upon these findings, this study adds to emerging data pointing to specific harms following e-cig exposure in pregnancy and suggests that e-cigs may not be a "safer" alternative to combustible cigarette smoking in pregnancy.
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Affiliation(s)
- Beth A. Bailey
- Department of Foundational Sciences, Central Michigan University College of Medicine, Mount Pleasant, MI 48859, USA
| | - Michelle Azar
- Department of Foundational Sciences, Central Michigan University College of Medicine, Mount Pleasant, MI 48859, USA
| | - Katherine Nadolski
- Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Phoebe Dodge
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA
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Manzoni P, Viora E, Lanari M, Iantomasi R, Montuori EA, Rodgers-Gray B, Waghorne N, Masturzo B. Maternal Risk Factors for Respiratory Syncytial Virus Lower Respiratory Tract Infection in Otherwise Healthy Preterm and Term Infants: A Systematic Review and Meta-analysis. Pediatr Infect Dis J 2024; 43:763-771. [PMID: 38754000 DOI: 10.1097/inf.0000000000004387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND/OBJECTIVE To date, there is no published, formal assessment of all maternal risk factors for respiratory syncytial virus lower respiratory tract infection (RSV-LRTI) in infants. A systematic literature review and meta-analysis were undertaken to ascertain: What maternal risk factors are associated with an increased risk of RSV-LRTI in infants? METHODS The systematic literature review used explicit methods to identify, select and analyze relevant data. PubMed, Embase and the Cochrane Library were searched (November 2022) using terms regarding: (1) RSV/LRTI; (2) risk factors; (3) pregnant/postpartum population. Bayesian meta-analysis compared RSV hospitalization (RSVH) risk in infants born to mothers with or without certain risk factors. RESULTS A total of 2353 citations were assessed and 20 were included in the final review (10 individual studies; 10 pooled analyses). In 10 studies examining infants (<1 year) without comorbidities (primary outcome), 10 maternal risk factors were associated with RSV-LRTI/RSVH in multivariate analyses. Meta-analysis revealed smoking while pregnant increased infant RSVH risk by 2.01 (95% credible interval: 1.52-2.64) times, while breast-feeding was protective (0.73, 95% credible interval: 0.58-0.90). Risk scoring tools have reported that maternal risk factors contribute between 9% and 21% of an infant's total risk score for RSVH. CONCLUSIONS A greater understanding of maternal risk factors and their relative contribution to infant RSV-LRTI will enable more accurate assessments of the impact of preventive strategies.
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Affiliation(s)
- Paolo Manzoni
- From the Department of Maternal-Infant Medicine, "Degli Infermi" Hospital, University of Torino School of Medicine, Ponderano, Biella, Italy
| | - Elsa Viora
- Obstetrics and Gynecology Department, Città della Salute e della Scienza S. Anna Hospital, Torino, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy
| | | | | | | | | | - Bianca Masturzo
- Obstetrics and Gynecology Unit, Department of Maternal-Infant Medicine, "Degli Infermi" Hospital, Ponderano, Biella, Italy
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Meredith Weiss S, Aydin E, Lloyd-Fox S, Johnson MH. Trajectories of brain and behaviour development in the womb, at birth and through infancy. Nat Hum Behav 2024; 8:1251-1262. [PMID: 38886534 DOI: 10.1038/s41562-024-01896-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/04/2024] [Indexed: 06/20/2024]
Abstract
Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature-nurture issues to a developmental human lifespan view beginning within the womb.
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Affiliation(s)
- Staci Meredith Weiss
- University of Cambridge, Department of Psychology, Cambridge, UK.
- University of Roehampton, School of Psychology, London, UK.
| | - Ezra Aydin
- University of Cambridge, Department of Psychology, Cambridge, UK
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sarah Lloyd-Fox
- University of Cambridge, Department of Psychology, Cambridge, UK
| | - Mark H Johnson
- University of Cambridge, Department of Psychology, Cambridge, UK
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
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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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Timing of Maternal Smoking Cessation and Newborn Weight, Height, and Head Circumference. Obstet Gynecol 2023; 141:119-125. [PMID: 36701612 DOI: 10.1097/aog.0000000000004991] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/18/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the relationship between timing of smoking cessation during pregnancy and anthropometric indices of newborns. METHODS Mothers and neonates enrolled in the JECS (Japan Environment and Children's Study), a nationwide birth cohort study, were examined. Patients with full-term neonates were included in the analysis, and 73,025 mother-neonate pairs with complete data were identified. The mothers were classified into six groups according to smoking status during pregnancy (nonsmokers [Q1, n=44,198]; ex-smokers who quit before pregnancy [Q2, n=16,461]; ex-smokers who quit in the first trimester [Q3, n=8,948]; ex-smokers who quit in the second trimester [Q4, n=498]; ex-smokers who quit in the third trimester [Q5, n=651]; and smokers who smoked throughout pregnancy [Q6, n=2,269)]). Data on smoking were based on questionnaires administered in the first, second, or third trimester and 1 month after delivery. The primary outcomes were birth weight, height, and head circumference. RESULTS Compared with nonsmokers (Q1), no adverse outcomes were observed for ex-smokers who quit before pregnancy (Q2). The mean adjusted weights of male and female neonates were 135 g and 125 g lower, respectively, in Q6 participants than in Q1 participants. Comparing Q1 and Q6 participants, height was 0.6 cm and 0.7 cm smaller for male and female neonates, respectively. Head circumference in neonates of Q6 participants was 0.3 cm and 0.3 cm smaller for male and female neonates, respectively, than that in Q1 participants. Across all three measures, smoking cessation in the first and second trimester reduced the differential in outcomes between nonsmokers and individuals who smoked throughout pregnancy. CONCLUSION Smoking during pregnancy is associated with reduced newborn birth weight, height, and head circumference. Earlier smoking cessation during pregnancy reduces the adverse effects of smoking on fetal growth.
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Fernandez-Rodriguez B, Gomez AR, Jimenez Moreno BS, de Alba C, Galindo A, Villalain C, Pallás C, Herraiz I. Smoking influence on early and late fetal growth. J Perinat Med 2022; 50:200-206. [PMID: 34929071 DOI: 10.1515/jpm-2021-0226] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking during pregnancy is a leading and modifiable risk factor for fetal growth restriction (FGR) and low birthweight (<10th centile). We studied the effects of smoking in the development of early and late FGR or low birthweight, as well as in uteroplacental and fetoplacental hemodynamics of growth-restricted fetuses. METHODS Retrospective cohort study of 5,537 consecutive singleton pregnancies delivered at ≤34 + 0 ("early delivery" group, n=95) and >34 + 0 ("late delivery" group, n=5,442) weeks of gestation. Each group was divided into smokers and non-smokers. Prenatal diagnosis of FGR was based on customized fetal growth standards and fetal Doppler, and postnatal birthweight was assessed using the Olsen newborn chart. RESULTS There were 15/95 (15.8%) and 602/5,442 (11.1%) smokers in the early and late delivery groups, respectively. In early deliveries, FGR was diagnosed in 3/15 (20%) of smokers and in 20/80 (25%) of non-smokers (p=0.68). We also found no differences in birthweights and hemodynamics. In late deliveres, FGR was detected in 30/602 (5%) smokers and 64/4,840 (1.3%) non-smokers (p<0.001). Birthweights <3rd centile and <10th centile were more common in smokers vs. non-smokers: 38/602 (6.3%) vs. 87/4,840 (1.8%) and 89/602 (14.8%) vs. 288/4,840 (6%), respectively (all p<0.01). Fetal Doppler of late FGR showed slightly higher umbilical artery resistances in smokers. CONCLUSIONS Smoking in pregnancy is associated with FGR, low birthweight and higher umbilical artery Doppler resistances after 34 weeks of gestation, but we could not confirm this association in earlier deliveries.
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Affiliation(s)
| | - Ana Roche Gomez
- Department of Neonatology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Blanca Sofia Jimenez Moreno
- Department of Neonatology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Concepción de Alba
- Department of Neonatology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Alberto Galindo
- Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Cecilia Villalain
- Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Carmen Pallás
- Department of Neonatology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
| | - Ignacio Herraiz
- Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, 12 de Octubre Research Institute (imas12), Complutense University of Madrid, Madrid, Spain
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Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094774. [PMID: 33947132 PMCID: PMC8124891 DOI: 10.3390/ijerph18094774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022]
Abstract
Smoking by women is associated with adverse pregnancy outcomes such as spontaneous abortion, preterm delivery, low birth weight, infertility, and prolonged time to pregnancy. Anogenital distance (AGD) is a sensitive biomarker of prenatal androgen and antiandrogen exposure. We investigated the effect of smoking and passive smoke exposure during pregnancy on anogenital distance in offspring at 4 years in the INMA-Asturias cohort (Spain). Women were interviewed during pregnancy to collect information on tobacco consumption, and anogenital distance was measured in 381 children: Anoscrotal distance in boys and anofourchetal distance in girls. We also measured maternal urinary cotinine levels at 32 weeks of pregnancy. We constructed linear regression models to analyze the association between prenatal smoke exposure and anogenital distance and adjusted the models by relevant covariates. Reported prenatal smoke exposure was associated with statistically significant increased anogenital index (AGI), both at week 12 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) and at week 32 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) in male children, suggesting altered androgenic signaling.
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Brand JS, Hiyoshi A, Cao Y, Lawlor DA, Cnattingius S, Montgomery S. Maternal smoking during pregnancy and fractures in offspring: national register based sibling comparison study. BMJ 2020; 368:l7057. [PMID: 31996343 PMCID: PMC7190030 DOI: 10.1136/bmj.l7057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study the impact of maternal smoking during pregnancy on fractures in offspring during different developmental stages of life. DESIGN National register based birth cohort study with a sibling comparison design. SETTING Sweden. PARTICIPANTS 1 680 307 people born in Sweden between 1983 and 2000 to women who smoked (n=377 367, 22.5%) and did not smoke (n=1 302 940) in early pregnancy. Follow-up was until 31 December 2014. MAIN OUTCOME MEASURE Fractures by attained age up to 32 years. RESULTS During a median follow-up of 21.1 years, 377 970 fractures were observed (the overall incidence rate for fracture standardised by calendar year of birth was 11.8 per 1000 person years). The association between maternal smoking during pregnancy and risk of fracture in offspring differed by attained age. Maternal smoking was associated with a higher rate of fractures in offspring before 1 year of age in the entire cohort (birth year standardised fracture rates in those exposed and unexposed to maternal smoking were 1.59 and 1.28 per 1000 person years, respectively). After adjustment for potential confounders the hazard ratio for maternal smoking compared with no smoking was 1.27 (95% confidence interval 1.12 to 1.45). This association followed a dose dependent pattern (compared with no smoking, hazard ratios for 1-9 cigarettes/day and ≥10 cigarettes/day were 1.20 (95% confidence interval 1.03 to 1.39) and 1.41 (1.18 to 1.69), respectively) and persisted in within-sibship comparisons although with wider confidence intervals (compared with no smoking, 1.58 (1.01 to 2.46)). Maternal smoking during pregnancy was also associated with an increased fracture incidence in offspring from age 5 to 32 years in whole cohort analyses, but these associations did not follow a dose dependent gradient. In within-sibship analyses, which controls for confounding by measured and unmeasured shared familial factors, corresponding point estimates were all close to null. Maternal smoking was not associated with risk of fracture in offspring between the ages of 1 and 5 years in any of the models. CONCLUSION Prenatal exposure to maternal smoking is associated with an increased rate of fracture during the first year of life but does not seem to have a long lasting biological influence on fractures later in childhood and up to early adulthood.
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Affiliation(s)
- Judith S Brand
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Sven Cnattingius
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Sweden
- Department of Epidemiology and Public Health, University College London, London, UK
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Brand JS, Gaillard R, West J, McEachan RRC, Wright J, Voerman E, Felix JF, Tilling K, Lawlor DA. Associations of maternal quitting, reducing, and continuing smoking during pregnancy with longitudinal fetal growth: Findings from Mendelian randomization and parental negative control studies. PLoS Med 2019; 16:e1002972. [PMID: 31721775 PMCID: PMC6853297 DOI: 10.1371/journal.pmed.1002972] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/21/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Maternal smoking during pregnancy is an established risk factor for low infant birth weight, but evidence on critical exposure windows and timing of fetal growth restriction is limited. Here we investigate the associations of maternal quitting, reducing, and continuing smoking during pregnancy with longitudinal fetal growth by triangulating evidence from 3 analytical approaches to strengthen causal inference. METHODS AND FINDINGS We analysed data from 8,621 European liveborn singletons in 2 population-based pregnancy cohorts (the Generation R Study, the Netherlands 2002-2006 [n = 4,682]) and the Born in Bradford study, United Kingdom 2007-2010 [n = 3,939]) with fetal ultrasound and birth anthropometric measures, parental smoking during pregnancy, and maternal genetic data. Associations with trajectories of estimated fetal weight (EFW) and individual fetal parameters (head circumference, femur length [FL], and abdominal circumference [AC]) from 12-16 to 40 weeks' gestation were analysed using multilevel fractional polynomial models. We compared results from (1) confounder-adjusted multivariable analyses, (2) a Mendelian randomization (MR) analysis using maternal rs1051730 genotype as an instrument for smoking quantity and ease of quitting, and (3) a negative control analysis comparing maternal and mother's partner's smoking associations. In multivariable analyses, women who continued smoking during pregnancy had a smaller fetal size than non-smokers from early gestation (16-20 weeks) through to birth (p-value for each parameter < 0.001). Fetal size reductions in continuing smokers followed a dose-dependent pattern (compared to non-smokers, difference in mean EFW [95% CI] at 40 weeks' gestation was -144 g [-182 to -106], -215 g [-248 to -182], and -290 g [-334 to -247] for light, moderate, and heavy smoking, respectively). Overall, fetal size reductions were most pronounced for FL. The fetal growth trajectory in women who quit smoking in early pregnancy was similar to that of non-smokers, except for a shorter FL and greater AC around 36-40 weeks' gestation. In MR analyses, each genetically determined 1-cigarette-per-day increase was associated with a smaller EFW from 20 weeks' gestation to birth in smokers (p = 0.01, difference in mean EFW at 40 weeks = -45 g [95% CI -81 to -10]) and a greater EFW from 32 weeks' gestation onwards in non-smokers (p = 0.03, difference in mean EFW at 40 weeks = 26 g [95% CI 5 to 47]). There was no evidence that partner smoking was associated with fetal growth. Study limitations include measurement error due to maternal self-report of smoking and the modest sample size for MR analyses resulting in unconfounded estimates being less precise. The apparent positive association of the genetic instrument with fetal growth in non-smokers suggests that genetic pleiotropy may have masked a stronger association in smokers. CONCLUSIONS A consistent linear dose-dependent association of maternal smoking with fetal growth was observed from the early second trimester onwards, while no major growth deficit was found in women who quit smoking early in pregnancy except for a shorter FL during late gestation. These findings reinforce the importance of smoking cessation advice in preconception and antenatal care and show that smoking reduction can lower the risk of impaired fetal growth in women who struggle to quit.
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Affiliation(s)
- Judith S. Brand
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Romy Gaillard
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia Children’s Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jane West
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | | | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Ellis Voerman
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia Children’s Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Janine F. Felix
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia Children’s Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
- * E-mail:
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Terzioglu F, Boztepe H, Erkekoglu P, Er Korucu A, Kocer-Gumusel B, Kandemir O. The effects of amniotic fluid and foetal cord blood cotinine concentrations on pregnancy complications and the anthropometric measurements of newborns. J OBSTET GYNAECOL 2019; 39:952-958. [PMID: 31215267 DOI: 10.1080/01443615.2019.1599834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (p>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy. Impact statement What is already known on this subject? The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight. What do the results of this study add? The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels. What are the implications of these findings for clinical practice and/or further research? Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life.
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Affiliation(s)
- Fusun Terzioglu
- Department of Nursing, Faculty of Health Sciences, Atilim University , Ankara , Turkey
| | - Handan Boztepe
- Faculty of Nursing, Hacettepe University , Ankara , Turkey
| | - Pinar Erkekoglu
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University , Ankara , Turkey
| | - Aslı Er Korucu
- Department of Midwifery, Faculty of Nursing, Ankara University , Ankara , Turkey
| | - Belma Kocer-Gumusel
- Department of Toxicology, Faculty of Pharmacy, Lokman Hekim University , Ankara , Turkey
| | - Omer Kandemir
- Zübeyde Hanım Etlik Woman Health and Disease, Teaching and Research Hospital , Ankara , Turkey
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Intrauterine smoke exposure deregulates lung function, pulmonary transcriptomes, and in particular insulin-like growth factor (IGF)-1 in a sex-specific manner. Sci Rep 2018; 8:7547. [PMID: 29765129 PMCID: PMC5953988 DOI: 10.1038/s41598-018-25762-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/30/2018] [Indexed: 12/13/2022] Open
Abstract
Prenatal exposure to tobacco smoke is a significant risk-factor for airway disease development. Furthermore, the high prevalence of pregnant smoking women requires the establishment of strategies for offspring lung protection. Therefore, we here aimed to understand the molecular mechanism of how prenatal smoke exposure affects fetal lung development. We used a mouse model recapitulating clinical findings of prenatally exposed children, where pregnant mice were exposed to smoke until c-section or spontaneous delivery, and offspring weight development and lung function was monitored. Additionally, we investigated pulmonary transcriptome changes in fetal lungs (GD18.5) by mRNA/miRNA arrays, network analyses and qPCR. The results demonstrated that prenatally exposed mice showed intrauterine and postnatal growth retardation, and impaired lung function. 1340 genes and 133 miRNAs were found to be significantly dysregulated by in utero smoke exposure, and we identified Insulin-like growth factor 1 (Igf1) as a top hierarchical node in a network analysis. Moreover, Igf1 mRNA was increased in female murine offspring and in prenatally exposed children. These findings suggest that prenatal smoking is associated with a dysregulation of several genes, including Igf1 in a sex-specific manner. Thus, our results could represent a novel link between smoke exposure, abberant lung development and impaired lung function.
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Robinson O, Keski-Rahkonen P, Chatzi L, Kogevinas M, Nawrot T, Pizzi C, Plusquin M, Richiardi L, Robinot N, Sunyer J, Vermeulen R, Vrijheid M, Vineis P, Scalbert A, Chadeau-Hyam M. Cord Blood Metabolic Signatures of Birth Weight: A Population-Based Study. J Proteome Res 2018; 17:1235-1247. [PMID: 29401400 DOI: 10.1021/acs.jproteome.7b00846] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Birth weight is an important indicator of maternal and fetal health and a predictor of health in later life. However, the determinants of variance in birth weight are still poorly understood. We aimed to identify the biological pathways, which may be perturbed by environmental exposures, that are important in determining birth weight. We applied untargeted mass-spectrometry-based metabolomics to 481 cord blood samples collected at delivery in four birth cohorts from across Europe: ENVIRONAGE (Belgium), INMA (Spain), Piccolipiu (Italy), and Rhea (Greece). We performed a metabolome-wide association scan for birth weight on over 4000 metabolic features, controlling the false discovery rate at 5%. Annotation of compounds was conducted through reference to authentic standards. We identified 68 metabolites significantly associated with birth weight, including vitamin A, progesterone, docosahexaenoic acid, indolelactic acid, and multiple acylcarnitines and phosphatidylcholines. We observed enrichment (p < 0.05) of the tryptophan metabolism, prostaglandin formation, C21-steroid hormone signaling, carnitine shuttle, and glycerophospholipid metabolism pathways. Vitamin A was associated with both maternal smoking and birth weight, suggesting a mediation pathway. Our findings shed new light on the pathways central to fetal growth and will have implications for antenatal and perinatal care and potentially for health in later life.
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Affiliation(s)
- Oliver Robinson
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
| | - Pekka Keski-Rahkonen
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete , Voutes University Campus, Heraklion, Crete, GR-70013, Greece
- Department of Preventive Medicine, Keck School of Medicine, University of South California , Soto Street Building 2001 N Soto Street, Suite 201-D, Los Angeles, California 90032-3628, United States
- Department of Genetics & Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University , Universiteitssingel 40, 6229 Maastricht, The Netherlands
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University , Campus Diepenbeek, Agoralaan building D, BE3590 Diepenbeek, Belgium
- Department of Public Health & Primary Care, Leuven University , Oude Markt 13, B-3000 Leuven, Belgium
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte , C.So, Dogliotti, 14, 10126 Turin, Italy
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University , Campus Diepenbeek, Agoralaan building D, BE3590 Diepenbeek, Belgium
- Department of Public Health & Primary Care, Leuven University , Oude Markt 13, B-3000 Leuven, Belgium
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte , C.So, Dogliotti, 14, 10126 Turin, Italy
| | - Nivonirina Robinot
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University , POB 80178, Utrecht NL-3508, The Netherlands
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
| | - Augustin Scalbert
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Marc Chadeau-Hyam
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
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Manzano-Salgado CB, Casas M, Lopez-Espinosa MJ, Ballester F, Iñiguez C, Martinez D, Costa O, Santa-Marina L, Pereda-Pereda E, Schettgen T, Sunyer J, Vrijheid M. Prenatal exposure to perfluoroalkyl substances and birth outcomes in a Spanish birth cohort. ENVIRONMENT INTERNATIONAL 2017; 108:278-284. [PMID: 28917208 DOI: 10.1016/j.envint.2017.09.006] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Prenatal perfluorooctanoate (PFOA) exposure has been associated with reduced birth weight but maternal glomerular filtration rate (GFR) may attenuate this association. Further, this association remains unclear for other perfluoroalkyl substances (PFAS), such as perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA). We estimated associations between prenatal PFAS exposure and birth outcomes, and the influence of GFR, in a Spanish birth cohort. METHODS We measured PFHxS, PFOS, PFOA, and PFNA in 1st-trimester maternal plasma (years: 2003-2008) in 1202 mother-child pairs. Continuous birth outcomes included standardized weight, length, head circumference, and gestational age. Binary outcomes included low birth weight (LBW), small-for-gestational-age, and preterm birth. We calculated maternal GFR from plasma-creatinine measurements in the 1st-trimester of pregnancy (n=765) using the Cockcroft-Gault formula. We used mixed-effects linear and logistic models with region of residence as random effect and adjustment for maternal age, parity, pre-pregnancy BMI, and fish intake during pregnancy. RESULTS Newborns in this study weighted on average 3263g and had a median gestational age of 39.8weeks. The most abundant PFAS were PFOS and PFOA (median: 6.05 and 2.35ng/mL, respectively). Overall, PFAS concentrations were not significantly associated to birth outcomes. PFOA, PFHxS, and PFNA showed weak, non-statistically significant associations with reduced birth weights ranging from 8.6g to 10.3g per doubling of exposure. Higher PFOS exposure was associated with an OR of 1.90 (95% CI: 0.98, 3.68) for LBW (similar in births-at-term) in boys. Maternal GFR did not confound the associations. CONCLUSIONS In this study, PFAS showed little association with birth outcomes. Higher PFHxS, PFOA, and PFNA concentrations were non-significantly associated with reduced birth weight. The association between PFOS and LBW seemed to be sex-specific. Finally, maternal GFR measured early during pregnancy had little influence on the estimated associations.
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Affiliation(s)
- Cyntia B Manzano-Salgado
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Maribel Casas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria-Jose Lopez-Espinosa
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Ferran Ballester
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Carmen Iñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - David Martinez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Olga Costa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Loreto Santa-Marina
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Subdirección de Salud Pública y Adicciones de Gipuzkoa, Donostia-San Sebastián, Spain; Instituto de Investigación Sanitaria BIODONOSTIA, Donostia-San Sebastián, Spain
| | - Eva Pereda-Pereda
- Instituto de Investigación Sanitaria BIODONOSTIA, Donostia-San Sebastián, Spain; Facultad de Psicología, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Thomas Schettgen
- Institute for Occupational Medicine, RWTH Aachen University, Aachen, Germany
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Chavkin U, Wainstock T, Sheiner E, Sergienko R, Walfisch A. Perinatal outcome of pregnancies complicated with extreme birth weights at term. J Matern Fetal Neonatal Med 2017; 32:198-202. [DOI: 10.1080/14767058.2017.1376048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Uri Chavkin
- Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
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Abraham M, Alramadhan S, Iniguez C, Duijts L, Jaddoe VWV, Den Dekker HT, Crozier S, Godfrey KM, Hindmarsh P, Vik T, Jacobsen GW, Hanke W, Sobala W, Devereux G, Turner S. A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PLoS One 2017; 12:e0170946. [PMID: 28231292 PMCID: PMC5322900 DOI: 10.1371/journal.pone.0170946] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/12/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. METHODS Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. RESULTS There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18 SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. CONCLUSIONS Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.
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Affiliation(s)
- Miriam Abraham
- Child Health, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Carmen Iniguez
- FISABIO – Universitat Jaume I – Universitat de València Epidemiology and Environmental Health Joint Research Unit and Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Valencia, Spain
| | - Liesbeth Duijts
- The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Herman T. Den Dekker
- The Generation R Study, Department of Paediatrics, Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sarah Crozier
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Torstein Vik
- Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Geir W. Jacobsen
- Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Wojciech Sobala
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Graham Devereux
- Child Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, United Kingdom
- * E-mail:
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Unachukwu U, Trischler J, Goldklang M, Xiao R, D'Armiento J. Maternal smoke exposure decreases mesenchymal proliferation and modulates Rho-GTPase-dependent actin cytoskeletal signaling in fetal lungs. FASEB J 2017; 31:2340-2351. [PMID: 28209772 DOI: 10.1096/fj.201601063r] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/30/2017] [Indexed: 12/12/2022]
Abstract
The present study tested the hypothesis that maternal smoke exposure results in fetal lung growth retardation due to dysregulation in various signaling pathways, including the Wnt (wingless-related integration site)/β-catenin pathway. Pregnant female C57BL/6J mice were exposed to cigarette smoke (100-150 mg/m3) or room air, and offspring were humanely killed on 12.5, 14.5, 16.5, and 18.5 d post coitum (dpc). We assessed lung stereology with Cavalieri estimation; apoptosis with proliferating cell nuclear antigen, TUNEL, and caspase assays; and gene expression with quantitative PCR (qPCR) and RNA sequencing on lung epithelium and mesenchyme retrieved by laser capture microdissection. Results demonstrated a significant decrease in body weight and lung volume of smoke-exposed embryos. At 16.5 dpc, the reduction in lung volume was due to loss of lung mesenchymal tissue correlating with a decrease in cell proliferation (n = 10; air: 61.65% vs. smoke: 44.21%, P < 0.05). RNA sequence analysis demonstrated an alteration in the Wnt pathway, and qPCR confirmed an increased expression of secreted frizzled-related protein 1 (sFRP-1) [n = 12; relative quantification (RQ) 1 vs. 2.33, P < 0.05] and down-regulation of Cyclin D1 (n = 7; RQ 1 vs. 0.61, P < 0.05) in mesenchymal tissue. Furthermore, genome expression studies revealed a smoke-induced up-regulation of Rho-GTPase-dependent actin cytoskeletal signaling that can lead to loss of tissue integrity.-Unachukwu, U., Trischler, J., Goldklang, M., Xiao, R., D'Armiento, J. Maternal smoke exposure decreases mesenchymal proliferation and modulates Rho-GTPase-dependent actin cytoskeletal signaling in fetal lungs.
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Affiliation(s)
- Uchenna Unachukwu
- Center for Pulmonary Disease, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jordis Trischler
- Center for Pulmonary Disease, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Monica Goldklang
- Center for Pulmonary Disease, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Rui Xiao
- Center for Pulmonary Disease, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jeanine D'Armiento
- Center for Pulmonary Disease, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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van Stuijvenberg ME, Schoeman SE, Nel J, Lombard CJ, Dhansay MA. Serum retinol in post-partum mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency is absent. MATERNAL & CHILD NUTRITION 2017; 13:10.1111/mcn.12223. [PMID: 26564246 PMCID: PMC6865866 DOI: 10.1111/mcn.12223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/23/2015] [Accepted: 08/20/2015] [Indexed: 11/30/2022]
Abstract
Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C-reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = -0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut-off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut-off values during this period.
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Affiliation(s)
- Martha E. van Stuijvenberg
- Nutritional Intervention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- Non‐communicable Diseases Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - Serina E. Schoeman
- Nutritional Intervention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - Jana Nel
- Integrated Nutrition ProgrammeDepartment of HealthNorthern CapeSouth Africa
| | - Carl J. Lombard
- Biostatistics UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - Muhammad A. Dhansay
- Nutritional Intervention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- Burden of Disease Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- Division of Human Nutrition, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- Department of Paediatrics and Child Health, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
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18
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Kullinger M, Wesström J, Kieler H, Skalkidou A. Maternal and fetal characteristics affect discrepancies between pregnancy-dating methods: a population-based cross-sectional register study. Acta Obstet Gynecol Scand 2016; 96:86-95. [PMID: 27696340 PMCID: PMC5213130 DOI: 10.1111/aogs.13034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Gestational age is estimated by ultrasound using fetal size as a proxy for age, although variance in early growth affects reliability. The aim of this study was to identify characteristics associated with discrepancies between last menstrual period-based (EDD-LMP) and ultrasound-based (EDD-US) estimated delivery dates. MATERIAL AND METHODS We identified all singleton births (n = 1 201 679) recorded in the Swedish Medical Birth Register in 1995-2010, to assess the association between maternal/fetal characteristics and large negative and large positive discrepancies (EDD-LMP earlier than EDD-US and 10th percentile in the discrepancy distribution vs. EDD-LMP later than EDD-US and 90th percentile). Analyses were adjusted for age, parity, height, body mass index, smoking, and employment status. RESULTS Women with a body mass index >40 kg/m2 had the highest odds for large negative discrepancies (-9 to -20 days) [odds ratio (OR) 2.16, 95% CI 2.01-2.33]. Other factors associated with large negative discrepancies were: diabetes, young maternal age, multiparity, body mass index between 30 and 39.9 kg/m2 or <18.5 kg/m2 , a history of gestational diabetes, female fetus, shorter stature (<-1 SD), a history of preeclampsia, smoking or snuff use, and unemployment. Large positive discrepancies (+4 to +20 days) were associated with male fetus (OR 1.80, 95% CI 1.77-1.83), age ≥30 years, multiparity, not living with a partner, taller stature (>+1 SD), and unemployment. CONCLUSIONS Several maternal and fetal characteristics were associated with discrepancies between dating methods. Systematic associations of discrepancies with maternal height, fetal sex, and partly obesity, may reflect an influence on the precision of the ultrasound estimate due to variance in early growth.
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Affiliation(s)
- Merit Kullinger
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Center for Clinical Research, Västmanland County Hospital, Västerås, Sweden
| | - Jan Wesström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Center for Clinical Research Dalarna, Falun, Sweden
| | - Helle Kieler
- Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Maitre L, Villanueva CM, Lewis MR, Ibarluzea J, Santa-Marina L, Vrijheid M, Sunyer J, Coen M, Toledano MB. Maternal urinary metabolic signatures of fetal growth and associated clinical and environmental factors in the INMA study. BMC Med 2016; 14:177. [PMID: 27814705 PMCID: PMC5097405 DOI: 10.1186/s12916-016-0706-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/28/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Maternal metabolism during pregnancy is a major determinant of the intra-uterine environment and fetal outcomes. Herein, we characterize the maternal urinary metabolome throughout pregnancy to identify maternal metabolic signatures of fetal growth in two subcohorts and explain potential sources of variation in metabolic profiles based on lifestyle and clinical data. METHODS We used 1H nuclear magnetic resonance (NMR) spectroscopy to characterize maternal urine samples collected in the INMA birth cohort at the first (n = 412 and n = 394, respectively, in Gipuzkoa and Sabadell cohorts) and third trimesters of gestation (n = 417 and 469). Metabolic phenotypes that reflected longitudinal intra- and inter-individual variation were used to predict measures of fetal growth and birth weight. RESULTS A metabolic shift between the first and third trimesters of gestation was characterized by 1H NMR signals arising predominantly from steroid by-products. We identified 10 significant and reproducible metabolic associations in the third trimester with estimated fetal, birth, and placental weight in two independent subcohorts. These included branched-chain amino acids; isoleucine, valine, leucine, alanine and 3 hydroxyisobutyrate (metabolite of valine), which were associated with a significant fetal weight increase at week 34 of up to 2.4 % in Gipuzkoa (P < 0.005) and 1 % in Sabadell (P < 0.05). Other metabolites included pregnancy-related hormone by-products of estrogens and progesterone, and the methyl donor choline. We could explain a total of 48-53 % of the total variance in birth weight of which urine metabolites had an independent predictive power of 12 % adjusting for all other lifestyle/clinical factors. First trimester metabolic phenotypes could not predict reproducibly weight at later stages of development. Physical activity, as well as other modifiable lifestyle/clinical factors, such as coffee consumption, vitamin D intake, and smoking, were identified as potential sources of metabolic variation during pregnancy. CONCLUSIONS Significant reproducible maternal urinary metabolic signatures of fetal growth and birth weight are identified for the first time and linked to modifiable lifestyle factors. This novel approach to prenatal screening, combining multiple risk factors, present a great opportunity to personalize pregnancy management and reduce newborn disease risk in later life.
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Affiliation(s)
- Léa Maitre
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health, School of Public Health, Imperial College London, W2 1PG, London, UK.,Division of Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College London, SW7 2AZ, London, UK
| | - Cristina M Villanueva
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 08003, Barcelona, Spain.,Universitat Pompeu Fabra UPF, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública CIBERESP, 28029, Madrid, Spain.,Municipal Institute of Medical Research IMIM-Hospital del Mar, 08003, Barcelona, Spain
| | - Matthew R Lewis
- MRC-NIHR National Phenome Centre, Department of Surgery and Cancer, Imperial College London, IRDB Building, Du Cane Road, W12 0NN, London, UK
| | - Jesús Ibarluzea
- CIBER Epidemiología y Salud Pública CIBERESP, 28029, Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, 20013, San Sebastián, Spain.,Health Research Institute, Biodonostia, 20013, San Sebastián, Spain
| | - Loreto Santa-Marina
- CIBER Epidemiología y Salud Pública CIBERESP, 28029, Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, 20013, San Sebastián, Spain.,Health Research Institute, Biodonostia, 20013, San Sebastián, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 08003, Barcelona, Spain.,Universitat Pompeu Fabra UPF, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública CIBERESP, 28029, Madrid, Spain.,Municipal Institute of Medical Research IMIM-Hospital del Mar, 08003, Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 08003, Barcelona, Spain.,Universitat Pompeu Fabra UPF, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública CIBERESP, 28029, Madrid, Spain.,Municipal Institute of Medical Research IMIM-Hospital del Mar, 08003, Barcelona, Spain
| | - Muireann Coen
- Division of Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College London, SW7 2AZ, London, UK.
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health, School of Public Health, Imperial College London, W2 1PG, London, UK.
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20
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Holmlund S, Kauko T, Matomäki J, Tuominen M, Mäkinen J, Rautava P. Induced abortion - impact on a subsequent pregnancy in first-time mothers: a registry-based study. BMC Pregnancy Childbirth 2016; 16:325. [PMID: 27776483 PMCID: PMC5078979 DOI: 10.1186/s12884-016-1109-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/11/2016] [Indexed: 12/03/2022] Open
Abstract
Background To date, several studies concerning the effects of induced abortion (IA) on women’s later psychosocial well-being and future delivery complications have been published. However, the lack of reports on woman’s physical well-being during their first full-term pregnancy occurring after IA is what inspired the current study. Here, we evaluate the physical well-being and use of maternity services of first-time mothers with a history of IA. Methods Finnish National Birth Registry data from 2008 to 2010 were linked with the Induced Abortion Registry data from 1983 to 2007. After excluding first-time mothers with a history of miscarriage, ectopic pregnancy or delivery, 57,406 mothers were eligible for the study, with 5,167 (9.0 %) having experienced prior IA. Data from the pregnancy follow-up visits were evaluated and compared between IA mothers and primiparous mothers. Results Women with IA had higher rates of smoking after the first trimester and were more likely to be overweight (body mass index >25 kg/m2) than the control group mothers. A higher use of maternity health clinic (MHC) services, thrombosis prophylaxis and participation in a second trimester ultrasound and amniotic fluid sample testing were evident in IA mothers, whereas the likelihood of assisted fertilisation procedure(s) was elevated in the control group. A shorter interpregnancy interval (IPI) seemed to contribute to a late first MHC visit and first trimester serum screening test participation, a higher incidence of placenta samples and an increased presence of preeclampsia and maternal care for poor foetal growth. Conclusions IA is associated with being overweight before the subsequent pregnancy and with smoking after the first trimester. More frequent pregnancy follow-up visits in the IA group may be due to greater participation in the placenta sample testing and use of thrombosis prophylaxis. No association between IA and preeclampsia, hypertension, gestational diabetes or preterm premature rupture of membranes was evident in the pregnancy parameters. According to our findings, experiencing IA decreased the need for fertilisation procedures before the next pregnancy when compared to primiparous mothers. Among the IA mothers, the short IPI seemed to contribute to the higher risk for preeclampsia and maternal care for poor foetal growth. However, more research is needed around the IPI before establishing its effect on later pregnancy.
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Affiliation(s)
- Susanna Holmlund
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland. .,Säkylä Main Health Centre, Säkylä, Finland. .,Department of Obstetrics and Gynecology, University of Turku, Turku, Finland.
| | - Tommi Kauko
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Jaakko Matomäki
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Miia Tuominen
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland.,Health Care Faculty, Turku University of Applied Sciences, Turku, Finland
| | - Juha Mäkinen
- Department of Obstetrics and Gynecology, University of Turku, Turku, Finland.,Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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21
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Robinson O, Martínez D, Aurrekoetxea JJ, Estarlich M, Somoano AF, Íñiguez C, Santa-Marina L, Tardón A, Torrent M, Sunyer J, Valvi D, Vrijheid M. The association between passive and active tobacco smoke exposure and child weight status among Spanish children. Obesity (Silver Spring) 2016; 24:1767-77. [PMID: 27367931 DOI: 10.1002/oby.21558] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/31/2016] [Accepted: 04/25/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To assess the impact of passive and active tobacco smoke exposure, both pre- and postnatally, on child body mass index (BMI) and overweight. METHODS Pregnant women were enrolled into the Spanish INMA prospective birth cohort during 1997 to 2008. Tobacco smoke exposure was assessed by questionnaire and corroborated by pre- and postnatal cotinine measurements. Children were followed up until 4 years in newer subcohorts (N = 1866) and until 14 years in one older subcohort (N = 427). Child age- and sex-specific BMI Z-scores were calculated, and generalized estimating equations were used to model their relationship with repeated measures of tobacco smoke exposure. RESULTS Associations between prenatal passive exposure to tobacco smoke (adjusted β = 0.15, 95% CI: 0.05-0.25) and active maternal smoking (adjusted β = 0.20, 95% CI: 0.08-0.33) and child zBMI up to 4 years were observed. Stronger associations were observed in the older subcohort between both prenatal and child passive smoke exposure and zBMI up to 14 years. CONCLUSIONS Evidence for an effect of both passive and maternal active smoking on child postnatal growth has been provided. Although residual confounding cannot be completely ruled out, associations were robust to adjustment for a range of lifestyle factors.
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Affiliation(s)
- Oliver Robinson
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - David Martínez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Juan J Aurrekoetxea
- Public Health Department, Basque Government, San Sebastian, Spain
- University of the Basque Country (UPV/EHU), San Sebastian, Spain
- Health Research Institute (BIODONOSTIA), San Sebastian, Spain
| | - Marisa Estarlich
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Spain
| | - Ana Fernández Somoano
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Medicine, University of Oviedo, Spain
| | - Carmen Íñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Spain
| | - Loreto Santa-Marina
- Public Health Department, Basque Government, San Sebastian, Spain
- University of the Basque Country (UPV/EHU), San Sebastian, Spain
- Health Research Institute (BIODONOSTIA), San Sebastian, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Medicine, University of Oviedo, Spain
| | - Maties Torrent
- Ib-salut, Area de Salut de Menorca, Balearic Islands, Spain
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Damaskini Valvi
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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22
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Żądzińska E, Kozieł S, Borowska-Strugińska B, Rosset I, Sitek A, Lorkiewicz W. Parental smoking during pregnancy shortens offspring's legs. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2016; 67:498-507. [PMID: 27908489 DOI: 10.1016/j.jchb.2016.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
Abstract
One of the most severe detrimental environmental factors acting during pregnancy is foetal smoke exposure. The aim of this study was to assess the effect of maternal, paternal and parental smoking during pregnancy on relative leg length in 7- to 10-year-old children. The research conducted in the years 2001-2002 included 978 term-born children, 348 boys and 630 girls, at the age of 7-10 years. Information concerning the birth weight of a child was obtained from the health records of the women. Information about the mother's and the father's smoking habits during pregnancy and about the mothers' education level was obtained from a questionnaire. The influence of parental smoking on relative leg length, controlled for age, sex, birth weight and the mother's education, as a proxy measure of socioeconomic status, and controlled for an interaction between sex and birth weight, was assessed by an analysis of covariance, where relative leg length was the dependent variable, smoking and sex were the independent variables, and birth weight as well as the mother's education were the covariates. Three separate analyses were run for the three models of smoking habits during pregnancy: the mother's smoking, the father's smoking and both parents' smoking. Only both parents' smoking showed a significant effect on relative leg length of offspring. It is probable that foetal hypoxia caused by carbon monoxide contained in smoke decelerated the growth of the long bones of foetuses.
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Affiliation(s)
- E Żądzińska
- Department of Anthropology, University of Łódź, 90-237 Łódź, Poland; School of Medical Sciences, The University of Adelaide, Adelaide 5005, Australia
| | - S Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 50-449 Wroclaw, Poland.
| | | | - I Rosset
- Department of Anthropology, University of Łódź, 90-237 Łódź, Poland
| | - A Sitek
- Department of Anthropology, University of Łódź, 90-237 Łódź, Poland
| | - W Lorkiewicz
- Department of Anthropology, University of Łódź, 90-237 Łódź, Poland
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23
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Carles S, Charles MA, Forhan A, Slama R, Heude B, Botton J. A Novel Method to Describe Early Offspring Body Mass Index (BMI) Trajectories and to Study Its Determinants. PLoS One 2016; 11:e0157766. [PMID: 27327164 PMCID: PMC4915665 DOI: 10.1371/journal.pone.0157766] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/18/2016] [Indexed: 12/30/2022] Open
Abstract
Background Accurately characterizing children’s body mass index (BMI) trajectories and studying their determinants is a statistical challenge. There is a need to identify early public health measures for obesity prevention. We describe a method that allows studies of the determinants of height, weight and BMI growth up to five years of age. We illustrated this method using maternal smoking during pregnancy as one of the early-life factors that is potentially involved in prenatal programming of obesity. Methods Individual height and weight trajectories were fitted using the Jenss-Bayley model on 28,381 and 30,515 measurements, respectively, from 1,666 children to deduce BMI trajectories. We assessed global associations between smoking and growth trajectories and cross-sectional associations at specific ages. Results Children exposed in late pregnancy had a 0.24 kg/m2 (95% confidence interval: 0.07, 0.41) higher BMI at 5 years of age compared with non-exposed children. Although the BMIs of children exposed during late pregnancy became significantly higher compared with those of non-exposed children from 2 years onwards, the trajectories began to diverge during the first weeks of life. Conclusion Our method is relevant for studies on the relationships between individual-level exposures and the dynamics and shapes of BMI growth during childhood, including key features such as instantaneous growth velocities and the age or BMI value at the BMI infancy peak that benefit from the monotonic pattern of height and weight growth.
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Affiliation(s)
- Sophie Carles
- Early determinants of the child’s health and development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France
- Paris Descartes University, Paris, France
- Univ Paris-Sud, Villejuif, France
- * E-mail:
| | - Marie-Aline Charles
- Early determinants of the child’s health and development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France
- Paris Descartes University, Paris, France
| | - Anne Forhan
- Early determinants of the child’s health and development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France
- Paris Descartes University, Paris, France
| | - Rémy Slama
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS and University Grenoble Alpes joint research center, Institute of Advanced Biosciences, U1209, Grenoble, France
- Grenoble Alpes University, Institute of Advanced Biosciences, U1209, Grenoble, France
| | - Barbara Heude
- Early determinants of the child’s health and development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France
- Paris Descartes University, Paris, France
| | - Jérémie Botton
- Early determinants of the child’s health and development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France
- Univ Paris-Sud, Villejuif, France
- Laboratoire de biomathématique, Faculté de Pharmacie, Univ Paris-Sud, Châtenay-Malabry, F-92290, France
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Inoue S, Naruse H, Yorifuji T, Kato T, Murakoshi T, Doi H, Subramanian S. Impact of maternal and paternal smoking on birth outcomes. J Public Health (Oxf) 2016; 39:1-10. [DOI: 10.1093/pubmed/fdw050] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sachiko Inoue
- Department of Nursing Science , Okayama Prefectural University , Okayama , Japan
| | - Hiroo Naruse
- Department of Obstetrics , Kaba Memorial Hospital , Shizuoka , Japan
| | - Takashi Yorifuji
- Department of Human Ecology , Okayama University Graduate School of Environmental and Life Science , Okayama , Japan
| | - Tsuguhiko Kato
- Department of Social Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Takeshi Murakoshi
- Department of Obstetrics and Gynecology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Shizuoka , Japan
| | - Hiroyuki Doi
- Department of Epidemiology , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan
| | - S.V. Subramanian
- Department of Social and Behavioral Sciences , Harvard School of Public Health , Boston, MA , USA
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25
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Gaccioli F, Lager S. Placental Nutrient Transport and Intrauterine Growth Restriction. Front Physiol 2016; 7:40. [PMID: 26909042 PMCID: PMC4754577 DOI: 10.3389/fphys.2016.00040] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/28/2016] [Indexed: 01/30/2023] Open
Abstract
Intrauterine growth restriction refers to the inability of the fetus to reach its genetically determined potential size. Fetal growth restriction affects approximately 5–15% of all pregnancies in the United States and Europe. In developing countries the occurrence varies widely between 10 and 55%, impacting about 30 million newborns per year. Besides having high perinatal mortality rates these infants are at greater risk for severe adverse outcomes, such as hypoxic ischemic encephalopathy and cerebral palsy. Moreover, reduced fetal growth has lifelong health consequences, including higher risks of developing metabolic and cardiovascular diseases in adulthood. Numerous reports indicate placental insufficiency as one of the underlying causes leading to altered fetal growth and impaired placental capacity of delivering nutrients to the fetus has been shown to contribute to the etiology of intrauterine growth restriction. Indeed, reduced expression and/or activity of placental nutrient transporters have been demonstrated in several conditions associated with an increased risk of delivering a small or growth restricted infant. This review focuses on human pregnancies and summarizes the changes in placental amino acid, fatty acid, and glucose transport reported in conditions associated with intrauterine growth restriction, such as maternal undernutrition, pre-eclampsia, young maternal age, high altitude and infection.
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Affiliation(s)
- Francesca Gaccioli
- Department of Obstetrics and Gynaecology, University of Cambridge Cambridge, UK
| | - Susanne Lager
- Department of Obstetrics and Gynaecology, University of Cambridge Cambridge, UK
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Lopez-Espinosa MJ, Murcia M, Iñiguez C, Vizcaino E, Costa O, Fernández-Somoano A, Basterrechea M, Lertxundi A, Guxens M, Gascon M, Goñi-Irigoyen F, Grimalt JO, Tardón A, Ballester F. Organochlorine Compounds and Ultrasound Measurements of Fetal Growth in the INMA Cohort (Spain). ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:157-63. [PMID: 26058084 PMCID: PMC4710595 DOI: 10.1289/ehp.1408907] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 06/05/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have reported decreases in birth size associated with exposure to organochlorine compounds (OCs), but uncertainties remain regarding the critical windows of prenatal exposure and the effects on fetal body segments. OBJECTIVE We examined the relationship between prenatal OC concentrations and fetal anthropometry. METHODS We measured 4,4´-dichlorodiphenyldichloroethylene (4,4´-DDE), hexachlorobenzene (HCB), and polychlorinated biphenyl (PCB) congeners (138, 153, and 180) in 2,369 maternal and 1,140 cord serum samples in four Spanish cohorts (2003-2008). We used linear mixed models to obtain longitudinal growth curves for estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), and femur length (FL) adjusted by parental and fetal characteristics. We calculated standard deviation (SD) scores of growth at 0-12, 12-20, and 20-34 weeks of gestation as well as size at gestational week 34 for the four parameters. We studied the association between OCs and the fetal outcomes by cohort-specific linear models and subsequent meta-analyses. RESULTS PCBs were associated with a reduction in AC up to mid-pregnancy, and BPD and FL from gestational week 20 onward. An inverse association was also found between HCB and AC growth in early pregnancy. The reduction of these parameters ranged from -4% to -2% for a doubling in the OC concentrations. No association between 4,4´-DDE and fetal growth was observed. CONCLUSIONS To our knowledge, this is the first study to report an association between prenatal exposure to some PCBs and HCB and fetal growth: AC during the first two trimesters of pregnancy, and BPD and FL later in pregnancy. CITATION Lopez-Espinosa MJ, Murcia M, Iñiguez C, Vizcaino E, Costa O, Fernández-Somoano A, Basterrechea M, Lertxundi A, Guxens M, Gascon M, Goñi-Irigoyen F, Grimalt JO, Tardón A, Ballester F. 2016. Organochlorine compounds and ultrasound measurements of fetal growth in the INMA cohort (Spain). Environ Health Perspect 124:157-163; http://dx.doi.org/10.1289/ehp.1408907.
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Affiliation(s)
- Maria-Jose Lopez-Espinosa
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Address correspondence to M.-J. Lopez-Espinosa, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO–Public Health, Valencia, Spain. Telephone: (34) 961925941. E-mail:
| | - Mario Murcia
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Carmen Iñiguez
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Nursing Department, School of Nursing, University of Valencia, Valencia, Spain
| | - Esther Vizcaino
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Barcelona, Spain
- Department of Surgery and Cancer, Imperial College London (UK), London, United Kingdom
| | - Olga Costa
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
| | - Mikel Basterrechea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Epidemiology, Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain
- Health Research Institute, Biodonostia, San Sebastian, Spain
| | - Aitana Lertxundi
- Health Research Institute, Biodonostia, San Sebastian, Spain
- Preventive Medicine and Public Health Department, University of the Basque Country, Bilbao, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Pompeu Fabra University, Barcelona, Catalonia, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Mireia Gascon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Pompeu Fabra University, Barcelona, Catalonia, Spain
| | - Fernando Goñi-Irigoyen
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Health Research Institute, Biodonostia, San Sebastian, Spain
- Public Health Laboratory, Basque Government, San Sebastian, Spain
| | - Joan O. Grimalt
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Barcelona, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
| | - Ferran Ballester
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Nursing Department, School of Nursing, University of Valencia, Valencia, Spain
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Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, Musicco M. Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants. Respir Res 2015; 16:152. [PMID: 26695759 PMCID: PMC4699376 DOI: 10.1186/s12931-015-0312-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
Background Tobacco smoke exposure (TSE) is a worldwide health problem and it is considered a risk factor for pregnant women’s and children’s health, particularly for respiratory morbidity during the first year of life. Few significant birth cohort studies on the effect of prenatal TSE via passive and active maternal smoking on the development of severe bronchiolitis in early childhood have been carried out worldwide. Methods From November 2009 to December 2012, newborns born at ≥33 weeks of gestational age (wGA) were recruited in a longitudinal multi-center cohort study in Italy to investigate the effects of prenatal and postnatal TSE, among other risk factors, on bronchiolitis hospitalization and/or death during the first year of life. Results Two thousand two hundred ten newborns enrolled at birth were followed-up during their first year of life. Of these, 120 (5.4 %) were hospitalized for bronchiolitis. No enrolled infants died during the study period. Prenatal passive TSE and maternal active smoking of more than 15 cigarettes/daily are associated to a significant increase of the risk of offspring children hospitalization for bronchiolitis, with an adjHR of 3.5 (CI 1.5–8.1) and of 1.7 (CI 1.1–2.6) respectively. Conclusions These results confirm the detrimental effects of passive TSE and active heavy smoke during pregnancy for infants’ respiratory health, since the exposure significantly increases the risk of hospitalization for bronchiolitis in the first year of life. Electronic supplementary material The online version of this article (doi:10.1186/s12931-015-0312-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcello Lanari
- Pediatrics and Neonatology Unit, Imola Hospital, Via Montericco, 4, Imola, Italy.
| | - Silvia Vandini
- Neonatology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 11 40138, Bologna, Italy.
| | - Fulvio Adorni
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy.
| | - Federica Prinelli
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy.
| | - Simona Di Santo
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. .,Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy.
| | - Michela Silvestri
- Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.
| | - Massimo Musicco
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. .,Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy.
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Tobacco use in the third trimester of pregnancy and its relationship to birth weight. A prospective study in Spain. Women Birth 2015; 28:e134-9. [DOI: 10.1016/j.wombi.2015.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 06/04/2015] [Accepted: 06/22/2015] [Indexed: 11/17/2022]
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Low intake of calcium and vitamin D, but not zinc, iron or vitamin A, is associated with stunting in 2- to 5-year-old children. Nutrition 2015; 31:841-6. [DOI: 10.1016/j.nut.2014.12.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/22/2014] [Accepted: 12/09/2014] [Indexed: 01/30/2023]
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Melchior M, Hersi R, van der Waerden J, Larroque B, Saurel-Cubizolles MJ, Chollet A, Galéra C. Maternal tobacco smoking in pregnancy and children's socio-emotional development at age 5: The EDEN mother-child birth cohort study. Eur Psychiatry 2015; 30:562-8. [PMID: 25843027 DOI: 10.1016/j.eurpsy.2015.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is debate as to whether maternal tobacco use in pregnancy is related to offspring behaviour later on. We tested this association examining multiple aspects of children's behaviour at age 5 and accounting for parental smoking outside of pregnancy, as well as child and family characteristics. METHODS Data come from a prospective community based birth cohort study (EDEN; n=1113 families in France followed since pregnancy in 2003-2005 until the child's 5th birthday). Maternal tobacco use in pregnancy was self-reported. Children's socio-emotional development (emotional symptoms, conduct problems, symptoms of hyperactivity/inattention, peer relationship problems, prosocial behaviour) was assessed by mothers using the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Logistic regression analyses controlled for Inverse Probability Weights (IPW) of maternal tobacco use calculated based on study center, children's characteristics (sex, premature birth, low birth weight, breastfeeding), maternal characteristics (age at the child's birth, psychological difficulties and alcohol use in pregnancy, post-pregnancy depression, and smoking), paternal smoking in and post-pregnancy, parental educational attainment, family income, parental separation, and maternal negative life events. RESULTS Maternal smoking in pregnancy only predicted children's high symptoms of hyperactivity/inattention (sex and study center-adjusted ORs: maternal smoking in the 1st trimester: 1.95, 95%CI: 1.13-3.38; maternal smoking throughout pregnancy: OR=2.11, 95%CI: 1.36-3.27). In IPW-controlled regression models, only children of mothers who smoked throughout pregnancy had significantly elevated levels of hyperactivity/inattention (OR=2.20, 95%CI: 1.21-4.00). CONCLUSIONS Maternal tobacco smoking in pregnancy may contribute directly or through epigenetic mechanisms to children's symptoms of hyperactivity/inattention.
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Affiliation(s)
- M Melchior
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France.
| | - R Hersi
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - J van der Waerden
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - B Larroque
- INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University, 75020 Paris, France; UMR-S 953, UPMC - Université Paris 06, 75020 Paris, France
| | - M-J Saurel-Cubizolles
- INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University, 75020 Paris, France; UMR-S 953, UPMC - Université Paris 06, 75020 Paris, France
| | - A Chollet
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - C Galéra
- Department of Child and Adolescent Psychiatry, Charles-Perrens Hospital, University of Bordeaux, 33076 Bordeaux, France; INSERM U897, Center for Research in Epidemiology and Biostatistics, prévention et prise en charge des traumatismes, Bordeaux, France
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31
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Morales E, Rodriguez A, Valvi D, Iñiguez C, Esplugues A, Vioque J, Marina LS, Jiménez A, Espada M, Dehli CR, Fernández-Somoano A, Vrijheid M, Sunyer J. Deficit of vitamin D in pregnancy and growth and overweight in the offspring. Int J Obes (Lond) 2014; 39:61-8. [PMID: 25189178 DOI: 10.1038/ijo.2014.165] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 08/25/2014] [Accepted: 09/02/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Maternal vitamin D status during fetal development may influence offspring growth and risk of obesity; however, evidence in humans is limited. OBJECTIVE To investigate whether maternal circulating 25-hydroxyvitamin D3 (25(OH)D3) concentration in pregnancy is associated with offspring prenatal and postnatal growth and overweight. METHODS Plasma 25(OH)D3 concentration was measured in pregnant women (median weeks of gestation 14.0, range 13.0-15.0) from the INMA (INfancia y Medio Ambiente) cohort (Spain, 2003-2008) (n = 2358). Offspring femur length (FL), biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) were evaluated at 12, 20 and 34 weeks of gestation by ultrasound examinations. Fetal overweight was defined either as AC or as EFW ⩾ 90th percentile. Child's anthropometry was recorded at ages 1 and 4 years. Rapid growth was defined as a weight gain z-score of >0.67 from birth to ages 6 months and 1 year. Age- and sex-specific z-scores for body mass index (BMI) were calculated at ages 1 and 4 years (World Health Organization referent); infant's overweight was defined as a BMI z-score ⩾ 85th percentile. RESULTS We found no association of maternal 25(OH)D3 concentration with FL and a weak inverse association with BPD at 34 weeks. Maternal deficit of 25(OH)D3 (<20 ng ml(-1)) was associated with increased risk of fetal overweight defined as AC ⩾ 90th percentile (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.01-2.21; P = 0.041) or either as EFW ⩾ 90th percentile (OR = 1.47, 95% CI: 1.00-2.16; P = 0.046). No significant associations were found with rapid growth. Deficit of 25(OH)D3 in pregnancy was associated with an increased risk of overweight in offspring at age 1 year (OR = 1.42, 95% CI: 1.02-1.97; P = 0.039); however, the association was attenuated at age 4 years (OR = 1.19, 95% CI: 0.83-1.72; P = 0.341). CONCLUSIONS Vitamin D deficiency in pregnancy may increase the risk of prenatal and early postnatal overweight in offspring. Clinical trials are warranted to determine the role of vitamin D in the early origins of obesity.
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Affiliation(s)
- E Morales
- 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain [3] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [4] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Rodriguez
- 1] Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Catalonia, Spain [2] Universitat Autònoma de Barcelona, Campus d'Excelència Internacional Bellaterra, Barcelona, Catalonia, Spain
| | - D Valvi
- 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C Iñiguez
- 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain
| | - A Esplugues
- 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain
| | - J Vioque
- 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Departamento de Salud Publica, Universidad Miguel Hernandez, Alicante, Spain
| | - L S Marina
- 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Gipuzkoa, Spain [3] Health Research Institute Biodonostia, San Sebastián, Gipuzkoa, Spain
| | - A Jiménez
- 1] Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Gipuzkoa, Spain [2] Health Research Institute Biodonostia, San Sebastián, Gipuzkoa, Spain
| | - M Espada
- Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain
| | - C R Dehli
- Hospital San Agustín, Avilés, Oviedo, Spain
| | - A Fernández-Somoano
- 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Asturias, Spain
| | - M Vrijheid
- 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Sunyer
- 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain [3] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [4] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Norris T, Tuffnell D, Wright J, Cameron N. Modelling foetal growth in a bi-ethnic sample: results from the Born in Bradford (BiB) birth cohort. Ann Hum Biol 2014; 41:481-7. [PMID: 24564820 DOI: 10.3109/03014460.2014.882412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Attempts to explain the increased risk for metabolic disorders observed in South Asians have focused on the "South Asian" phenotype at birth and subsequent post-natal growth, with little research on pre-natal growth. AIM To identify whether divergent growth patterns exist for foetal weight, head (HC) and abdominal circumferences (AC) in a sample of Pakistani and White British foetuses. SUBJECTS AND METHODS Models were based on 5553 (weight), 5154 (HC) and 5099 (AC) foetuses from the Born in Bradford birth cohort. Fractional polynomials and mixed effects models were employed to determine growth patterns from ~15 weeks of gestation-birth. RESULTS Pakistani foetuses were significantly smaller and lighter as early as 20 weeks. However, there was no ethnic difference in the growth patterns of weight and HC. For AC, Pakistani foetuses displayed a trend for reduced growth in the final trimester. CONCLUSION As the pattern of weight and HC growth was not significantly different during the period under investigation, the mechanism culminating in the reduced Pakistani size at birth may act earlier in gestation. Reduced AC growth in Pakistanis may represent reduced growth of the visceral organs, with consequences for post-natal liver metabolism and renal function.
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Affiliation(s)
- Tom Norris
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough , UK and
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Vila L, Velasco I, González S, Morales F, Sánchez E, Torrejón S, Soldevila B, Stagnaro-Green A, Puig-Domingo M. Controversies in endocrinology: On the need for universal thyroid screening in pregnant women. Eur J Endocrinol 2014; 170:R17-30. [PMID: 24128429 DOI: 10.1530/eje-13-0561] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There is a well-known controversy among scientific societies regarding the recommendation to screen for thyroid dysfunction (TD) during pregnancy. Although several studies have shown an association between maternal subclinical hypothyroidism and/or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, there is only limited evidence on the possible positive effects of thyroxine (T4) treatment in such cases. Despite the scarcity of this evidence, there is a widespread agreement among clinicians on the need for treatment of clinical hypothyroidism during pregnancy and the risks that could arise due to therapeutic abstention. As maternal TD is a quite prevalent condition, easily diagnosed and for which an effective and safe treatment is available, some scientific societies have proposed to assess thyroid function during the first trimester of pregnancy and ideally before week 10 of gestational age. Given the physiologic changes of thyroid function during pregnancy, hormone assessment should be performed using trimester-specific reference values ideally based on locally generated data as geographic variations have been detected. Screening of TD should be based on an initial determination of TSH performed early during the first trimester and only if abnormal should it be followed by either a free or total T4 measurement. Furthermore, adequate iodine supplementation during pregnancy is critical and if feasible it should be initiated before the woman attempts to conceive.
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Affiliation(s)
- Lluís Vila
- Department of Endocrinology and Nutrition, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain
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