1
|
Kong KL, Lee JK, Shisler S, Thanos PK, Huestis MA, Hawk L, Eiden RD. Prenatal tobacco and cannabis co-exposure and offspring obesity development from birth to mid-childhood. Pediatr Obes 2023; 18:e13010. [PMID: 36734672 PMCID: PMC10288513 DOI: 10.1111/ijpo.13010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although the association between prenatal tobacco exposure and child obesity risk is well-established, less is known about co-exposure to tobacco and cannabis. OBJECTIVE Determine the relation between prenatal substance co-exposure and obesity risk. METHODS In a diverse sample of pregnant women, we examined the association between prenatal substance exposure (tobacco-only and co-exposure) and child BMI (kg/m2 ) trajectories from birth to mid-childhood (n = 262), overweight/obese status based on BMI percentiles from toddlerhood (24 months) to mid-childhood (9-12 years), and adiposity outcomes at mid-childhood (fat mass [kg], fat mass [%] and fat free mass [kg]; n = 128). Given that the major goal of this study was to examine the associations between prenatal substance exposure and child outcomes, we oversampled pregnant women for substance use (with tobacco as the primary focus). RESULTS Multilevel models demonstrated that children in both exposure groups had a steeper increase in BMI trajectory from birth to mid-childhood and among co-exposed children, girls had a steeper increase than boys. Odds ratio of having obesity by mid-childhood was 12 times higher among those co-exposed than non-exposed. Co-exposure led to significantly greater fat mass and fat mass % compared with no exposure, but exposure to only tobacco was no different than no exposure. CONCLUSIONS Results highlight potentiating effects of cannabis exposure in the context of maternal tobacco use in pregnancy on obesity risk and the importance of multi-method assessments of obesity.
Collapse
Affiliation(s)
- Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri- Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jin-kyung Lee
- Department of Psychology and The Social Science Research Institute, The Pennsylvania State University, University Park, PA 16801, USA
| | - Shannon Shisler
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, 14203, USA
| | - Panayotis K. Thanos
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14203, USA
| | - Marilyn A. Huestis
- Institute on Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Larry Hawk
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14203, USA
| | - Rina D. Eiden
- Department of Psychology and The Social Science Research Institute, The Pennsylvania State University, University Park, PA 16801, USA
| |
Collapse
|
2
|
Moore BF, Kreitner KJ, Starling AP, Martenies SE, Magzamen S, Clark M, Dabelea D. Early-life exposure to tobacco and childhood adiposity: Identifying windows of susceptibility. Pediatr Obes 2022; 17:e12967. [PMID: 36350199 PMCID: PMC10035041 DOI: 10.1111/ijpo.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Early-life exposure to tobacco is associated with obesity, but the most susceptible developmental periods are unknown. OBJECTIVE To explore windows of susceptibility in a cohort of 568 mother-child pairs. METHODS We measured seven measures of tobacco exposure (five self-reported and two biomarkers) spanning from pre-conception to age 5 years. Mothers self-reported active smoking (pre-conception, 17 weeks, and delivery) and household smokers (5 and 18 months postnatally). Cotinine was measured in maternal urine (27 weeks) and child urine (5 years). Adiposity (fat mass percentage) was measured at birth and 5 years via air displacement plethysmography. Using a multiple informant approach, we tested whether adiposity (5 years) and changes in adiposity (from birth to 5 years) differed by the seven measures of tobacco exposure. RESULTS The associations may depend on timing. For example, only pre-conception (β = 3.1%; 95% CI: 1.0-5.1) and late gestation (β = 4.0%; 95% CI: 0.4-7.6) exposures influenced adiposity accretion from birth to 5 years (p for interaction = 0.01). Early infancy exposure was also associated with 1.7% higher adiposity at 5 years (95% CI: 0.1-3.2). Mid-pregnancy and early childhood exposures did not influence adiposity. CONCLUSIONS Pre-conception, late gestation, and early infancy exposures to tobacco may have the greatest impact on childhood adiposity.
Collapse
Affiliation(s)
- Brianna F. Moore
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center, Austin, Texas, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado, USA
| | - Kimberly J. Kreitner
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center, Austin, Texas, USA
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado, USA
| | - Sheena E. Martenies
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Maggie Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| |
Collapse
|
3
|
Handakas E, Keski-Rahkonen P, Chatzi L, Alfano R, Roumeliotaki T, Plusquin M, Maitre L, Richiardi L, Brescianini S, Scalbert A, Robinot N, Nawrot T, Sassi F, Vrijheid M, Vineis P, Robinson O. Cord blood metabolic signatures predictive of childhood overweight and rapid growth. Int J Obes (Lond) 2021; 45:2252-2260. [PMID: 34253844 PMCID: PMC8455328 DOI: 10.1038/s41366-021-00888-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/30/2021] [Accepted: 06/22/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Metabolomics may identify biological pathways predisposing children to the risk of overweight and obesity. In this study, we have investigated the cord blood metabolic signatures of rapid growth in infancy and overweight in early childhood in four European birth cohorts. METHODS Untargeted liquid chromatography-mass spectrometry metabolomic profiles were measured in cord blood from 399 newborns from four European cohorts (ENVIRONAGE, Rhea, INMA and Piccolipiu). Rapid growth in the first year of life and overweight in childhood was defined with reference to WHO growth charts. Metabolome-wide association scans for rapid growth and overweight on over 4500 metabolic features were performed using multiple adjusted logistic mixed-effect models and controlling the false discovery rate (FDR) at 5%. In addition, we performed a look-up analysis of 43 pre-annotated metabolites, previously associated with birthweight or rapid growth. RESULTS In the Metabolome-Wide Association Study analysis, we identified three and eight metabolites associated with rapid growth and overweight, respectively, after FDR correction. Higher levels of cholestenone, a cholesterol derivative produced by microbial catabolism, were predictive of rapid growth (p = 1.6 × 10-3). Lower levels of the branched-chain amino acid (BCAA) valine (p = 8.6 × 10-6) were predictive of overweight in childhood. The area under the receiver operator curve for multivariate prediction models including these metabolites and traditional risk factors was 0.77 for rapid growth and 0.82 for overweight, compared with 0.69 and 0.69, respectively, for models using traditional risk factors alone. Among the 43 pre-annotated metabolites, seven and five metabolites were nominally associated (P < 0.05) with rapid growth and overweight, respectively. The BCAA leucine, remained associated (1.6 × 10-3) with overweight after FDR correction. CONCLUSION The metabolites identified here may assist in the identification of children at risk of developing obesity and improve understanding of mechanisms involved in postnatal growth. Cholestenone and BCAAs are suggestive of a role of the gut microbiome and nutrient signalling respectively in child growth trajectories.
Collapse
Affiliation(s)
- Evangelos Handakas
- Μedical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rossella Alfano
- Μedical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Léa Maitre
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - Sonia Brescianini
- Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Augustin Scalbert
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Nivonirina Robinot
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Franco Sassi
- Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College Business School, South Kensington Campus, London, UK
| | - Martine Vrijheid
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Paolo Vineis
- Μedical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Oliver Robinson
- Μedical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
| |
Collapse
|
4
|
Joint effects of ambient air pollution and maternal smoking on neonatal adiposity and childhood BMI trajectories in the Healthy Start study. Environ Epidemiol 2021; 5:e142. [PMID: 34131612 PMCID: PMC8196098 DOI: 10.1097/ee9.0000000000000142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
Coexposure to air pollution and tobacco smoke may influence early-life growth, but few studies have investigated their joint effects. We examined the interaction between fetal exposure to maternal smoking and ozone (O3) or fine particulate matter (PM2.5) on birth weight, neonatal adiposity, and body mass index (BMI) trajectories through age 3 years. Methods Participants were 526 mother-child pairs, born ≥37 weeks. Cotinine was measured at ~27 weeks gestation. Whole pregnancy and trimester-specific O3 and PM2.5 were estimated via. inverse-distance weighted interpolation from stationary monitors. Neonatal adiposity (fat mass percentage) was measured via. air displacement plethysmography. Child weight and length/height were abstracted from medical records. Interaction was assessed by introducing cotinine (<31.5 vs. ≥31.5 ng/mL [indicating active smoking]), O3/PM2.5 (low [tertiles 1-2] vs. high [tertile 3]), and their product term in linear regression models for birth weight and neonatal adiposity and mixed-effects models for BMI trajectories. Results The rate of BMI growth among offspring jointly exposed to maternal smoking and high PM2.5 (between 8.1 and 12.7 μg/m3) in the third trimester was more rapid than would be expected due to the individual exposures alone (0.8 kg/m2 per square root year; 95% CI = 0.1, 1.5; P for interaction = 0.03). We did not detect interactions between maternal smoking and O3 or PM2.5 at any other time on birth weight, neonatal adiposity, or BMI trajectories. Conclusions Although PM2.5 was generally below the EPA annual air quality standards of 12.0 μg/m3, exposure during the third trimester may influence BMI trajectories when combined with maternal smoking.
Collapse
|
5
|
Smart SJ, Nikaj AN, Yu L, Li H, Yan F, Zhang J. Association between maternal smoking during pregnancy and offspring overweight in U.S.-born children. Pediatr Obes 2021; 16:e12717. [PMID: 32924334 DOI: 10.1111/ijpo.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The criticism of the literature on smoking during pregnancy and offspring overweight was the confounding from postnatal factors. Interaction between gestational age and prenatal maternal smoking has not yet assessed. METHODS We used the Third National Health and Nutrition Examination Survey (1988-1994), linked with natality files of US-born singletons aged 2 to 6 years. A body mass index in the 85th percentile or higher were considered overweight, including obesity. Gestational age was dichotomized as preterm (<37 weeks, n = 240) or full-term (n = 2125). Smoking status during pregnancy was ascertained by a questionnaire-based interview during National Health and Nutrition Examination Survey. RESULTS The prevalence of offspring overweight and obesity combined was 17.3% (SE = 1.3%). And 24.0% (1.3%) of mothers smoked while pregnant. A significant interaction was observed between maternal smoking and gestational age. In preterm children, a higher prevalence of overweight (34.3% [6.7%]) was found among the offspring of smoking mothers compared to non-smoking mothers (15.8% [3.6%]). After adjustment for socio-demographics, prenatal and postnatal factors, in preterm born offspring, the odds ratio of being born to smoking mothers was 2.46 (95% confidence intervals: 1.13-5.37) among children with overweight/obesity compared to children with healthy weight born to non-smoking mothers. In full-term children, the OR of being born to smoking mothers was 0.72 (0.50-1.03) among offspring with overweight/obesity relative to offspring with healthy weight born to non-smoking mothers. CONCLUSIONS Maternal smoking during pregnancy was strongly associated with offspring overweight and obesity in preterm births after control for postnatal factors. Preterm children of smoking mothers should be prioritized for obesity prevention.
Collapse
Affiliation(s)
- Shirley J Smart
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Aurela N Nikaj
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Lili Yu
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Hongxia Li
- Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China.,Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Fei Yan
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| |
Collapse
|
6
|
Hu J, Aris IM, Lin PID, Rifas-Shiman SL, Perng W, Woo Baidal JA, Wen D, Oken E. Longitudinal associations of modifiable risk factors in the first 1000 days with weight status and metabolic risk in early adolescence. Am J Clin Nutr 2020; 113:113-122. [PMID: 33184628 PMCID: PMC7779210 DOI: 10.1093/ajcn/nqaa297] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Many studies have identified early-life risk factors for childhood overweight/obesity (OwOb), but few have evaluated how they combine to influence later cardiometabolic health. OBJECTIVES We aimed to examine the association of risk factors in the first 1000 d with adiposity and cardiometabolic risk in early adolescence. METHODS We studied 1038 mother-child pairs in Project Viva. We chose 6 modifiable early-life risk factors previously associated with child adiposity or metabolic health in the cohort: smoking during pregnancy (yes compared with no); gestational weight gain (excessive compared with nonexcessive); sugar-sweetened beverage consumption during pregnancy (≥0.5 compared with <0.5 servings/d); breastfeeding duration (<12 compared with ≥12 mo); timing of complementary food introduction (<4 compared with ≥4 mo); and infant sleep duration (<12 compared with ≥12 h/d). We computed risk factor scores by calculating the cumulative number of risk factors for each child. In early adolescence (median: 13.1 y) we measured indicators of adiposity [BMI, fat mass index (FMI), trunk fat mass index (TFMI)]. We also calculated OwOb prevalence and metabolic syndrome (MetS) risk z score of adolescents. RESULTS Among 1038 adolescents, 71% had >1 early-life risk factor. In covariate-adjusted models, we observed positive monotonic increases in BMI, FMI, TFMI, and MetS z scores with increasing risk factor score. Children with 5‒6 risk factors (compared with 0-1 risk factors) had the highest risk of OwOb [risk ratio (RR): 2.53; 95% CI: 1.63, 3.91] and being in the highest MetS quartile (RR: 2.46; 95% CI: 1.43, 4.21). The predicted probability of OwOb in adolescence varied from 9.4% (favorable levels for all factors) to 63.6% (adverse levels for all factors), and for being in the highest MetS quartile from 9.6% to 56.6%. CONCLUSIONS Early-life risk factors in the first 1000 d cumulatively predicted higher adiposity and cardiometabolic risk in early adolescence. Intervention strategies to prevent later obesity and cardiometabolic risk may be more effective if they concurrently target multiple modifiable factors.
Collapse
Affiliation(s)
- Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China,Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, Liaoning, China,Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Pi-I D Lin
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Wei Perng
- Department of Epidemiology, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer A Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University and New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - Emily Oken
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
7
|
Ng S, Aris IM, Tint MT, Gluckman PD, Godfrey KM, Shek LPC, Yap F, Tan KH, Lek N, Teoh OH, Chan YH, Chong MFF, Lee YS, Chong YS, Kramer MS, Chan SY. High Maternal Circulating Cotinine During Pregnancy is Associated With Persistently Shorter Stature From Birth to Five Years in an Asian Cohort. Nicotine Tob Res 2020; 21:1103-1112. [PMID: 30032178 DOI: 10.1093/ntr/nty148] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 07/16/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Self-reported maternal active smoking has been associated with reduced offspring birth length and shorter stature in early and late childhood. OBJECTIVE To use circulating cotinine as an objective biomarker to investigate the association between smoking and environmental tobacco smoke (ETS) exposure in pregnancy and longitudinal measures of offspring length/height from birth to 60 months. METHODS In 969 maternal-offspring dyads from the GUSTO cohort, maternal plasma cotinine at 26-28 weeks' gestation was measured by LC/MS/MS and categorized into four groups: Group 1: cotinine <0.17 ng/mL (the assay's detection limit) and no ETS exposure; Group 2: cotinine <0.17 ng/mL but self-reported ETS; Group 3: cotinine 0.17-13.99 ng/mL (ETS or light smoking); Group 4: cotinine ≥14 ng/mL (active smoking). RESULTS Adjusting for infant sex, gestational age at birth, ethnicity, maternal age, education, parity, BMI, and height, Group 4 offspring were shorter at birth [z-score β = -0.42 SD units (SDs) (95% CI = -0.77 to -0.06)] than Group 1 offspring. Group 4 offspring continued to be shorter at older ages, with similar effect sizes at 3 months [-0.57 SDs (-0.95 to -0.20)], 36 months [-0.53 SDs (-0.92 to -0.15)], 48 months [-0.43 SDs (-0.81 to -0.04)], and 60 months [-0.57 SDs (-0.96 to -0.17)]. Associations were particularly marked in boys. No significant differences in stature were observed in Groups 2 or 3 compared with Group 1. CONCLUSIONS This Asian longitudinal study associated high prenatal cotinine with persistently shorter stature in offspring from birth and into early childhood, whilst low prenatal cotinine levels and ETS exposure showed no such association. IMPLICATIONS Little is known about the long-term effects of prenatal tobacco exposure on offspring stature in Asia where passive smoking is common. This study has used an objective biomarker to reveal that the association of prenatal tobacco exposure with offspring length/height mainly occurs at a high maternal cotinine level of greater than 14 ng/mL in pregnancy, consistent with active smoking, but no significant associations were found with lower cotinine levels, consistent with passive smoking. Encouraging women to quit smoking prior to or during pregnancy may avert the long-term negative impact on their child's height despite appreciable prenatal ETS exposure.
Collapse
Affiliation(s)
- Sharon Ng
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Ngee Lek
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Oon Hoe Teoh
- Respiratory Medicine Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Michael S Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.,Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| |
Collapse
|
8
|
Qureshi R, Jadotte Y, Zha P, Porter SA, Holly C, Salmond S, Watkins EA. The association between prenatal exposure to environmental tobacco smoke and childhood obesity: a systematic review. ACTA ACUST UNITED AC 2019; 16:1643-1662. [PMID: 30113549 DOI: 10.11124/jbisrir-2017-003558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of the review was to determine if prenatal exposure to environmental tobacco smoke (ETS) increases the risk of obesity and overweight in children. INTRODUCTION Childhood obesity has reached epidemic proportions in many developed countries. This is of great concern as childhood obesity is associated with early onset of chronic diseases such as coronary artery disease, type II diabetes and hypertension in adulthood. Extensive research suggests a multifactorial etiology. These factors include genetic markers, individual lifestyle, social and environmental factors, particularly the interaction between these factors. Among environmental factors, prenatal exposure to ETS has been linked to increased rates of obesity and overweight in childhood. INCLUSION CRITERIA This review considered studies on children of women who were non-smokers and who reported exposure to ETS during pregnancy. The exposure of interest was exposure to ETS or second hand smoke during pregnancy, determined by either: i) self-reported maternal exposure; and/or ii) serum cotinine levels. Observational studies such as cohort studies, case control studies, retrospective studies and analytical cross-sectional studies were included. Outcomes of interest were weight, height and body mass index of children from birth up to 18 years. METHODS A three-step search strategy was used to search for published and unpublished studies in the English language. No search range (years) was set. Two reviewers assessed the studies for inclusion and methodological quality using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) standardized appraisal instruments. Data was extracted by two people independently and entered into the JBI extraction tool. Extracted data was pooled in a statistical meta-analysis based on a random effects model. RESULTS Nineteen studies were included in the review. Eight of the studies were included in the final meta-analysis. Findings suggest that there was an association between prenatal exposure to ETS and childhood obesity (odds ratio [OR]: 1.905, CI: 1.23-2.94), and no association between ETS exposure and overweight (OR: 1.51, CI: 0.49-4.59). The high rates of heterogeneity between studies in both of the meta-analyses determined by the I statistic (97% and 99%, respectively) sanction caution in the interpretation and use of these findings. CONCLUSIONS Based on the evidence, childhood obesity is associated with exposure to prenatal ETS, however overweight does not appear to be associated with this type of exposure.
Collapse
Affiliation(s)
- Rubab Qureshi
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Yuri Jadotte
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Peijia Zha
- School of Nursing, Rutgers University, Newark, USA
| | - Sallie Ann Porter
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Cheryl Holly
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Susan Salmond
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | | |
Collapse
|
9
|
da Silva Magalhães EI, Peixoto Lima N, Baptista Menezes AM, Gonçalves H, Wehrmeister FC, Formoso Assunção M, Lessa Horta B. Maternal smoking during pregnancy and offspring body composition in adulthood: Results from two birth cohort studies. BMJ Open 2019; 9:e023852. [PMID: 31196896 PMCID: PMC6575638 DOI: 10.1136/bmjopen-2018-023852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate the association of maternal smoking during pregnancy with offspring body composition in adulthood and explore the causality of this association. DESIGN Birth cohort. SETTING Population-based study in Pelotas, Brazil. PARTICIPANTS All newborn infants in the city's hospitals were enrolled in 1982 and 1993. At a mean age of 30.2 and 22.6 years, the 1982 and 1993 cohorts, respectively, followed the subjects and 7222 subjects were evaluated. PRIMARY OUTCOME MEASURES Body mass index (BMI), fat mass index, android to gynoid fat ratio, waist circumference, waist to height ratio, lean mass index and height. RESULTS Prevalence of maternal smoking during pregnancy was 35.1% and 32.6%, in 1982 and 1993 cohorts, respectively. Offspring of smoking mothers showed higher mean BMI (β: 0.84; 95% CI: 0.55 to 1.12 kg/m2), fat mass index (β: 0.44; 95% CI: 0.23 to 0.64 kg/m2), android to gynoid fat ratio (β: 0.016; 95% CI: 0.010 to 0.023), waist circumference (β: 1.74; 95% CI: 1.15 to 2.33 cm), waist to height ratio (β: 0.013; 95% CI: 0.010 to 0.017) and lean mass index (β: 0.33; 95% CI: 0.24 to 0.42 kg/m2), whereas height was lower (β: -0.95; -1.26 to -0.65). Weight gain in the first 2 years captured most of the association of maternal smoking with BMI (96.2%), waist circumference (86.1%) and fat mass index (71.7%). CONCLUSIONS Maternal smoking in pregnancy was associated with offspring body composition measures in adulthood.
Collapse
Affiliation(s)
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando C Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
10
|
Wen X, Eiden RD, Justicia-Linde FE, Wang Y, Higgins ST, Thor N, Haghdel A, Peters AR, Epstein LH. A multicomponent behavioral intervention for smoking cessation during pregnancy: a nonconcurrent multiple-baseline design. Transl Behav Med 2019; 9:308-318. [PMID: 29648615 DOI: 10.1093/tbm/iby027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy. In this nonconcurrent, multiple-baseline intervention pilot study, 48 daily smoking pregnant women (mean 13.7 weeks of gestation) were recruited from Buffalo, NY, USA. Upon completion of the repeated baseline smoking monitoring (up to 3 weeks), 30 continuous smokers received a contingent financial incentive-based intervention with three additional components (education and counseling, monitoring and feedback, and family support). After the quit date, participants met with counselors (~1 hr/visit) daily for 2 weeks and twice a week for another 6 weeks. Twenty-one out of 30 participants quit smoking completely (verified by urine cotinine) after receiving the intervention, and the other nine nonquitters decreased smoking substantially. The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others. This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.
Collapse
Affiliation(s)
- Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Rina D Eiden
- Research Institute on Addictions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Faye E Justicia-Linde
- Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Youfa Wang
- Fisher Institute of Health and Well-being, Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Nicolas Thor
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Arsalan Haghdel
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Ariel R Peters
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| |
Collapse
|
11
|
Kerling EH, Hilton JM, Thodosoff JM, Wick J, Colombo J, Carlson SE. Effect of Prenatal Docosahexaenoic Acid Supplementation on Blood Pressure in Children With Overweight Condition or Obesity: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2019; 2:e190088. [PMID: 30794304 PMCID: PMC6484605 DOI: 10.1001/jamanetworkopen.2019.0088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE The blood pressure-lowering property of docosahexaenoic acid (DHA) in children and adults is known, and an observational study from the Netherlands has linked higher intrauterine DHA exposure to lower childhood blood pressure. However, the association of prenatal intake of DHA supplement with childhood blood pressure has not been evaluated in randomized clinical trials. OBJECTIVE To determine the effect of DHA supplementation during pregnancy on childhood blood pressure. DESIGN, SETTING, AND PARTICIPANTS This prespecified secondary analysis of the Kansas University DHA Outcome Study (KUDOS), a phase 3, double-blind, randomized, placebo-controlled clinical trial was conducted at several local hospitals in the Kansas City, Kansas, metropolitan area. Pregnant women (n = 350) were enrolled in the KUDOS trial between January 10, 2006, and November 17, 2009, and were followed up until their children were 18 months of age. During pregnancy, the women received either 3 capsules per day of placebo or 600 mg per day of DHA from a mean (SD) of 14.5 (3.7) weeks' (all before 20 weeks) gestation until birth. The parents of 190 children consented to additional follow-up of their children until 6 years, which ended April 29, 2016. Study personnel involved in testing were blind to the randomization until all children had completed the trial. Data analysis was performed from May 23, 2017, to July 10, 2018. INTERVENTIONS Pregnant women were assigned to either 600 mg per day of DHA or a placebo that was half soy and half corn oil. Both placebo and DHA were provided in 3 capsules per day. MAIN OUTCOMES AND MEASURES Childhood blood pressure was a planned secondary outcome of a study powered to measure cognitive development. The hypothesis was that DHA would lower blood pressure prior to data analysis. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at 4, 4.5, 5, 5.5, and 6 years and were analyzed for possible covariates using mixed models to generate a final model. RESULTS In total, 171 children (88 [51.5%] female) were included in this analysis. Of these children, 89 (52.0%) were randomized to the DHA group and 82 (47.9%) to the placebo group. A statistically significant interaction was found between treatment (placebo or DHA) and child weight status (5-year body mass index ≤85th or >85th percentile) for both SBP and DBP. Children who were overweight or obese whose mothers received placebo during pregnancy had higher SBP and DBP compared with children who were overweight or obese whose mothers received DHA (mean [SE] SBP, 104.28 [1.37] mm Hg vs 100.34 [1.02] mm Hg; DBP, 64.7 [1.23] mm Hg vs 59.76 [0.91] mm Hg). No differences in the SBP and DBP were found between children who were overweight or obese whose mothers received DHA and children who were not overweight or obese. In the mixed model analysis, the child's age at blood pressure measurement and the maternal prepregnancy body mass index were the only other statistically significant variables (child age, SBP: F = 7.385; P = .001; DBP: F = 7.39; P = .001; prepregnancy BMI, SBP: r = 0.284; P = .001; DBP: r = 0.216; P = .01). CONCLUSIONS AND RELEVANCE Maternal docosahexaenoic acid intake during pregnancy appeared to mitigate the association between childhood overweight condition or obesity and blood pressure. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02487771.
Collapse
Affiliation(s)
- Elizabeth H. Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City
| | - Jamie M. Hilton
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City
| | - Jocelynn M. Thodosoff
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City
| | - Jo Wick
- Department of Biostatistics, University of Kansas, Lawrence
| | - John Colombo
- Department of Psychology, University of Kansas, Lawrence
| | - Susan E. Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City
| |
Collapse
|
12
|
Magalhães EIDS, Sousa BAD, Lima NP, Horta BL. Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2019; 35:e00176118. [DOI: 10.1590/0102-311x00176118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/02/2019] [Indexed: 08/30/2023] Open
Abstract
Abstract: The present study aimed to conduct a systematic review and meta-analysis to evaluate the evidence on the association of maternal smoking during pregnancy with offspring body composition in childhood, adolescence and adulthood. MEDLINE, Web of Science and LILACS databases were searched. Reference lists were also screened. We included original studies, conducted in humans, that assessed the association of maternal smoking during pregnancy with offspring body mass index (BMI) and overweight in childhood, adolescence and adulthood, published through May 1st, 2018. A meta-analysis was used to estimate pooled effect sizes. The systematic review included 64 studies, of which 37 evaluated the association of maternal smoking during pregnancy with overweight, 13 with BMI, and 14 evaluated both outcomes. Of these 64 studies, 95 measures of effect were extracted and included in the meta-analysis. We verified that the quality of evidence across studies regarding maternal smoking in pregnancy and overweight and BMI of offspring to be moderate and low, respectively. Most studies (44 studies) were classified as moderate risk bias. Heterogeneity among studies included was high and, in the random-effects pooled analysis, maternal smoking during pregnancy increased the odds of offspring overweight (OR: 1.43, 95%CI: 1.35; 1.52) and mean difference of BMI (β: 0.31, 95%CI: 0.23; 0.39). In conclusion, offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood.
Collapse
|
13
|
Fetal exposure to maternal active and secondhand smoking with offspring early-life growth in the Healthy Start study. Int J Obes (Lond) 2018; 43:652-662. [PMID: 30341407 DOI: 10.1038/s41366-018-0238-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/18/2018] [Accepted: 08/13/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies have modeled the association between fetal exposure to tobacco smoke and body mass index (BMI) growth trajectories, but not the timing of catch-up growth. Research on fetal exposure to maternal secondhand smoking is limited. OBJECTIVES To explore the associations between fetal exposure to maternal active and secondhand smoking with body composition at birth and BMI growth trajectories through age 3 years. METHODS We followed 630 mother-child pairs enrolled in the Healthy Start cohort through age 3 years. Maternal urinary cotinine was measured at ~ 27 weeks gestation. Neonatal body composition was measured using air displacement plethysmography. Child weight and length/height were abstracted from medical records. Linear regression models examined the association between cotinine categories (no exposure, secondhand smoke, active smoking) with weight, fat mass, fat-free mass, and percent fat mass at birth. A mixed-effects regression model estimated the association between cotinine categories and BMI. RESULTS Compared to unexposed offspring, birth weight was significantly lower among offspring born to active smokers (-343-g; 95% CI: -473, -213), but not among offspring of women exposed to secondhand smoke (-47-g; 95% CI: -130, 36). There was no significant difference in the rate of BMI growth over time between offspring of active and secondhand smokers (p = 0.58). Therefore, our final model included a single growth rate parameter for the combined exposure groups of active and secondhand smokers. The rate of BMI growth for the combined exposed group was significantly more rapid (0.27 kg/m2 per year; 95% CI: 0.05, 0.69; p < 0.01) than the unexposed. CONCLUSIONS Offspring prenatally exposed to maternal active or secondhand smoking experience rapid and similar BMI growth in the first three years of life. Given the long-term consequences of rapid weight gain in early childhood, it is important to encourage pregnant women to quit smoking and limit their exposure to secondhand smoke.
Collapse
|
14
|
Albers L, Sobotzki C, Kuß O, Ajslev T, Batista RF, Bettiol H, Brabin B, Buka SL, Cardoso VC, Clifton VL, Devereux G, Gilman SE, Grzeskowiak LE, Heinrich J, Hummel S, Jacobsen GW, Jones G, Koshy G, Morgen CS, Oken E, Paus T, Pausova Z, Rifas-Shiman SL, Sharma AJ, da Silva AA, Sørensen TI, Thiering E, Turner S, Vik T, von Kries R. Maternal smoking during pregnancy and offspring overweight: is there a dose-response relationship? An individual patient data meta-analysis. Int J Obes (Lond) 2018; 42:1249-1264. [PMID: 29717267 DOI: 10.1038/s41366-018-0050-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/13/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose-response relationship across number of cigarettes and whether this differs by sex remains unclear. SUBJECT/METHODS Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex. RESULTS Of 26 identified studies, 16 authors provided data on a total of 238,340 mother-child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02-1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results. CONCLUSIONS A linear dose-response relationship of maternal smoking was observed in the range of 1-15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.
Collapse
Affiliation(s)
- Lucia Albers
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Christina Sobotzki
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Oliver Kuß
- German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, 40225, Germany
| | - Teresa Ajslev
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Rosangela Fl Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Bernard Brabin
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Community Child Health,Royal Liverpool Children's Hospital, NHS Trust Alder Hey, Liverpool, UK.,Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Viviane C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Vicki L Clifton
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Stephen E Gilman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luke E Grzeskowiak
- Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joachim Heinrich
- Institute of Occupational, Social, and Environmental Medicine, University Hospital, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Occupational, Social, and Environmental Medicine, University Hospital, Neuherberg, Germany
| | - Sandra Hummel
- Forschergruppe Diabetes der Technischen Universität München, Munich, Germany.,Institut für Diabetesforschung der Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, Munich, Germany
| | - Geir W Jacobsen
- Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Gibby Koshy
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tomas Paus
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Zdenka Pausova
- Hospital for Sick Children and Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Antônio Am da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Thorkild Ia Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark.,Novo Nordisk Foundation Centre for Basic Metabolic Research, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Thiering
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | | | - Torstein Vik
- Department of Laboratory Medicine, Children and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Paediatrics and Adolescents Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| |
Collapse
|
15
|
Houghton LC, Goldberg M, Wei Y, Cirillo PM, Cohn BA, Michels KB, Terry MB. Why do studies show different associations between intrauterine exposure to maternal smoking and age at menarche? Ann Epidemiol 2018; 28:197-203. [PMID: 29482744 DOI: 10.1016/j.annepidem.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/13/2017] [Accepted: 01/08/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Studies suggests that intrauterine exposure to maternal smoking both accelerates or delays age at menarche. We hypothesize that these opposing findings relate to different infant and childhood growth patterns across cohorts. METHODS Using data from an adult follow-up study of the Child Health and Development Studies and the National Collaborative Perinatal Project, we examined, using generalized estimating linear regression models, whether intrauterine exposure to maternal smoking was associated with age at menarche in 1090 daughters before and after accounting for growth in weight. RESULTS Compared to the nonexposed, intrauterine exposure to maternal smoking was associated with a 4-month acceleration in menarche in the National Collaborative Perinatal Project (β = -0.35 years; 95% confidence interval [CI]: -0.63, -0.08), but a 6-month delay in menarche in the Child Health and Development Studies (β = 0.48 years; 95% CI: 0.13, 0.83), despite having a similar reduction in birth weight in both cohorts (∼300 g). The results were more consistent across cohorts when we stratified by postnatal growth patterns. For example, in those with rapid weight gain (increasing two growth references from 0 to 4 years), intrauterine exposure to maternal smoking was related to a 7-month acceleration in menarche (β = -0.56 years; 95% CI: -0.95, -0.17). CONCLUSIONS These findings suggest that the association of intrauterine exposure to maternal smoking on age at menarche depends on postnatal growth patterns.
Collapse
Affiliation(s)
- Lauren C Houghton
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY.
| | - Mandy Goldberg
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY
| | - Ying Wei
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY
| | - Piera M Cirillo
- The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Barbara A Cohn
- The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY
| |
Collapse
|
16
|
Lucendo-Villarin B, Filis P, Swortwood MJ, Huestis MA, Meseguer-Ripolles J, Cameron K, Iredale JP, O'Shaughnessy PJ, Fowler PA, Hay DC. Modelling foetal exposure to maternal smoking using hepatoblasts from pluripotent stem cells. Arch Toxicol 2017; 91:3633-3643. [PMID: 28510779 PMCID: PMC5696490 DOI: 10.1007/s00204-017-1983-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 05/08/2017] [Indexed: 12/17/2022]
Abstract
The liver is a dynamic organ which is both multifunctional and highly regenerative. A major role of the liver is to process both endo and xenobiotics. Cigarettes are an example of a legal and widely used drug which can cause major health problems for adults and constitute a particular risk to the foetus, if the mother smokes during pregnancy. Cigarette smoke contains a complex mixture of thousands of different xenobiotics, including nicotine and polycyclic aromatic hydrocarbons. These affect foetal development in a sex-specific manner, inducing sex-dependant molecular responses in different organs. To date, the effect of maternal smoking on the foetal liver has been studied in vitro using cell lines, primary tissue and animal models. While these models have proven to be useful, poor cell phenotype, tissue scarcity, batch-to-batch variation and species differences have led to difficulties in data extrapolation toward human development. Therefore, in this study we have employed hepatoblasts, derived from pluripotent stem cells, to model the effects of xenobiotics from cigarette smoke on human hepatocyte development. Highly pure hepatocyte populations (>90%) were produced in vitro and exposed to factors present in cigarette smoke. Analysis of ATP levels revealed that, independent of the sex, the majority of smoking derivatives tested individually did not deplete ATP levels below 50%. However, following exposure to a cocktail of smoking derivatives, ATP production fell below 50% in a sex-dependent manner. This was paralleled by a loss metabolic activity and secretory ability in both female and male hepatocytes. Interestingly, cell depletion was less pronounced in female hepatocytes, whereas caspase activation was ~twofold greater, indicating sex differences in cell death upon exposure to the smoking derivatives tested.
Collapse
Affiliation(s)
- Baltasar Lucendo-Villarin
- Medical Research Council Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, Scotland, UK
| | - Panagiotis Filis
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Madeleine J Swortwood
- Department of Forensic Science, College of Criminal Justice, Sam Houston State University, Huntsville, TX, USA
| | - Marilyn A Huestis
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Jose Meseguer-Ripolles
- Medical Research Council Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, Scotland, UK
| | - Kate Cameron
- Medical Research Council Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, Scotland, UK
| | - John P Iredale
- University of Bristol, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Peter J O'Shaughnessy
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G61 1QH, UK
| | - Paul A Fowler
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - David C Hay
- Medical Research Council Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, Scotland, UK.
| |
Collapse
|
17
|
Carles S, Charles MA, Heude B, Ahmed I, Botton J. Joint Bayesian weight and height postnatal growth model to study the effects of maternal smoking during pregnancy. Stat Med 2017; 36:3990-4006. [PMID: 28795415 DOI: 10.1002/sim.7407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/10/2017] [Accepted: 06/19/2017] [Indexed: 11/09/2022]
Abstract
Growth models used for describing the dynamics of body weight and height generally consider each trait independently. We proposed modeling height and weight trajectories jointly with a nonlinear heteroscedastic mixed model based on the Jenss-Bayley growth function with correlated individual random effects and using Bayesian inference techniques. Simulations showed that our model provides good estimates of the growth parameters. We illustrated how it can be used to assess the associations between maternal smoking during pregnancy, an early-life factor potentially involved in prenatal programming of obesity, and children's growth from birth to 5 years of age. We used real data from the EDEN study, a large French mother-child cohort study with a high number of height and weight measurements (a total of approximately 30 000 measurements for each of the 2 traits across the 1666 children). Our results supported the existence of a relationship between maternal smoking during pregnancy and growth from birth to 5 years of age. Children from mothers who smoked throughout pregnancy were shown to display a higher body mass index from the first few months of life onwards compared to children from nonsmokers. At 5 years of age, their mean body mass index was 0.21 kg/m2 higher than unexposed children. It was mainly explained by the fact that these children tended to be smaller at birth but rapidly exceeded the weight of children from nonsmokers postnatally.
Collapse
Affiliation(s)
- Sophie Carles
- Early origins of the child's health and development Team (ORCHAD), UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), INSERM, Paris, France.,Paris Descartes University, Paris, France.,Paris-Sud University, Paris, France
| | - Marie-Aline Charles
- Early origins of the child's health and development Team (ORCHAD), UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), INSERM, Paris, France.,Paris Descartes University, Paris, France
| | - Barbara Heude
- Early origins of the child's health and development Team (ORCHAD), UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), INSERM, Paris, France.,Paris Descartes University, Paris, France
| | - Ismaïl Ahmed
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Villejuif, France
| | - Jérémie Botton
- Early origins of the child's health and development Team (ORCHAD), UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), INSERM, Paris, France.,Faculty of Pharmacy, Paris-Sud University, Paris-Saclay University, Châtenay-Malabry, France
| | | |
Collapse
|
18
|
Ding M, Yuan C, Gaskins AJ, Field AE, Missmer SA, Michels KB, Hu F, Zhang C, Gillman MW, Chavarro J. Smoking during pregnancy in relation to grandchild birth weight and BMI trajectories. PLoS One 2017; 12:e0179368. [PMID: 28700699 PMCID: PMC5507479 DOI: 10.1371/journal.pone.0179368] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background Maternal smoking has been linked to lower birth weight and higher risk of childhood obesity. However, it is unknown whether grand-maternal smoking during pregnancy is associated with grandchildren birth weight and body mass index (BMI) trajectories. Methods We investigated associations of smoking during pregnancy with birth weight, risks of overweight and BMI trajectories among 46,858 mother-child dyads and 6,583 grandmother-mother-child triads of three cohort studies of related individuals. Smoking during pregnancy was reported by mothers, and anthropometric data were provided by participants in each cohort. Results Compared to grandchildren of non-smoking women, grandchildren of women who smoked more than 14 cigarettes per day throughout pregnancy were 70 g (95% CI: 12, 129 g; P for trend = 0.01) heavier at birth, and 18% (95% CI: 4%, 34%; P for trend = 0.01) more likely to become overweight. The mean BMI of grandchildren of women who smoked during pregnancy was 0.45 kg/m2 (95% CI: 0.14, 0.75 kg/m2; P for trend = 0.006) higher through adolescence and young adulthood than that of grandchildren of non-smoking mothers. Conclusions Grandmothers’ smoking during pregnancy was associated with higher birth weight, higher risk of overweight, and higher BMI through adolescence and young adulthood.
Collapse
Affiliation(s)
- Ming Ding
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Changzheng Yuan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Audrey J. Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Alison E. Field
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Division of Adolescent Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Stacey A. Missmer
- Division of Adolescent Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Karin B. Michels
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School Boston, MA, United States of America
| | - Frank Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Division of Adolescent Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Cuilin Zhang
- Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Matthew W. Gillman
- Department of Population Medicine, Harvard Pilgrim HealthCare and Harvard Medical School, Boston, MA, United States of America
| | - Jorge Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Division of Adolescent Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- * E-mail:
| |
Collapse
|
19
|
Molnar DS, Rancourt D, Schlauch R, Wen X, Huestis MA, Eiden RD. Tobacco Exposure and Conditional Weight-for-Length Gain by 2 Years of Age. J Pediatr Psychol 2017; 42:679-688. [PMID: 28169405 PMCID: PMC5896634 DOI: 10.1093/jpepsy/jsw095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/26/2016] [Accepted: 11/08/2016] [Indexed: 11/14/2022] Open
Abstract
Objective To prospectively examine dose-response and timing effects of prenatal (PTE) and postnatal tobacco exposure on obesity risk assessed by conditional weight-for-length gain (CWFLG), by 2 years of age. CWFLG over the first 2 years of life was examined for 117 PTE and 57 nonexposed children. Repeated assessments of PTE were conducted beginning in the first trimester of pregnancy, using multiple methods. PTE or postnatal exposure status was not predictive of CWFLG. However, there was a dose-response association and an association with fetal exposure ascertained by infant meconium positive for nicotine and metabolites. PTE is related to restricted growth at birth, yet associated with accelerated CWFLG by 2 years of age, a measure that controls for birthweight differences. Results highlight the importance of examining dose-response and timing of exposure associations, along with the importance of obesity risk-reduction interventions within the first 2 years of life among PTE children.
Collapse
Affiliation(s)
- Danielle S. Molnar
- Department of Child and Youth Studies, Brock University
- Research Institute on Addictions, State University of New York at Buffalo
| | | | | | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, National Institutes of Health
| | - Rina D. Eiden
- Research Institute on Addictions, State University of New York at Buffalo
| |
Collapse
|
20
|
Doi L, Williams AJ, Frank J. How has child growth around adiposity rebound altered in Scotland since 1990 and what are the risk factors for weight gain using the Growing Up in Scotland birth cohort 1? BMC Public Health 2016; 16:1081. [PMID: 27737667 PMCID: PMC5064913 DOI: 10.1186/s12889-016-3752-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 10/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiposity rebound is considered critical to the development of overweight and obesity. The purpose of this study was to investigate how growth has changed in comparison to the UK 1990 BMI growth reference curves between the ages 4-8 years and identify any marked deviations in growth. We also examined potential maternal and child risk/protective factors associated with the altered growth patterns. METHODS We used data from birth cohort 1 of the Growing Up in Scotland study. Height and weight data (N = 2 857) were available when the children were aged approximately 4 (sweep 4), 6 (sweep 6) and 8 years (sweep 7). For each child, percentile change per month was calculated to identify deviations from the UK 1990 growth patterns. Marked changes (>10 % annual change) in percentiles or weight category between each sweep for each child were considered as reflecting a decreasing (leptogenic), increasing (obesogenic) or no change pattern. Logistic regression was used to explore which maternal or child risk factors were associated with belonging to the different growth patterns. RESULTS Sixty six percent (66 %) of the cohort did not show marked changes in BMI percentile and growth compared to the UK 1990 reference population. However, the median BMI percentile of this group was around the 70th. The most common deviation in BMI percentile was early decrease (11.5 %). In terms of weight categories, contemporary maternal obesity (odd ratio (OR) =2.89; 95 % confidence interval (CI) 2.09, 3.98) and mother smoking during pregnancy (OR =1.56; 95 % CI 1.13, 2.15) were found to be significantly associated with increased odds of obesogenic growth trajectory relative to no change trajectory. Breastfeeding (OR = 1.18; 95 % CI 0.88, 1.57) was also associated with increased odds of obesogenic growth but this was not significant in the adjusted model. CONCLUSIONS This study has shown that there is a substantial shift in the general population distribution of BMI since 1990. We identified maternal weight status as the strongest obesogenic factor and this is an indication that more innovative obesity preventive strategies should also consider intergenerational approaches.
Collapse
Affiliation(s)
- Lawrence Doi
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| | - Andrew James Williams
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.,Farr Institute at Scotland, University of Edinburgh, Nine, Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK.,European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - John Frank
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.,Farr Institute at Scotland, University of Edinburgh, Nine, Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
| |
Collapse
|
21
|
Rayfield S, Plugge E. Systematic review and meta-analysis of the association between maternal smoking in pregnancy and childhood overweight and obesity. J Epidemiol Community Health 2016; 71:162-173. [PMID: 27480843 DOI: 10.1136/jech-2016-207376] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND By 2020, it is predicted that 60 million children worldwide will be overweight. Maternal smoking in pregnancy has been suggested as a contributing factor. Our objective was to systematically review studies on this, thereby expanding the evidence base for this association. METHODS Systematic review with meta-analysis, Prospero Registration number CRD42012002859. We searched PubMed, Embase, Global Health, Web of Science and the Grey literature. We included prevalence, cohort and cross-sectional studies involving full-term, singleton pregnancies. Published and unpublished studies through to 1 January 2015 in all languages, demonstrating an objective overweight outcome up until 18 years of age and data presented as an OR, were included. Quality assessment was undertaken using an adaption of the Newcastle-Ottawa scale. Statistical analysis was performed using Review Manager V.5.3. FINDINGS The meta-analysis included 39 studies of 236 687 children from Europe, Australia, North America and South America and Asia. Maternal smoking in pregnancy ranged from 5.5% to 38.7%, with the prevalence of overweight from 6.3% to 32.1% and obesity from 2.6% to 17%. Pooled adjusted ORs demonstrated an elevated odds of maternal smoking in pregnancy for childhood overweight (OR 1.37, 95% CI 1.28 to 1.46, I2 45%) and childhood obesity (OR 1.55, 95% CI 1.40 to 1.73, I2 24%). INTERPRETATION Our results demonstrate an association between maternal prenatal smoking and childhood overweight. This contributes to the growing evidence for the aetiology of childhood overweight, providing important information for policymakers and health professionals alike in planning cessation programmes or antismoking interventions for pregnant female smokers.
Collapse
Affiliation(s)
- Sarah Rayfield
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford, UK
| | - Emma Plugge
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford, UK
| |
Collapse
|
22
|
Massion S, Wickham S, Pearce A, Barr B, Law C, Taylor-Robinson D. Exploring the impact of early life factors on inequalities in risk of overweight in UK children: findings from the UK Millennium Cohort Study. Arch Dis Child 2016; 101:724-30. [PMID: 27162002 PMCID: PMC4975808 DOI: 10.1136/archdischild-2015-309465] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 02/29/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Overweight and obesity in childhood are socially patterned, with higher prevalence in more disadvantaged populations, but it is unclear to what extent early life factors attenuate the social inequalities found in childhood overweight/obesity. METHODS We estimated relative risks (RRs) for being overweight (combining with obesity) at age 11 in 11 764 children from the UK Millennium Cohort Study (MCS) according to socio-economic circumstances (SEC). Early life risk factors were explored to assess if they attenuated associations between SECs and overweight. RESULTS 28.84% of children were overweight at 11 years. Children of mothers with no academic qualifications were more likely to be overweight (RR 1.72, 95% CI 1.48 to 2.01) compared to children of mothers with degrees and higher degrees. Controlling for prenatal, perinatal, and early life characteristics (particularly maternal pre-pregnancy overweight and maternal smoking during pregnancy) reduced the RR for overweight to 1.44, 95% CI 1.23 to 1.69 in the group with the lowest academic qualifications compared to the highest. CONCLUSIONS We observed a clear social gradient in overweight 11-year-old children using a representative UK sample. Moreover, we identified specific early life risk factors, including maternal smoking during pregnancy and maternal pre-pregnancy overweight, that partially account for the social inequalities found in childhood overweight. Policies to support mothers to maintain a healthy weight, breastfeed and abstain from smoking during pregnancy are important to improve maternal and child health outcomes, and our study provides some evidence that they may also help to address the continuing rise in inequalities in childhood overweight.
Collapse
Affiliation(s)
- Samuel Massion
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Sophie Wickham
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Anna Pearce
- Institute of Child Health, University College London, London, UK
| | - Ben Barr
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Catherine Law
- Institute of Child Health, University College London, London, UK
| | - David Taylor-Robinson
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK,Institute of Child Health, University College London, London, UK
| |
Collapse
|
23
|
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.
Collapse
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
| | | |
Collapse
|
24
|
Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med 2016; 50:761-779. [PMID: 26916261 DOI: 10.1016/j.amepre.2015.11.012] [Citation(s) in RCA: 559] [Impact Index Per Article: 69.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/27/2022]
Abstract
CONTEXT Mounting evidence suggests that the origins of childhood obesity and related disparities can be found as early as the "first 1,000 days"-the period from conception to age 2 years. The main goal of this study is to systematically review existing evidence for modifiable childhood obesity risk factors present from conception to age 2 years. EVIDENCE ACQUISITION PubMed, Embase, and Web of Science were searched for studies published between January 1, 1980, and December 12, 2014, of childhood obesity risk factors present during the first 1,000 days. Prospective, original human subject, English-language research with exposure occurrence during the first 1,000 days and with the outcome of childhood overweight or obesity (BMI ≥85th percentile for age and sex) collected between age 6 months and 18 years were analyzed between December 13, 2014, and March 15, 2015. EVIDENCE SYNTHESIS Of 5,952 identified citations, 282 studies met inclusion criteria. Several risk factors during the first 1,000 days were consistently associated with later childhood obesity. These included higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain. Fewer studies also supported gestational diabetes, child care attendance, low strength of maternal-infant relationship, low SES, curtailed infant sleep, inappropriate bottle use, introduction of solid food intake before age 4 months, and infant antibiotic exposure as risk factors for childhood obesity. CONCLUSIONS Modifiable risk factors in the first 1,000 days can inform future research and policy priorities and intervention efforts to prevent childhood obesity.
Collapse
Affiliation(s)
- Jennifer A Woo Baidal
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Lindsey M Locks
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Erika R Cheng
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; Kraft Center for Community Health Leadership, Partners Healthcare, Boston, Massachusetts
| | - Meghan E Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
| |
Collapse
|
25
|
Li L, Peters H, Gama A, Carvalhal MIM, Nogueira HGM, Rosado‐Marques V, Padez C. Maternal smoking in pregnancy association with childhood adiposity and blood pressure. Pediatr Obes 2016; 11:202-9. [PMID: 26178147 PMCID: PMC4949567 DOI: 10.1111/ijpo.12046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 03/04/2015] [Accepted: 05/01/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy has been associated with increased risk of childhood overweight/obesity defined by body mass index (BMI). We examined its association with a range of adiposity measures and cardiovascular indicators in children aged 3-10 years. METHODS We used data from a cross-sectional study of schoolchildren across mainland Portuguese districts (2009-2010). We applied quantile regressions to examine maternal smoking associations with adiposity (n = 17 286), blood pressure (BP) and resting pulse rate (RPR) (n ≈ 2500) measures across the age range, adjusting for prenatal and early life factors. RESULTS Maternal smoking during pregnancy was associated with increases in offspring adiposity levels. The difference in median BMI between children of smokers and non-smokers was 0.39 kg m(-2) (95% confidence interval: 0.25, 0.53) in boys and 0.46 kg m(-2) (0.31, 0.62) in girls; 0.55 cm (0.24, 0.87) and 0.82 cm (0.45, 1.19), respectively, in median waist circumference; and 0.94 mm (0.49, 1.40) and 1.47 mm (0.87, 2.07) in median sum of (triceps, subscapular, suprailiac) skin-folds. The associations appeared to be stronger with increasing age. The differences in the 90th centile tended to be greater than those in median. There was no consistent association of maternal smoking with BP and RPR. CONCLUSIONS Children whose mother smoked during pregnancy had higher adiposity levels than children of non-smokers, across several measures, particularly among older children. Although there was no consistent association with cardiovascular indicators, maternal smoking association with childhood obesity may have implications for cardiovascular risk factors over the life course.
Collapse
Affiliation(s)
- L. Li
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - H. Peters
- Population, Policy, and Practice ProgrammeInstitute of Child HealthUniversity College LondonLondonUK
| | - A. Gama
- Departamento de Biologia AnimalFaculdade de CiênciasUniversity of LisbonLisbonPortugal,Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
| | | | - H. G. M. Nogueira
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Department of GeographyUniversity of CoimbraCoimbraPortugal
| | - V. Rosado‐Marques
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal,Tropical Research Institute of LisbonLisbonPortugal
| | - C. Padez
- Research Centre for Anthropology and HealthDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
| |
Collapse
|
26
|
Lim J, Kong W, Lu M, Luderer U. The Mouse Fetal Ovary Has Greater Sensitivity Than the Fetal Testis to Benzo[a]pyrene-Induced Germ Cell Death. Toxicol Sci 2016; 152:372-81. [PMID: 27208085 DOI: 10.1093/toxsci/kfw083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The polycyclic aromatic hydrocarbon pollutant benzo[a]pyrene (BaP) is a known developmental gonadotoxicant. However, the mechanism of BaP-induced germ cell death is unclear. We investigated whether exposure to BaP induces apoptotic germ cell death in the mouse fetal ovary or testis. Mouse fetal gonads were dissected at embryonic day 13.5 days postcoitum (dpc) and fixed immediately or cultured for 6, 24, 48, or 72 h with various concentrations of BaP (1-1000 ng/ml). Germ cells numbers, apoptosis, and proliferation were evaluated by immunostaining. Treatment of fetal ovaries with BaP for 72 h concentration-dependently depleted germ cells. Treatment with BaP elevated the expression of BAX protein at 6 h and activated downstream caspases-9 and -3 at 24 h in a concentration-dependent manner in germ cells of fetal ovaries. As a consequence, ovarian germ cell numbers were significantly and concentration-dependently decreased at 48 h. Pretreatment with z-VAD-fmk, a pan-caspase inhibitor, prior to exposure to 1000 ng/ml BaP prevented BaP-mediated ovarian germ cell death; there were no effects of BaP or z-VAD-fmk on germ cell proliferation. No significant effects of BaP exposure on caspase 3 activation or germ cell numbers were observed in fetal testes after 48 h of culture. Our findings show that BaP exposure increases caspase-dependent and BAX-associated germ cell apoptosis in the mouse fetal ovary, leading to germ cell depletion. In contrast, the cultured 13.5 dpc fetal testis is relatively resistant to BaP-induced germ cell death. This study provides a novel insight into molecular mechanisms by which BaP has direct gonadotoxicity in the mouse fetal ovary.
Collapse
Affiliation(s)
| | | | | | - Ulrike Luderer
- *Departments of Medicine Developmental and Cell Biology Program in Public Health, University of California, Irvine 92617
| |
Collapse
|
27
|
Braun JM, Chen A, Romano ME, Calafat AM, Webster GM, Yolton K, Lanphear BP. Prenatal perfluoroalkyl substance exposure and child adiposity at 8 years of age: The HOME study. Obesity (Silver Spring) 2016; 24:231-7. [PMID: 26554535 PMCID: PMC4688224 DOI: 10.1002/oby.21258] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 07/21/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine relationships between prenatal perfluoroalkyl substance (PFAS) exposure and adiposity in children born to women who lived downstream from a fluoropolymer manufacturing plant. METHODS Data are from a prospective cohort in Cincinnati, Ohio (HOME Study). Perfluorooctanoic (PFOA), perfluorooctane sulfonic (PFOS), perfluorononanoic (PFNA), and perfluorohexane sulfonic (PFHxS) acids were measured in prenatal serum samples. Differences were measured in body mass index z-scores (BMI), waist circumference, and body fat at 8 years of age (n = 204) and BMI between 2-8 years of age (n = 285) according to PFAS concentrations. RESULTS Children born to women in the top two PFOA terciles had greater adiposity at 8 years than children in the 1st tercile. For example, waist circumference (cm) was higher among children in the 2nd (4.3; 95% CI: 1.7, 6.9) and 3rd tercile (2.2; 95% CI: -0.5, 4.9) compared to children in the 1st tercile. Children in the top two PFOA terciles also had greater BMI gains from 2 to 8 years compared to children in the 1st tercile (P < 0.05). PFOS, PFNA, and PFHxS were not associated with adiposity. CONCLUSIONS In this cohort, higher prenatal serum PFOA concentrations were associated with greater adiposity at 8 years and a more rapid increase in BMI between 2-8 years.
Collapse
Affiliation(s)
- Joseph M. Braun
- Department of Epidemiology, Brown University School of Public Health, Brown University, Providence, RI
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45267
| | - Megan E. Romano
- Department of Epidemiology, Brown University School of Public Health, Brown University, Providence, RI
| | | | - Glenys M. Webster
- Child and Family Research Institute, BC Children’s and Women’s Hospital, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kimberly Yolton
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Bruce P. Lanphear
- Child and Family Research Institute, BC Children’s and Women’s Hospital, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| |
Collapse
|
28
|
Lei X, Zhang Y, Fang F, Wu T, Chen Y, Zhang J. Choosing the Best Newborn Anthropometric Measure Associated With the Risks and Outcomes of Intrauterine Growth Restriction. Clin Pediatr (Phila) 2015; 54:1315-21. [PMID: 25854788 DOI: 10.1177/0009922815579688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Intrauterine growth restriction (IUGR) is associated with various prenatal risks and postnatal adverse outcomes. The aim of this study is to choose the most sensitive newborn anthropometric measure, which is closely associated with IUGR-related risks and outcomes, to substitute IUGR after delivery. Data were obtained from the Collaborative Perinatal Project, a multicenter prospective cohort study in the United States from 1959 to 1976. Maternal heavy smoking and severe hypertensive disorders during pregnancy, neonatal polycythemia and hypothermia, low intelligence quotient (<70) at age 7 years were chosen as IUGR-related risks and outcomes. Eight anthropometric measures at birth were tested by logistic regression model. Birth weight-to-head circumference (W/HC) had the largest odds ratio (OR) for neonatal polycythemia (OR = 1.8, 95% confidence interval [CI] = 1.5-2.0), severe hypertensive disorders (OR = 1.9, 95% CI = 1.5-2.2), and maternal heavy smoking (OR = 1.9, 95% CI = 1.7-2.1) during pregnancy. It also had the highest summary OR (9.3). Thus, W/HC may be a good measure for IUGR.
Collapse
Affiliation(s)
- XiaoPing Lei
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan, China
| | - YongJun Zhang
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Fang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Wu
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
29
|
Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age. J Dev Orig Health Dis 2015; 6:485-92. [DOI: 10.1017/s2040174415007151] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women’s and Children’s Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01–0.29) and 0.21 (0.13–0.29), respectively. A significant dose–response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P<0.001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.
Collapse
|
30
|
Wen X, Higgins ST, Xie C, Epstein LH. Improving Public Acceptability of Using Financial Incentives for Smoking Cessation During Pregnancy: A Randomized Controlled Experiment. Nicotine Tob Res 2015; 18:913-8. [PMID: 26385928 DOI: 10.1093/ntr/ntv204] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/07/2015] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Financial incentives are effective for smoking cessation during pregnancy. Public opinion is important for successful dissemination of this approach from research into clinical practice. We developed a brief information-based intervention to improve public acceptability. METHODS We recruited 166 adult participants (54.2% females [6.7% pregnant], 25.3% smokers, mean age 32.4 years [SD, 9.9]) currently living the United States from Amazon Mechanical Turk. They were randomized to either intervention (N = 84) or control (N = 82). The control group read educational materials on car safety for pregnant women and young children. The intervention group read educational materials on the rationale behind using financial incentives for smoking cessation during pregnancy. Key outcomes were 11 opinion items regarding whether using financial incentives to help pregnant smokers to quit is a good idea; its effectiveness, fairness, cost, health benefits, and saved healthcare cost; and pregnant women's responsibility and difficulty of quitting smoking. RESULTS Intervention and control groups had similar pretest opinion on using financial incentives for smoking cessation during pregnancy. All 11 mean opinion scores significantly increased in the intervention group, but remained stable in the control group. After the intervention, 27.7% more of participants (from 62.6% to 90.3%; P value < .001) in the intervention group and only 4.8% more (from 64.6% to 69.4%; P value = .557) in the control group agreed that "Paying pregnant women who smoke to quit smoking is a good idea" (interaction P value = .015). CONCLUSIONS Our low-cost information-based intervention has the potential to improve public acceptability of this efficacious approach to promoting smoking cessation during pregnancy. IMPLICATIONS In this sample of educated young adults, our low-cost information-based intervention substantially improved their acceptability of using financial incentives for smoking cessation during pregnancy. Our intervention can be used to gain public support before implementing this approach as a policy in the general population. One potential concern that needs to be further addressed by future intervention is unfairness of this smoking cessation approach to pregnant nonsmokers.
Collapse
Affiliation(s)
- Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY;
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT
| | - Chuanbo Xie
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| |
Collapse
|
31
|
Currie LM, Tolley EA, Thodosoff JM, Kerling EH, Sullivan DK, Colombo J, Carlson SE. Long chain polyunsaturated fatty acid supplementation in infancy increases length- and weight-for-age but not BMI to 6 years when controlling for effects of maternal smoking. Prostaglandins Leukot Essent Fatty Acids 2015; 98:1-6. [PMID: 25936840 PMCID: PMC4444372 DOI: 10.1016/j.plefa.2015.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 11/16/2022]
Abstract
Long chain polyunsaturated fatty acids (LCPUFA) are added to infant formula but their effect on long-term growth of children is under studied. We evaluated the effects of feeding LCPUFA-supplemented formula (n = 54) compared to control formula (n = 15) throughout infancy on growth from birth-6 years. Growth was described using separate models developed with the MIXED procedure of SAS(®) that included maternal smoking history and gender. Compared to children fed control formula, children who consumed LCPUFA supplemented formula had higher length-/stature-/and weight-for-age percentiles but not body mass index (BMI) percentile from birth to 6 years. Maternal smoking predicted lower stature (2-6 years), higher weight-for-length (birth-18 months) and BMI percentile (2-6 years) independent of LCPUFA effects. Gender interacted with the effect of LCPUFA on stature, and the relationship between smoking and BMI, with a larger effect for boys. Energy intake did not explain growth differences. A relatively small control sample is a limitation.
Collapse
Affiliation(s)
- L M Currie
- Department of Dietetics and Nutrition, University of Kansas Medical Center, United States
| | - E A Tolley
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, United States
| | - J M Thodosoff
- Department of Dietetics and Nutrition, University of Kansas Medical Center, United States
| | - E H Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, United States
| | - D K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, United States
| | - J Colombo
- Lifespan Institute and Department of Psychology, University of Kansas, United States
| | - S E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, United States.
| |
Collapse
|
32
|
Filis P, Nagrath N, Fraser M, Hay DC, Iredale JP, O'Shaughnessy P, Fowler PA. Maternal Smoking Dysregulates Protein Expression in Second Trimester Human Fetal Livers in a Sex-Specific Manner. J Clin Endocrinol Metab 2015; 100:E861-70. [PMID: 25803269 PMCID: PMC4533306 DOI: 10.1210/jc.2014-3941] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Maternal smoking during pregnancy has adverse effects on the offspring (eg, increased likelihood of metabolic syndrome and infertility), which may involve alterations in fetal liver function. OBJECTIVE Our aim was to analyze, for the first time, the human fetal liver proteome to identify pathways affected by maternal smoking. DESIGN Fetal liver proteins extracted from elective second trimester pregnancy terminations (12-16 weeks of gestation) were divided in four balanced groups based on sex and maternal smoking. SETTING AND PARTICIPANTS Livers were collected from 24 morphologically normal fetuses undergoing termination for nonmedical reasons and analyzed at the Universities of Aberdeen and Glasgow. MAIN OUTCOME MEASURES Protein extracts were resolved by 2D-PAGE and analyzed with SameSpots software. Ingenuity pathway analysis was used to investigate likely roles of dysregulated proteins identified by tandem liquid chromatography/mass spectroscopy. RESULTS Significant expression differences between one or more groups (fetal sex and/or maternal smoking) were found in 22 protein spots. Maternal smoking affected proteins with roles in post-translational protein processing and secretion (ERP29, PDIA3), stress responses and detoxification (HSP90AA1, HSBP1, ALDH7A1, CAT), and homeostasis (FTL1, ECHS1, GLUD1, AFP, SDHA). Although proteins involved in necrosis and cancer development were affected in both sexes, pathways affecting cellular homeostasis, inflammation, proliferation, and apoptosis were affected in males and pathways affecting glucose metabolism were affected in females. CONCLUSIONS The fetal liver exhibits marked sex differences at the protein level, and these are disturbed by maternal smoking. The foundations for smoke-induced post-natal diseases are likely to be due to sex-specific effects on diverse pathways.
Collapse
|
33
|
Mourtakos SP, Tambalis KD, Panagiotakos DB, Antonogeorgos G, Arnaoutis G, Karteroliotis K, Sidossis LS. Maternal lifestyle characteristics during pregnancy, and the risk of obesity in the offspring: a study of 5,125 children. BMC Pregnancy Childbirth 2015; 15:66. [PMID: 25885759 PMCID: PMC4373521 DOI: 10.1186/s12884-015-0498-z] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 03/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the association between gestational weight gain, maternal age and lifestyle habits (e.g., physical activity, smoking, and alcohol consumption) during pregnancy, with Body Mass Index of the offspring at the age of 8. METHODS Α random sample of 5,125 children was extracted from a national database and matched with their mothers. With the use of a standardised questionnaire, telephone interviews were carried out for the collection of information like: maternal age at pregnancy, gestational weight gain (GWG), exercise levels, smoking and alcohol consumption. The Body Mass Index (BMI) status of the offspring at the age of 8 was calculated from data retrieved from the national database (e.g., height and weight). RESULTS The odds for being overweight/obese at the age of 8 for 1 kg GWG, for smoking, and for mild exercise during pregnancy compared to sedentary was 1.01 (95%CI: 1.00, 1.02), 1.23 (95%CI: 1.03, 1.47) and 0.77 (95%CI: 0.65, 0.91), respectively. Further analysis revealed that offspring of women who exceeded the Institute of Medicine (IOM) maternal weight gain recommendations were at an increased risk of obesity (OR: 1.45; 95%CI, 1.26, 1.67) compared with offspring of women with GWG within the recommended range. Maternal age and alcohol consumption were not associated with the outcome (p > 0.05). CONCLUSION GWG, physical activity and smoking status during pregnancy were significantly associated with obesity for the offspring at the age of 8. Health care professionals should strongly advise women to not smoke and to perform moderate exercise during pregnancy to prevent obesity in the offspring in later life.
Collapse
Affiliation(s)
- Stamatis P Mourtakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
| | - Konstantinos D Tambalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. .,Department of Physical Education and Sport Science, University of Athens, Athens, Greece.
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
| | - Giannis Arnaoutis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
| | | | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. .,Department of Internal Medicine, Sealy Center on Aging, Institute for Translational Sciences and Shriners Hospital for Children, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX, USA.
| |
Collapse
|
34
|
Wang L, Mamudu HM, Alamian A, Anderson JL, Brooks B. Independent and joint effects of prenatal maternal smoking and maternal exposure to second-hand smoke on the development of adolescent obesity: a longitudinal study. J Paediatr Child Health 2014; 50:908-15. [PMID: 24920104 DOI: 10.1111/jpc.12667] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2014] [Indexed: 10/25/2022]
Abstract
AIM To examine associations of prenatal maternal smoking and second-hand smoke (SHS) exposure with the development of adolescent obesity. METHODS Longitudinal data (1991-2007) from National Institute of Child Health and Human Development Study of Early Child Care and Youth Development involving mothers that smoked and or exposed to SHS during the year before birth were analysed. Adolescent obesity in ages 12.0-15.9 years was defined as a BMI ≥ 95th percentile. Generalised estimating equations (GEE) were used for the analyses. RESULTS Obesity was more prevalent among adolescents whose mothers smoked or had SHS exposure than those that did not smoke or exposed to SHS. After adjusting for maternal and child factors, GEE models showed that odds of adolescent obesity increased with prenatal maternal smoking (OR = 1.57, 95% CI = 1.03-2.39) and SHS exposure (OR = 1.53, 95% CI = 1.04-2.27). The odds for obesity increased more than two times among adolescents exposed to both maternal smoking and SHS (OR = 2.10, 95% CI = 1.24, 3.56) compared with those without exposure. Additionally, not breastfeeding, maternal obesity, and longer screen viewing hours per day were associated with increased odds of obesity. CONCLUSIONS There is possibly a long-term joint effect of prenatal maternal smoke (smoking and SHS) exposure on obesity among adolescent offspring, and the effect is independent of birthweight. These findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programmes for families during the year before birth.
Collapse
Affiliation(s)
- Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States
| | | | | | | | | |
Collapse
|
35
|
Risk of childhood overweight after exposure to tobacco smoking in prenatal and early postnatal life. PLoS One 2014; 9:e109184. [PMID: 25310824 PMCID: PMC4195647 DOI: 10.1371/journal.pone.0109184] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 09/09/2014] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To investigate the association between exposure to mothers smoking during prenatal and early postnatal life and risk of overweight at age 7 years, while taking birth weight into account. METHODS From the Danish National Birth Cohort a total of 32,747 families were identified with available information on maternal smoking status in child's pre- and postnatal life and child's birth weight, and weight and height at age 7 years. Outcome was overweight according to the International Obesity Task Force gender and age specific body mass index. Smoking exposure was categorized into four groups: no exposure (n = 25,076); exposure only during pregnancy (n = 3,343); exposure only postnatally (n = 140); and exposure during pregnancy and postnatally (n = 4,188). Risk of overweight according to smoking status as well as dose-response relationships were estimated by crude and adjusted odds ratios using logistic regression models. RESULTS Exposure to smoking only during pregnancy, or both during pregnancy and postnatally were both significantly associated with overweight at 7 years of age (OR: 1.31, 95% CI: 1.15-1.48, and OR: 1.76, 95% CI: 1.58-1.97, respectively). Analyses excluding children with low birth weight (<2,500 gram) revealed similar results. A significant prenatal dose-response relationship was found. Per one additional cigarette smoked per day an increase in risk of overweight was observed (OR: 1.02, 95% CI: 1.01-1.03). When adjusting for quantity of smoking during pregnancy, prolonged exposure after birth further increased the risk of later overweight in the children (OR 1.28, 95% CI:1.09-1.50) compared with exposure only in the prenatal period. CONCLUSIONS Mother's perinatal smoking increased child's OR of overweight at age 7 years irrespective of birth weight, and with higher OR if exposed both during pregnancy and in early postnatal life. Clear dose-response relationships were observed, which emphasizes the need for prevention of any tobacco exposure of infants.
Collapse
|
36
|
Limaye S, Salvi S. Obesity and asthma: the role of environmental pollutants. Immunol Allergy Clin North Am 2014; 34:839-55. [PMID: 25282295 DOI: 10.1016/j.iac.2014.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Air pollution is a well-known risk for lung diseases, including asthma. Growing evidences suggesting air pollution as a novel risk factor for the development of obesity. Several Epidemiological studies have ascertained an association between various ambient and indoor air pollutants and obesity by medium of endocrine disruptive chemicals that can disrupt the normal development and homeostatic controls over adipogenesis and energy balance and induce obesity. Several obesity-induced mechanisms have been proposed that increases this vulnerability of obese individuals to harmful effects of air pollution rendering them more susceptible to developing air-pollution driven incident asthma or worsening of already existing asthma.
Collapse
Affiliation(s)
- Sneha Limaye
- Chest Research Foundation, Marigold Premises, Survey No 15, Vadgaonsheri, Kalyaninagar, Pune 411 014, India.
| | - Sundeep Salvi
- Chest Research Foundation, Marigold Premises, Survey No 15, Vadgaonsheri, Kalyaninagar, Pune 411 014, India
| |
Collapse
|
37
|
Riedel C, Schönberger K, Yang S, Koshy G, Chen YC, Gopinath B, Ziebarth S, von Kries R. Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking--a meta-analysis. Int J Epidemiol 2014; 43:1593-606. [PMID: 25080528 DOI: 10.1093/ije/dyu150] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Some studies reported similar effect estimates for the impact of maternal smoking in pregnancy and paternal smoking on childhood obesity, whereas others suggested higher effects for maternal smoking. We performed a meta-analysis to compare the effect of in utero exposure to maternal smoking and that of paternal or household smoking exposure in utero or after birth with mutual adjustment. METHODS Meta-analysis of observational studies identified in MEDLINE, EMBASE and Web of Knowledge published in 1900-2013. Study inclusion criterion was assessment of the association of maternal smoking during pregnancy and paternal or household smoking (anyone living in the household who smokes) at any time with childhood overweight and obesity. The analyses were based on all studies with mutually adjusted effect estimates for maternal and paternal/household smoking applying a random-effects model. RESULTS Data for 109,838 mother/child pairs were reported in 12 studies. The pooled odds ratios (ORs) for overweight 1.33 [95% confidence interval (CI) 1.23;1.44] (n=6, I2=0.00%) and obesity 1.60 (95% CI 1.37;1.88) (n=4, I2=32.47%) for maternal smoking during pregnancy were higher than for paternal smoking: 1.07 (95% CI 1.00;1.16) (n=6, I2=41.34%) and 1.23 (95% CI 1.10;1.38) (n=4, I2=14.61%), respectively. Similar estimates with widely overlapping confidence limits were found for maternal smoking during pregnancy and childhood overweight and obesity: 1.35 (95% CI 1.20;1.51) (n=3, I2=0.00%) and 1.28 (95% CI 1.07;1.54) (n=3, I2=0.00%) compared with household smoking 1.22 (95% CI 1.06;1.39) (n=3, I2=72.14%) and 1.31 (95% CI 1.15;1.50)] (n=3, I2=0.00%). CONCLUSIONS Higher effect estimates for maternal smoking in pregnancy compared with paternal smoking in mutually adjusted models may suggest a direct intrauterine effect.
Collapse
Affiliation(s)
- Christina Riedel
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Katharina Schönberger
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Seungmi Yang
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Gibby Koshy
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Yang-Ching Chen
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Stephanie Ziebarth
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Rüdiger von Kries
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| |
Collapse
|
38
|
The impact of tobacco smoke exposure on wheezing and overweight in 4-6-year-old children. BIOMED RESEARCH INTERNATIONAL 2014; 2014:240757. [PMID: 25110663 PMCID: PMC4109218 DOI: 10.1155/2014/240757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/08/2014] [Accepted: 06/24/2014] [Indexed: 11/17/2022]
Abstract
Aim. To investigate the association between maternal smoking during pregnancy, second-hand tobacco smoke (STS) exposure, education level, and preschool children's wheezing and overweight. Methods. This cohort study used data of the KANC cohort—1,489 4–6-year-old children from Kaunas city, Lithuania. Multivariate logistic regression was employed to study the influence of prenatal and postnatal STS exposure on the prevalence of wheezing and overweight, controlling for potential confounders. Results. Children exposed to maternal smoking during pregnancy had a slightly increased prevalence of wheezing and overweight. Postnatal exposure to STS was associated with a statistically significantly increased risk of wheezing and overweight in children born to mothers with lower education levels (OR 2.12; 95% CI 1.04–4.35 and 3.57; 95% CI 1.76–7.21, accordingly). Conclusions. The present study findings suggest that both maternal smoking during pregnancy and STS increase the risk of childhood wheezing and overweight, whereas lower maternal education might have a synergetic effect. Targeted interventions must to take this into account and address household smoking.
Collapse
|
39
|
Riedel C, Fenske N, Müller MJ, Plachta-Danielzik S, Keil T, Grabenhenrich L, von Kries R. Differences in BMI z-scores between offspring of smoking and nonsmoking mothers: a longitudinal study of German children from birth through 14 years of age. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:761-767. [PMID: 24695368 PMCID: PMC4080541 DOI: 10.1289/ehp.1307139] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 03/31/2014] [Indexed: 05/30/2023]
Abstract
BACKGROUND Children of mothers who smoked during pregnancy have a lower birth weight but have a higher chance to become overweight during childhood. OBJECTIVES We followed children longitudinally to assess the age when higher body mass index (BMI) z-scores became evident in the children of mothers who smoked during pregnancy, and to evaluate the trajectory of changes until adolescence. METHODS We pooled data from two German cohort studies that included repeated anthropometric measurements until 14 years of age and information on smoking during pregnancy and other risk factors for overweight. We used longitudinal quantile regression to estimate age- and sex-specific associations between maternal smoking and the 10th, 25th, 50th, 75th, and 90th quantiles of the BMI z-score distribution in study participants from birth through 14 years of age, adjusted for potential confounders. We used additive mixed models to estimate associations with mean BMI z-scores. RESULTS Mean and median (50th quantile) BMI z-scores at birth were smaller in the children of mothers who smoked during pregnancy compared with children of nonsmoking mothers, but BMI z-scores were significantly associated with maternal smoking beginning at the age of 4-5 years, and differences increased over time. For example, the difference in the median BMI z-score between the daughters of smokers versus nonsmokers was 0.12 (95% CI: 0.01, 0.21) at 5 years, and 0.30 (95% CI: 0.08, 0.39) at 14 years of age. For lower BMI z-score quantiles, the association with smoking was more pronounced in girls, whereas in boys the association was more pronounced for higher BMI z-score quantiles. CONCLUSIONS A clear difference in BMI z-score (mean and median) between children of smoking and nonsmoking mothers emerged at 4-5 years of age. The shape and size of age-specific effect estimates for maternal smoking during pregnancy varied by age and sex across the BMI z-score distribution.
Collapse
|
40
|
Dior UP, Lawrence GM, Sitlani C, Enquobahrie D, Manor O, Siscovick DS, Friedlander Y, Hochner H. Parental smoking during pregnancy and offspring cardio-metabolic risk factors at ages 17 and 32. Atherosclerosis 2014; 235:430-7. [PMID: 24937467 DOI: 10.1016/j.atherosclerosis.2014.05.937] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/10/2014] [Accepted: 05/19/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To examine the association of maternal and/or paternal smoking during pregnancy with offspring cardio-metabolic risk (CMR) factors at adolescence and early adulthood, taking into account socio-demographic, medical and lifestyle characteristics of parents and offspring, as well as offspring common genetic variation. METHODS We used a population-based cohort of all 17 003 births in Jerusalem during 1974-76, with available archival data on parental and birth characteristics. Measurements at age 17 were assessed at military induction examinations for 11 530 offspring. 1440 offspring from the original 1974-1976 birth cohort were sampled using a stratified sampling approach, and were interviewed and examined at age 32. Parental smoking during pregnancy (i.e. maternal, paternal and any parent) was primarily defined dichotomously (any number of cigarettes smoked daily by mother or father during pregnancy vs. non-smokers). Additionally, smoking was assessed by quantity of cigarettes smoked daily. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with various offspring CMR factors, after controlling for potential confounders and for genetic variation in candidate genes. RESULTS Prevalence of exposure to parental smoking in-utero (i.e. smoking of any parent) was 53.2% and 48.4% among the 17 years old and 32 years old samples, respectively. At age 17, smoking of at least one parent during pregnancy was significantly associated with weight (B = 1.39), height (B = 0.59), BMI (B = 0.32) and pulse rate (B = -0.78) (p-values < 0.001). At age 32, parental smoking, adjusted for covariates, was associated with 2.22 kg higher mean offspring weight, 0.95 cm higher mean offspring height, 0.57 kg/m(2) higher BMI, and 1.46 cm higher waist-circumference (p-values ≤ 0.02). Similar results, reflecting a dose response, were observed when maternal and paternal smokings were assessed by number of cigarettes smoked daily. CONCLUSIONS This prospective study demonstrates a potential long-term adverse effect of parental smoking during pregnancy on offspring health and calls for increasing efforts to promote smoking cessation of both parents before pregnancy.
Collapse
Affiliation(s)
- Uri P Dior
- Department of Obstetrics and Gynecology, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel; Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
| | - Gabriella M Lawrence
- Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel
| | - Colleen Sitlani
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Medicine, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA
| | - Daniel Enquobahrie
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA
| | - Orly Manor
- Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel
| | - David S Siscovick
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Medicine, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA
| | - Yechiel Friedlander
- Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel
| | - Hagit Hochner
- Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel
| |
Collapse
|
41
|
Fowler PA, Childs AJ, Courant F, MacKenzie A, Rhind SM, Antignac JP, Le Bizec B, Filis P, Evans F, Flannigan S, Maheshwari A, Bhattacharya S, Monteiro A, Anderson RA, O'Shaughnessy PJ. In utero exposure to cigarette smoke dysregulates human fetal ovarian developmental signalling. Hum Reprod 2014; 29:1471-89. [PMID: 24847019 DOI: 10.1093/humrep/deu117] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
STUDY QUESTION How does maternal cigarette smoking disturb development of the human fetal ovary? SUMMARY ANSWER Maternal smoking increases fetal estrogen titres and dysregulates several developmental processes in the fetal ovary. WHAT IS KNOWN ALREADY Exposure to maternal cigarette smoking during gestation reduces human fetal ovarian cell numbers, germ cell proliferation and subsequent adult fecundity. STUDY DESIGN, SIZE, DURATION The effects of maternal cigarette smoking on the second trimester human fetal ovary, fetal endocrine signalling and fetal chemical burden were studied. A total of 105 fetuses were studied, 56 from mothers who smoked during pregnancy and 49 from those who did not. PARTICIPANTS/MATERIALS, SETTING METHODS Ovary, liver and plasma samples were collected from electively terminated, normally progressing, second trimester human fetuses. Circulating fetal hormones, levels of 73 fetal ovarian transcripts, protein localization, density of oocytes/primordial follicles and levels of 16 polycyclic aromatic hydrocarbons (PAHs) in the fetal liver were determined. MAIN RESULTS AND THE ROLE OF CHANCE Circulating fetal estrogen levels were very high and were increased by maternal smoking (ANOVA, P = 0.055-0.004 versus control). Smoke exposure also dysregulated (two-way ANOVA, smoking versus gestation weeks interaction, P = 0.046-0.023) four fetal ovarian genes (cytochrome P450 scc [CYP11A1], NOBOX oogenesis homeobox [NOBOX], activator of apoptosis harakiri [HRK], nuclear receptor subfamily 2, group E, member 1 [NR2E1]), shifted the ovarian Inhibin βA/inhibin α ratio (NHBA/INHA) transcript ratio in favour of activin (ANOVA, P = 0.049 versus control) and reduced the proportion of dominant-negative estrogen receptor 2 (ERβ: ESR2) isoforms in half the exposed fetuses. PAHs, ligands for the aryl hydrocarbon receptor (AHR), were increased nearly 6-fold by maternal smoking (ANOVA, P = 0.011 versus control). A fifth transcript, COUP transcription factor 1 (nuclear receptor subfamily 2, group F, member 1: NR2F1, which contains multiple AHR-binding sites), was both significantly increased (ANOVA, P = 0.026 versus control) and dysregulated by (two-way ANOVA, smoking versus gestation weeks interaction, P = 0.021) maternal smoking. NR2F1 is associated with repression of FSHR expression and smoke-exposed ovaries failed to show the normal increase in FSHR expression during the second trimester. There was a significantly higher number of DEAD (Asp-Glu-Ala-Asp) box polypeptide 4 (DDX4) VASA-positive (ANOVA, P = 0.016 versus control), but not POU domain, class 1, transcription factor 1 (POU5F1) OCT3/4-positive, oocytes in smoke-exposed fetuses and this matched with a significantly higher number of primordial follicles (ANOVA, P = 0.024 versus control). LIMITATIONS, REASONS FOR CAUTION The effects of maternal smoking on establishment of the maximum fetal primordial follicle pool cannot be reliably studied in our population since the process is not completed until 28 weeks of gestation and normal fetuses older than 21 weeks of gestation are not available for study. Our data suggest that some fetal ovaries are affected by smoke exposure while others are not, indicating that additional studies, with larger numbers, may show more significant effects. WIDER IMPLICATIONS OF THE FINDINGS Fetal exposure to chemicals in cigarette smoke is known to lead to reduced fecundity in women. Our study suggests, for the first time, that this occurs via mechanisms involving activation of AHR, disruption of inhibin/activin and estrogen signalling, increased exposure to estrogen and dysregulation of multiple molecular pathways in the exposed human fetal ovary. Our data also suggest that alterations in the ESR2 positive and dominant negative isoforms may be associated with reduced sensitivity of some fetuses to increased estrogens and maternal smoking. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by grants from the Chief Scientist Office (Scottish Executive, CZG/1/109, and CZG/4/742), NHS Grampian Endowments (08/02), the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 212885, a Society for Reproduction & Fertility summer studentship, Medical Research Scotland (research grant 354 FRG) and the Medical Research Council (WBS: U.1276.00.002.00001 and G1100357). The authors declare they have no competing interests, be it financial, personal or professional.
Collapse
|
42
|
Florath I, Kohler M, Weck MN, Brandt S, Rothenbacher D, Schöttker B, Moß A, Gottmann P, Wabitsch M, Brenner H. Association of pre- and post-natal parental smoking with offspring body mass index: an 8-year follow-up of a birth cohort. Pediatr Obes 2014; 9:121-34. [PMID: 23420701 DOI: 10.1111/j.2047-6310.2012.00146.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 12/14/2012] [Accepted: 12/17/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although many epidemiological studies have shown an association between maternal smoking during pregnancy and offspring overweight, it is still under debate whether intrauterine tobacco smoke exposure directly affects offspring obesity or if the association is rather due to confounding by lifestyle factors. OBJECTIVES The association of parental smoking habits at pre- and post-natal periods with offspring body mass index (BMI) was investigated, whereas maternal smoking during pregnancy was validated by cord serum cotinine measurements. METHODS Multivariable linear regression analysis, based on the German Ulm Birth Cohort Study of 1045 children born in 2000 with annual/biennial follow-up until the age of 8 years (n = 609), was conducted. RESULTS BMI of offspring from mothers who smoked during pregnancy and non-smoking mothers differed significantly at 8 years. Maternal smoking during pregnancy was associated with an increase in BMI of 0.73 kg m(-2) [95% confidence interval: 0.21-1.25] in 8-year-old children after adjustment for multiple potential confounding variables. Both pre- and post-natal smoking of fathers (0.34 [0.01-0.66]/0.45 [0.08-0.81]) and of both parents (1.03 [0.43-1.63]/0.56 [0.14-0.98]) were likewise significantly associated with offspring BMI. CONCLUSIONS The observed patterns suggest that residual confounding by living conditions in smoking families rather than specific intrauterine exposure to tobacco smoke may account for the increased risk of offspring overweight.
Collapse
Affiliation(s)
- I Florath
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Bammann K, Peplies J, De Henauw S, Hunsberger M, Molnar D, Moreno LA, Tornaritis M, Veidebaum T, Ahrens W, Siani A. Early life course risk factors for childhood obesity: the IDEFICS case-control study. PLoS One 2014; 9:e86914. [PMID: 24551043 PMCID: PMC3923715 DOI: 10.1371/journal.pone.0086914] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 12/16/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. OBJECTIVES The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. METHODS A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007-05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. RESULTS For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00-1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08-2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10-1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62-0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. CONCLUSIONS Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.
Collapse
Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Jenny Peplies
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | | | - Monica Hunsberger
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Denes Molnar
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Alfonso Siani
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | | |
Collapse
|
44
|
Timmermans SH, Mommers M, Gubbels JS, Kremers SPJ, Stafleu A, Stehouwer CDA, Prins MH, Penders J, Thijs C. Maternal smoking during pregnancy and childhood overweight and fat distribution: the KOALA Birth Cohort Study. Pediatr Obes 2014; 9:e14-25. [PMID: 23362054 DOI: 10.1111/j.2047-6310.2012.00141.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 12/09/2012] [Accepted: 12/10/2012] [Indexed: 11/28/2022]
Abstract
UNLABELLED What is already known about this subject There is an association between maternal smoking during pregnancy and higher body mass index (BMI) and overweight in childhood. What this study adds The association between maternal smoking during pregnancy and childhood overweight develops with age, starting with a lower birth weight, followed by weight catch-up in the first year after birth, finally leading to overweight at school age. Children of mothers who had smoked during pregnancy had a higher risk of exceeding the 85th percentile of BMI, waist circumference and total skinfold thickness at school age. BACKGROUND Maternal smoking during pregnancy is associated with childhood overweight, but the association with fat distribution is not clear. OBJECTIVE To explore the longitudinal association between smoking during pregnancy and childhood overweight and fat distribution. METHODS In the KOALA Birth Cohort Study, repeated questionnaires were administered to 2698 mother-child pairs, including questions on smoking at 14 and 34 weeks of pregnancy. Main outcomes were birth weight, weight gain in the first year, body mass index (BMI) z-scores and overweight (BMI ≥85th percentile) at 1, 2, 4-5 and 6-7 years (n = 1730) and waist circumference and four skinfold thicknesses measured at home visits at age 6-7 years in a subgroup (n = 418). We used multivariable linear and logistic regression, with generalized estimating equations (GEE) for repeated measurements. RESULTS Maternal smoking was associated with lower birth weight, higher weight gain in the first year and increasing overweight after infancy (change with age P = 0.02 in the GEE). Maternal smoking vs. non-smoking during pregnancy was associated with a higher risk of the child exceeding the 85th percentile of BMI (adjusted odds ratio [aOR] 3.72; 95% CI 1.33-10.4), waist circumference (aOR 2.65; 95% CI 1.06-6.59) and sum of skinfold thicknesses (aOR 4.45; 95% CI 1.63-12.2) at the age of 6-7 years. CONCLUSIONS Maternal smoking during pregnancy is associated with lower birth weight, weight catch-up and development of overweight into childhood.
Collapse
Affiliation(s)
- S H Timmermans
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Prevention of childhood obesity risk from a pre-conceptual and pregnancy care perspective. J Perinat Neonatal Nurs 2014; 28:14-6. [PMID: 24476647 DOI: 10.1097/jpn.0000000000000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Seal N, Krakower G, Seal J. Maternal Smoking During Pregnancy and Metabolic Syndrome in Their Children. J Nurse Pract 2013. [DOI: 10.1016/j.nurpra.2013.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
47
|
Exposure to parental smoking and child growth and development: a cohort study. BMC Pediatr 2013; 13:104. [PMID: 23842036 PMCID: PMC3717101 DOI: 10.1186/1471-2431-13-104] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 06/26/2013] [Indexed: 11/30/2022] Open
Abstract
Background Studies on adverse childhood health and development outcomes associated with parental smoking have shown inconsistent results. Using a cohort of Belarusian children, we examined differences in cognition, behaviors, growth, adiposity, and blood pressure at 6.5 years according to prenatal and postnatal exposure to parental smoking. Methods Using cluster-adjusted multivariable regression, effects of exposure to prenatal smoking were examined by comparing (1) children whose mothers smoked during pregnancy with those of mothers who smoked neither during nor after pregnancy and (2) children whose mothers smoked during and after pregnancy with those whose mothers smoked after pregnancy only; effects of postnatal smoking were examined by comparing (1) children whose mothers smoked after pregnancy only with those of mothers who smoked neither during nor after pregnancy and (2) children whose fathers smoked with those whose fathers did not smoke among children of non-smoking mothers after adjusting for a wide range of socioeconomic and family characteristics. Results After adjusting for confounders, children exposed vs unexposed to prenatal maternal smoking had no differences in mean IQ, teacher-rated behavioral problems, adiposity, or blood pressure. Children exposed to maternal postnatal smoking had slightly increased behavioral problems [0.9, 95% CI: 0.6, 1.2 for total difficulties], higher body mass index [0.2, 95% CI: 0.1, 0.3], greater total skinfold thickness [0.4, 95% CI: 0.04, 0.71], and higher odds of overweight or obesity [1.4, 95% CI; 1.1, 1.7]. Similar magnitudes of association were observed with postnatal paternal smoking. Conclusions No adverse cognitive, behavioral and developmental outcomes were associated with exposure to maternal prenatal smoking. Observed associations with postnatal smoking of both parents may reflect residual confounding by genetic and family environmental factors.
Collapse
|
48
|
Behl M, Rao D, Aagaard K, Davidson TL, Levin ED, Slotkin TA, Srinivasan S, Wallinga D, White MF, Walker VR, Thayer KA, Holloway AC. Evaluation of the association between maternal smoking, childhood obesity, and metabolic disorders: a national toxicology program workshop review. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:170-80. [PMID: 23232494 PMCID: PMC3569686 DOI: 10.1289/ehp.1205404] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 12/04/2012] [Indexed: 05/15/2023]
Abstract
BACKGROUND An emerging literature suggests that environmental chemicals may play a role in the development of childhood obesity and metabolic disorders, especially when exposure occurs early in life. OBJECTIVE Here we assess the association between these health outcomes and exposure to maternal smoking during pregnancy as part of a broader effort to develop a research agenda to better understand the role of environmental chemicals as potential risk factors for obesity and metabolic disorders. METHODS PubMed was searched up to 8 March 2012 for epidemiological and experimental animal studies related to maternal smoking or nicotine exposure during pregnancy and childhood obesity or metabolic disorders at any age. A total of 101 studies-83 in humans and 18 in animals-were identified as the primary literature. DISCUSSION Current epidemiological data support a positive association between maternal smoking and increased risk of obesity or overweight in offspring. The data strongly suggest a causal relation, although the possibility that the association is attributable to unmeasured residual confounding cannot be completely ruled out. This conclusion is supported by findings from laboratory animals exposed to nicotine during development. The existing literature on human exposures does not support an association between maternal smoking during pregnancy and type 1 diabetes in offspring. Too few human studies have assessed outcomes related to type 2 diabetes or metabolic syndrome to reach conclusions based on patterns of findings. There may be a number of mechanistic pathways important for the development of aberrant metabolic outcomes following perinatal exposure to cigarette smoke, which remain largely unexplored. CONCLUSIONS From a toxicological perspective, the linkages between maternal smoking during pregnancy and childhood overweight/obesity provide proof-of-concept of how early-life exposure to an environmental toxicant can be a risk factor for childhood obesity.
Collapse
Affiliation(s)
- Mamta Behl
- Kelly Government Solutions, Research Triangle Park, North Carolina, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP. Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child 2012; 97:1019-26. [PMID: 23109090 PMCID: PMC3512440 DOI: 10.1136/archdischild-2012-302263] [Citation(s) in RCA: 405] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/21/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention. DESIGN Systematic review and meta-analysis. SEARCH STRATEGY Electronic database search of MEDLINE, EMBASE, PubMed and CAB Abstracts. ELIGIBILITY CRITERIA Prospective observational studies following up children from birth for at least 2 years. RESULTS Thirty prospective studies were identified. Significant and strong independent associations with childhood overweight were identified for maternal pre-pregnancy overweight, high infant birth weight and rapid weight gain during the first year of life. Meta-analysis comparing breastfed with non-breastfed infants found a 15% decrease (95% CI 0.74 to 0.99; I(2)=73.3%; n=10) in the odds of childhood overweight. For children of mothers smoking during pregnancy there was a 47% increase (95% CI 1.26 to 1.73; I(2)=47.5%; n=7) in the odds of childhood overweight. There was some evidence associating early introduction of solid foods and childhood overweight. There was conflicting evidence for duration of breastfeeding, socioeconomic status at birth, parity and maternal marital status at birth. No association with childhood overweight was found for maternal age or education at birth, maternal depression or infant ethnicity. There was inconclusive evidence for delivery type, gestational weight gain, maternal postpartum weight loss and 'fussy' infant temperament due to the limited number of studies. CONCLUSIONS Several risk factors for both overweight and obesity in childhood are identifiable during infancy. Future research needs to focus on whether it is clinically feasible for healthcare professionals to identify infants at greatest risk.
Collapse
Affiliation(s)
- Stephen Franklin Weng
- Division of Psychiatry, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
| | | | | | | | | |
Collapse
|
50
|
Martínez-Mesa J, Menezes AM, González DA, Horta BL, Matijasevich A, Gigante DP, Hallal PC. Life course association of maternal smoking during pregnancy and offspring's height: data from the 1993 Pelotas (Brazil) birth cohort. J Adolesc Health 2012; 51:S53-7. [PMID: 23283162 PMCID: PMC3508408 DOI: 10.1016/j.jadohealth.2012.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 08/29/2012] [Accepted: 08/30/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of (1) maternal smoking during pregnancy; and (2) partner smoking on offspring's height in infancy, childhood, and adolescence. METHODS All hospital live births from 1993 (5,249) were identified, and these infants were followed up at several ages. Height for age, expressed as z-scores using the World Health Organization growth curves, was measured at all follow-up visits. Maternal smoking during pregnancy was collected retrospectively at birth and analyzed as number of cigarettes/day smoked categorized in four categories (never smoked, <10, 10-19, and ≥ 20 cigarettes/day). Partner smoking was analyzed as a dichotomous variable (No/Yes). Unadjusted and adjusted analyses were performed by use of linear regression. RESULTS The prevalence of self-reported maternal smoking during pregnancy was 33.5%. In the crude analysis, the number of cigarettes/day smoked by the mother during pregnancy negatively affected offspring's height in infancy, childhood, and adolescence. After adjustment for confounders and mediators, this association remained statistically significant, although the magnitude of the regression coefficients was reduced. Paternal smoking was not associated with offspring's height in the adjusted analyses. CONCLUSIONS In addition to the well-known harmful effects of smoking, maternal smoking during pregnancy negatively affects offspring's height. Public health policies aimed at continuing to reduce the prevalence of maternal smoking during pregnancy must be encouraged.
Collapse
Affiliation(s)
- Jeovany Martínez-Mesa
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Ana M.B. Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - David A. González
- Postgraduate Program in Nutrition, Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Bernardo L. Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Denise P. Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Pedro C. Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|