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Hartel TC, Oelofse A, De Smidt JJA. Vascular Effects, Potential Pathways and Mediators of Fetal Exposure to Alcohol and Cigarette Smoking during Pregnancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6398. [PMID: 37510630 PMCID: PMC10378932 DOI: 10.3390/ijerph20146398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Programming of atherosclerosis results in vascular structure and function alterations, which may be attributed to fetal exposure to maternal tobacco smoking, alcohol consumption and several lifestyle factors in the first few years of life. This review aims to study the effects of teratogen exposure in utero on vascular dysfunction in offspring and consider mediators and pathways originating from the fetal environment. (2) Methods: Eligible studies were identified in the PubMed, Scopus and Web of Science databases. After the full-text screening, 20 articles were included in the narrative synthesis. (3) Results: The literature presents evidence supporting the detrimental effects of fetal exposure to tobacco smoking on vascular alterations in both human and animal studies. Alcohol exposure impaired endothelial dilation in animal studies, but human studies on both tobacco and alcohol exposure are still sparse. Reduction in nitric oxide (NO) bioavailability and alterations in the epigenome in infants through the upregulation of pro-oxidative and proinflammatory genes may be the common denominators. (4) Conclusion: While maternal smoking and alcohol consumption have more negative outcomes on the infant in the short term, several factors during the first few years of life may mediate the development of vascular dysfunction. Therefore, more prospective studies are needed to ascertain the long-term effects of teratogen exposure, specifically in South Africa.
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Affiliation(s)
- Tammy C Hartel
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
| | - André Oelofse
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
| | - Juléy J A De Smidt
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
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2
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Maternal smoking in pregnancy and blood pressure during childhood and adolescence: a meta-analysis. Eur J Pediatr 2023; 182:2119-2132. [PMID: 36823476 PMCID: PMC10175379 DOI: 10.1007/s00431-023-04836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
UNLABELLED Arterial hypertension during childhood or adolescence is rising, and smoking during pregnancy may constitute a modifiable risk factor. This study aims to evaluate the effect of maternal smoking during pregnancy on diastolic (DBP) and systolic blood pressure (SBP) in childhood and adolescence. A bibliographic search was conducted in PubMed, Embase, and CENTRAL databases in March 2022. Meta-analysis was performed with the difference in mean-adjusted SBP/DBP of children and adolescents aged 3-17 years, according to maternal smoking/non-smoking in pregnancy. A random effects model was applied; a leave-one-out analysis and meta-analysis by subgroups were performed. A modified Newcastle-Ottawa scale was used to assess the quality of the studies. Evidence levels were rated using the GRADE system. Fifteen studies were included in the meta-analysis; all of them evaluated the mean-adjusted SBP difference in children or adolescents (N = 73,448), and 6 also that of DBP (N = 31,459). Results showed that maternal smoking during pregnancy significantly increased SBP (β = 0.31 mmHg 95% CI 0.14-0.49). A greater increase in mean-adjusted SBP was observed in those studies that completed the recruitment before 1990, were conducted in non-European countries, used standard mercury or manual sphygmomanometry, adjusted for birth weight, and were in the lowest quality subgroup. No significant association was found for DBP. The GRADE level of evidence was low for SBP and very low for DBP. CONCLUSION Smoking in pregnancy might increase SBP in childhood and adolescence. Due to the low level of evidence, solid inferences cannot be drawn about the clinical relevance of these findings. WHAT IS KNOWN • AHT is the leading cause of premature death among adults worldwide. • Deleterious effects derived from SHS exposure on children's health have been documented since early 1970. To date, there are contradictory results about the effects of prenatal SHS exposure on children's BP. WHAT IS NEW • Smoking in pregnancy may increase SBP during childhood and adolescence. • Maternal smoking during pregnancy could have greater influence on their offspring's SBP than on DBP.
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3
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Gao LT, Yuan JQ, Zhang ZY, Zhao HM, Gao L. Hypermethylation of the Bmp4 promoter dampens binding of HIF-1α and impairs its cardiac protective effects from oxidative stress in prenatally GC-exposed offspring. Cell Mol Life Sci 2023; 80:58. [PMID: 36746787 PMCID: PMC9902418 DOI: 10.1007/s00018-023-04703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/08/2023]
Abstract
The exposure to an unhealthy environment in utero can lead to the occurrence of cardiovascular diseases in the offspring. Glucocorticoids (GC) are essential for normal development and maturation of fetal organs and is a first-line treatment for pregnant women affected by autoimmune diseases. However, excess prenatal GC exposure might program the development of fetal organs and cause a number of chronic diseases in later life. Our previous studies indicated that cardiac functions were significantly compromised in rat offspring prenatally exposed to the synthetic glucocorticoid dexamethasone (DEX), only after ischemia-reperfusion. In the present study, we further observed that DNA hypermethylation of bone morphogenetic protein 4 (Bmp4) promoter in cardiomyocytes caused by prenatal DEX exposure substantially dampened the binding activity of transcription factor HIF-1α induced by cardiac ischemia. Therefore, prenatal DEX exposure inhibits the induction of BMP4 upon I/R and attenuates the protective effects of BMP4 in cardiomyocytes, which eventually manifests as malfunction of the adult heart. Moreover, we employed two cardiac-specific Bmp4 knock-in mouse models and found that in vivo BMP4 overexpression could rescue the cardiac dysfunction caused by prenatal GC exposure. In depth mechanistic research revealed that BMP4 protects the cardiomyocytes from mitophagy and apoptosis by attenuating mitochondrial PGC-1α expression in a p-Smad and Parkin-dependent manner. These findings suggest that prenatal GC exposure increases the susceptibility of the offspring's heart to a "second strike" after birth, due to the failure of hypoxia-induced HIF-1α transactivation of the hypermethylated Bmp4 promoter in cardiomyocytes. Pretreatment with the DNA methylation inhibitor, 5-Aza-2'-deoxycytidine, could be a potential therapeutic method for this programming effect of GC exposure during pregnancy on neonatal cardiac dysfunction.
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Affiliation(s)
- Ling-Tong Gao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Jian-Qiang Yuan
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Zhi-Yu Zhang
- Department of Health Management, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People's Republic of China
| | - Hou-Ming Zhao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Lu Gao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People's Republic of China. .,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, People's Republic of China.
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4
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Liang J, Fu Z, Liu Q, Shen Y, Zhang X, Weng Z, Xu J, Li W, Xu C, Zhou Y, Gu A. Interactions among maternal smoking, breastfeeding, and offspring genetic factors on the risk of adult-onset hypertension. BMC Med 2022; 20:454. [PMID: 36424578 PMCID: PMC9694874 DOI: 10.1186/s12916-022-02648-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous studies have reported that maternal smoking during pregnancy and breastfeeding may affect the occurrence of hypertension, but whether early life factors modify the impact of the offspring's genetic risk on hypertension is still unknown. The aim of this study was to investigate the relationships among maternal smoking and breastfeeding with adult-onset hypertension and the modified impact of offspring genetic susceptibility. METHODS This study included 437,185 participants from the UK Biobank who were initially free of hypertension and provided a prospective cohort of individuals aged 40 to 69 years. The association of maternal smoking during pregnancy and breastfeeding with hypertension was examined by using the Cox regression model. Then, a polygenic risk score (PRS) for hypertension was used to test the gene-environmental interaction on hypertension. RESULTS During a median follow-up period of 8.7 years, a total of 68,148 cases of hypertension were identified in this study. The hazard ratios (HRs) and 95% confidence intervals (CIs) of hypertension for maternal smoking and breastfeeding were 1.11 (1.09, 1.13) and 0.96 (0.94, 0.98), respectively. However, no evidence of an interaction between maternal smoking and breastfeeding was observed. Across all levels of genetic risk, including high genetic risk, maternal smoking and nonbreastfeeding had higher hypertension hazards than nonmaternal smoking and breastfeeding, respectively. The adjusted HRs (95% CIs) of hypertension were 1.80 (1.73, 1.87) in those who had high genetic predisposition plus maternal smoking and 1.67 (1.60-1.74) in those with nonbreastfeeding and high genetic risk. There were significant additive interactions between maternal smoking or breastfeeding and genetic factors on the incidence of hypertension. CONCLUSIONS Maternal smoking and nonbreastfeeding were associated with a higher risk of hypertension in adulthood and may attenuate the risk of hypertension related to genetic factors. These results suggested that adherence to nonmaternal smoking and breastfeeding was associated with a lower risk of hypertension among participants with all gradients of genetic risk.
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Affiliation(s)
- Jingjia Liang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zuqiang Fu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.,School of Public Health, Southeast University, Nanjing, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Yuehong Shen
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Wenxiang Li
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China. .,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.
| | - Yong Zhou
- CAS Key Laboratory of Tissue Microenvironment and Tumour, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China. .,Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences & Shanghai Jiao Tong University School of Medicine, Shanghai, 200031, China.
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China. .,Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China. .,School of Public Health, Southeast University, Nanjing, China.
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5
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Xiao H, Li M, Li A, Amaerjiang N, Zunong J, Vermund SH, Pérez-Escamilla R, Song M, Hu Y, Jiang G. Passive Smoking Exposure Modifies Cardiovascular Structure and Function: Beijing Child Growth and Health Cohort (PROC) Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14585-14593. [PMID: 36094430 DOI: 10.1021/acs.est.2c00991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Passive smoking exposure in children is prevalent worldwide and exposes children to respiratory and systemic toxins. In this study, we enrolled 568 children to study how secondhand smoke (SHS) might affect children's cardiovascular health in China. The measurement of nicotine and its metabolites in urine showed that 78.9% of children were exposed to SHS. Children exposed to SHS had greater interventricular septum thickness (p = 0.005) and left ventricular mass index (p = 0.008) than nonexposed children. Urinary norcotinine levels were associated with increased ascending aorta diameter (β = 0.10, 95%CI 0.02-0.17) and decreased left ventricular end systolic diameter (β = -0.10, 95%CI -0.19 to -0.01). The effects of SHS exposure on cardiovascular function: norcotinine levels associated with lower left ventricular mass index (β = -0.32, 95%CI -0.59 to -0.05), left ventricular end diastolic volume index (β = -0.43, 95%CI -0.85 to -0.02), and left ventricular end systolic volume index (β = -0.20, 95%CI -0.37 to -0.03). Moreover, there no no significant associations of nicotine, cotinine, and trans-3'-hydroxycotinine with cardiovascular health. Overall, SHS exposure in children remains prevalent in Beijing and may affect children's cardiovascular development, in both structure and function. It suggests that stricter and practical measures are needed toward the elimination of tobacco use in children's environments.
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Affiliation(s)
- Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Rafael Pérez-Escamilla
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
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6
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Monasso GS, Felix JF, Gaillard R, Jaddoe VWV. Fetal and Childhood Exposure to Parental Tobacco Smoking and Arterial Health at Age 10 Years. Am J Hypertens 2022; 35:867-874. [PMID: 35882377 PMCID: PMC9527773 DOI: 10.1093/ajh/hpac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/14/2022] [Accepted: 07/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Exposure to parental tobacco smoking during fetal life and childhood is associated with adverse cardiovascular health outcomes. It is not known whether these adverse parental lifestyle exposures are also associated with changes in the structure and function of the carotid arteries in children aged 10 years. METHODS In a population-based prospective cohort study among 4,639 healthy children, we examined the associations of fetal exposure to maternal (no, first trimester only, continued), paternal (no, yes), and combined parental tobacco smoking (nonsmoking parents, mother only, father only, both parents smoked) with carotid intima-media thickness and distensibility at 10 years. We also assessed the associations of exposure to any parental tobacco smoking at ages 6 and 10 years with these outcomes. RESULTS Compared with no exposure, fetal exposure to continued maternal smoking was not associated with carotid intima-media thickness (-0.04 standard deviation score (SDS); 95% confidence interval (CI): -0.13, 0.05); and distensibility (0 SDS, 95% CI: -0.09, 0.09) at age 10 years. Fetal exposure to two smoking parents was also not associated with carotid intima-media thickness (-0.07 SDS, 95% CI: -0.16, 0.02) and distensibility (0 SDS, 95% CI: -0.09, 0.10) at this age. Exposure to any parental smoking during childhood also was not associated with these outcomes at age 10 years. CONCLUSIONS Exposure to parental tobacco smoking during fetal life and childhood was not associated with markers of arterial health in children aged 10 years. Prevention strategies aiming at minimizing smoke exposure later in life are still relevant regarding arterial health.
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Affiliation(s)
- Giulietta S Monasso
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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7
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Early life determinants of arterial stiffness in neonates, infants, children and adolescents: A systematic review and meta-analysis. Atherosclerosis 2022; 355:1-7. [PMID: 35841718 DOI: 10.1016/j.atherosclerosis.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/22/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Certain exposures and risk factors during the first 1,000 days of life are known to influence future cardiovascular disease (CVD) risk. Pulse wave velocity (PWV) is a measure of arterial stiffness and a recognised surrogate marker of CVD. We performed a systematic review and meta-analyses to investigate whether early life exposures were associated with increased PWV compared with controls in youth. METHODS Databases AMED, MEDLINE, EMBASE, CINAHL and Scopus were searched from inception until February 2022. ELIGIBILITY CRITERIA observational controlled studies in youth aged <20 years with risk factors/exposure during the first 1,000 days and PWV measurement. This review is registered with PROSPERO (CRD42019137559). Outcome data were pooled using random-effects meta-analysis. Meta-regression was used to investigate potential confounders. RESULTS We identified 24 eligible studies. Age of participants ranged from 1-day to 19-years at time of PWV assessment. Exposures included pre-term birth, small for gestational age (SGA), maternal diabetes and assisted reproductive technologies, none of which were significantly associated with PWV in meta-analysis. Sub-group analysis by age demonstrated increased PWV in childhood and adolescence in those exposed to maternal diabetes or born SGA. In meta-regression of pre-term studies, higher prevalence of SGA was associated with increased PWV compared with controls (p = 0.034, R2 = 1). CONCLUSIONS We found limited evidence that youth exposed to maternal diabetes or born SGA have increased PWV, consistent with increased future CVD risk. These changes in PWV appear to manifest in later childhood and adolescence. Further research is required to better understand the observed relationships.
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8
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Šarac J, Havaš Auguštin D, Zajc Petranović M, Novokmet N, Bočkor L, Stanišić L, Petherick E, Karelović D, Šelović A, Mrdjen Hodžić R, Musić Milanović S, Demerath EW, Schell LM, Cameron N, Missoni S. Testing the Institute of Medicine (IOM) recommendations on maternal reproductive health and associated neonatal characteristics in a transitional, Mediterranean population. Ann Hum Biol 2022; 49:91-99. [PMID: 35604837 DOI: 10.1080/03014460.2022.2080863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND High pre-pregnancy body mass index (BMI) and excessive gestational weight gain (GWG) are significant risk factors for maternal and neonatal health. AIM To assess pre-pregnancy BMI and GWG during pregnancy and their association with different maternal and neonatal characteristics in the transitional Mediterranean population from the Eastern Adriatic islands. SUBJECTS AND METHODS 262 mother-child dyads from the CRoatian Islands' Birth Cohort Study (CRIBS) were included in the study. Chi-square test, ANOVA and regression analysis were used to test the association between selected characteristics. RESULTS 22% of women entered pregnancy with overweight/obesity and 46.6% had excessive GWG. Pre-pregnancy overweight and obesity were significantly associated with elevated triglycerides uric acid levels, and decreased HDL cholesterol in pregnancy. Excessive GWG was associated with elevated fibrinogen and lipoprotein A levels. Women with high pre-pregnancy BMI and GWG values were more likely to give birth to babies that were large for gestational age (LGA), additionally confirmed in the multiple logistic regression model. CONCLUSION High maternal pre-pregnancy BMI and excessive GWG were both significantly associated with deviated biochemical parameters and neonatal size. More careful monitoring of maternal nutritional status can lead to better pre- and perinatal maternal health care.
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Affiliation(s)
- Jelena Šarac
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | - Dubravka Havaš Auguštin
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | | | | | - Luka Bočkor
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | - Lada Stanišić
- Department of Medical Laboratory Diagnostics, Split University Hospital Centre, Split, Croatia
| | - Emily Petherick
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Deni Karelović
- Department of Obstetrics and Gynaecology, Split University Hospital Centre, Split, Croatia
| | - Alen Šelović
- Gynaecological practice Dr. Alen Šelović, Bjelovar, Croatia
| | | | - Sanja Musić Milanović
- Croatian National Institute of Public Health, Zagreb, Croatia.,University of Zagreb, School of Medicine, School of Public Health "Andrija Štampar", Zagreb, Croatia
| | - Ellen W Demerath
- School of Public Health, University of Minnesota, Minneapolis, USA
| | | | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Saša Missoni
- Institute for Anthropological Research, Zagreb, Croatia.,"J. J. Strossmayer" University, School of Medicine, Osijek, Croatia
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9
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Ludwig-Walz H, Nyasordzi J, Weber KS, Buyken AE, Kroke A. Maternal pregnancy weight or gestational weight gain and offspring's blood pressure: A systematic review. Nutr Metab Cardiovasc Dis 2022; 32:833-852. [PMID: 35078676 DOI: 10.1016/j.numecd.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
AIMS An increasing number of studies suggest that maternal weight parameters in pregnancy are associated with offspring's blood pressure (BP). The aim of this systematic review - following the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement - was to assess and judge the evidence for an association between maternal pregnancy weight/body mass index (BMI) or gestational weight gain (GWG) with offspring's BP in later life. DATA SYNTHESIS MEDLINE, EMBASE, Cochrane Library, CINAHL and Web of Science were searched without limits. Risk of bias was assessed using the "US National Heart, Lung and Blood Institute"-tool, and an evidence grade was allocated following the "World Cancer Research Fund" criteria. Of 7,124 publications retrieved, 16 studies (all cohort studies) were included in the systematic review. Overall data from 52,606 participants (0 years [newborns] to 32 years) were enclosed. Association between maternal pregnancy BMI and offspring's BP were analyzed in 2 (both "good-quality" rated) studies, without consistent results. GWG and offspring's BP was analyzed in 14 studies (2 "good-quality", 9 "fair-quality", 3 "poor-quality" rated). Of these, 3 "fair-quality" studies described significant positive results for systolic BP and significant results, but partly with varying directions of effect estimates for diastolic BP. Mean arterial pressure (MAP) was analyzed in 1 "poor-quality" congress paper. Overall, based on the small number of "good-quality"-rated studies and the inconsistency of effect direction, no firm conclusion can be drawn. CONCLUSION Evidence for an association of maternal pregnancy weight determinants with offspring's BP was overall graded as "limited - no conclusion".
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Affiliation(s)
- Helena Ludwig-Walz
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany.
| | - Juliana Nyasordzi
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany; University of Health and Allied Sciences, Ho, Volta Region, Ghana.
| | | | - Anette E Buyken
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
| | - Anja Kroke
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany.
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10
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Cajachagua‐Torres KN, El Marroun H, Reiss IKM, Santos S, Jaddoe VWV. Foetal tobacco and cannabis exposure, body fat and cardio-metabolic health in childhood. Pediatr Obes 2022; 17:e12863. [PMID: 34674394 PMCID: PMC9285056 DOI: 10.1111/ijpo.12863] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/04/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Foetal tobacco and cannabis exposure may have persistent cardio-metabolic consequences in the offspring. OBJECTIVE We examined the associations of maternal and paternal tobacco and cannabis use during pregnancy with offspring body fat and cardio-metabolic outcomes. METHODS In a population-based prospective cohort study among 4792 mothers, fathers, and children, we assessed parental substance use by questionnaires. Childhood outcomes included body mass index (BMI), body fat, blood pressure, and lipid, glucose and insulin concentrations at 10 years. RESULTS Children exposed to maternal tobacco use during pregnancy had a higher android/gynoid fat mass ratio (difference 0.22 SDS, 95% confidence interval [CI]: 0.13, 0.30), fat mass index (difference 0.20 SDS, 95% CI: 0.12, 0.28), triglyceride concentrations (difference 0.15 SDS, 95% CI: 0.04, 0.26), and a higher risk of overweight (odds ratio [OR] 1.35, 95% CI: 1.07, 1.71), compared to non-exposed. Children exposed to maternal cannabis during pregnancy had a higher BMI (difference 0.26 SDS, 95% CI: 0.08, 0.44), android/gynoid fat mass ratio (difference 0.21 SDS, 95% CI: 0.04, 0.39), and fat-free mass index (difference 0.24 SDS, 95% CI: 0.06, 0.41), compared to non-exposed. The associations for paternal substance use with child cardio-metabolic health outcomes were similar as those for maternal use. CONCLUSIONS Similar associations for maternal and paternal substance use during pregnancy suggest that these findings may be explained by shared family-based social and lifestyle factors, rather than by direct foetal programming.
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Affiliation(s)
- Kim N. Cajachagua‐Torres
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- The Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Hanan El Marroun
- The Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- The Department of Child and Adolescent Psychiatry, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- The Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus University RotterdamRotterdamThe Netherlands
| | - Irwin K. M. Reiss
- The Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- The Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- The Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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11
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Maternal body mass index, offspring body mass index, and blood pressure at 18 years: a causal mediation analysis. Int J Obes (Lond) 2021; 45:2532-2538. [PMID: 34341469 DOI: 10.1038/s41366-021-00930-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Understanding the natural history of hypertension is key to identifying prevention strategies. Previous work suggests that in utero exposures and offspring anthropometrics may play a role. This study examined the relationship between maternal pre-pregnancy body mass index (BMI) and the mediating role of childhood and adolescent BMI on offspring blood pressure at 18 years. METHODS We performed multivariable regression and causal mediation analyses within 3217 mother - offspring pairs from the Avon Longitudinal Study of Parents and Children prospective birth cohort. The main exposure was maternal pre-pregnancy BMI, and the outcome was offspring blood pressure at 18 years of age categorized as normal or elevated. Latent trajectory analysis was used to quantify the mediator, offspring BMI trajectories, derived from multiple measurements throughout childhood and adolescence. Mediation analyses were repeated using current offspring BMI at 18 years as a continuous variable. RESULTS Multivariable logistic regression revealed that for every 1 unit increase in maternal BMI, the risk of elevated blood pressure at 18 years of age increased by 5% (aOR: 1.05, 95% CI: 1.03-1.07; p < 0.001). The strength of this association was reduced after adjusting for offspring BMI trajectory (aOR: 1.03, 95% CI: 1.00-1.05; p = 0.017) and eliminated after adjusting for offspring BMI at 18 years (aOR: 1.00; 95% CI: 0.98-1.03; p = 0.70). Causal mediation analysis confirmed offspring BMI at 18 years as a mediator, where BMI trajectory accounted for 46% of the total effect of maternal BMI on elevated offspring blood pressure and current BMI account for nearly the entire effect. CONCLUSIONS Maternal pre-pregnancy BMI is associated with an increased risk of elevated blood pressure in offspring at 18 years of age although it appears to be entirely mediated by offspring BMI.
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12
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Vrijheid M, Basagaña X, Gonzalez JR, Jaddoe VWV, Jensen G, Keun HC, McEachan RRC, Porcel J, Siroux V, Swertz MA, Thomsen C, Aasvang GM, Andrušaitytė S, Angeli K, Avraam D, Ballester F, Burton P, Bustamante M, Casas M, Chatzi L, Chevrier C, Cingotti N, Conti D, Crépet A, Dadvand P, Duijts L, van Enckevort E, Esplugues A, Fossati S, Garlantezec R, Gómez Roig MD, Grazuleviciene R, Gützkow KB, Guxens M, Haakma S, Hessel EVS, Hoyles L, Hyde E, Klanova J, van Klaveren JD, Kortenkamp A, Le Brusquet L, Leenen I, Lertxundi A, Lertxundi N, Lionis C, Llop S, Lopez-Espinosa MJ, Lyon-Caen S, Maitre L, Mason D, Mathy S, Mazarico E, Nawrot T, Nieuwenhuijsen M, Ortiz R, Pedersen M, Perelló J, Pérez-Cruz M, Philippat C, Piler P, Pizzi C, Quentin J, Richiardi L, Rodriguez A, Roumeliotaki T, Sabin Capote JM, Santiago L, Santos S, Siskos AP, Strandberg-Larsen K, Stratakis N, Sunyer J, Tenenhaus A, Vafeiadi M, Wilson RC, Wright J, Yang T, Slama R. Advancing tools for human early lifecourse exposome research and translation (ATHLETE): Project overview. Environ Epidemiol 2021; 5:e166. [PMID: 34934888 PMCID: PMC8683140 DOI: 10.1097/ee9.0000000000000166] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 06/28/2021] [Indexed: 11/26/2022] Open
Abstract
Early life stages are vulnerable to environmental hazards and present important windows of opportunity for lifelong disease prevention. This makes early life a relevant starting point for exposome studies. The Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project aims to develop a toolbox of exposome tools and a Europe-wide exposome cohort that will be used to systematically quantify the effects of a wide range of community- and individual-level environmental risk factors on mental, cardiometabolic, and respiratory health outcomes and associated biological pathways, longitudinally from early pregnancy through to adolescence. Exposome tool and data development include as follows: (1) a findable, accessible, interoperable, reusable (FAIR) data infrastructure for early life exposome cohort data, including 16 prospective birth cohorts in 11 European countries; (2) targeted and nontargeted approaches to measure a wide range of environmental exposures (urban, chemical, physical, behavioral, social); (3) advanced statistical and toxicological strategies to analyze complex multidimensional exposome data; (4) estimation of associations between the exposome and early organ development, health trajectories, and biological (metagenomic, metabolomic, epigenetic, aging, and stress) pathways; (5) intervention strategies to improve early life urban and chemical exposomes, co-produced with local communities; and (6) child health impacts and associated costs related to the exposome. Data, tools, and results will be assembled in an openly accessible toolbox, which will provide great opportunities for researchers, policymakers, and other stakeholders, beyond the duration of the project. ATHLETE's results will help to better understand and prevent health damage from environmental exposures and their mixtures from the earliest parts of the life course onward.
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Affiliation(s)
- Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Corresponding Author. Address: ISGlobal, Institute for Global Health, C. Doctor Aiguader 88, 08003 Barcelona, Spain. E-mail: (M. Vrijheid)
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan R. Gonzalez
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Genon Jensen
- Health & Environment Alliance (HEAL), Brussels, Belgium
| | - Hector C. Keun
- Department of Surgery & Cancer and Department of Metabolism, Digestion & Reproduction, Imperial College London, London, United Kingdom
| | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Joana Porcel
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Valerie Siroux
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Morris A. Swertz
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Cathrine Thomsen
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunn Marit Aasvang
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sandra Andrušaitytė
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Karine Angeli
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Maisons-Alfort, France
| | - Demetris Avraam
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Paul Burton
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Cécile Chevrier
- University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | | | - David Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Amélie Crépet
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Maisons-Alfort, France
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Esther van Enckevort
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | - María Dolores Gómez Roig
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Kristine B. Gützkow
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Department of Child and Adolescence Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sido Haakma
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Ellen V. S. Hessel
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Lesley Hoyles
- Department of Biosciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Eleanor Hyde
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Jana Klanova
- RECETOX Centre, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Jacob D. van Klaveren
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Andreas Kortenkamp
- Brunel University London, College of Health, Medicine and Life Sciences, Uxbridge, United Kingdom
| | - Laurent Le Brusquet
- University Paris-Saclay, CNRS, CentraleSupélec, Laboratoire des Signaux et Systèmes, Gif-sur-Yvette, France
| | - Ivonne Leenen
- Health & Environment Alliance (HEAL), Brussels, Belgium
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Basque Country UPV/EHU, Basque Country, Bilbao, Spain
- Biodonostia, Research Health Institute, Donostia-San Sebastian, Spain
| | - Nerea Lertxundi
- University of Basque Country UPV/EHU, Basque Country, Bilbao, Spain
- Biodonostia, Research Health Institute, Donostia-San Sebastian, Spain
| | - Christos Lionis
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Lea Maitre
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Sandrine Mathy
- University Grenoble Alpes, CNRS, INRAE, Grenoble INP, GAEL, Grenoble, France
| | - Edurne Mazarico
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Centre for Health and Environment, Leuven University, Leuven, Belgium
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Rodney Ortiz
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Marie Pedersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Míriam Pérez-Cruz
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Claire Philippat
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Pavel Piler
- RECETOX Centre, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Joane Quentin
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | | | - Susana Santos
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alexandros P. Siskos
- Department of Surgery & Cancer and Department of Metabolism, Digestion & Reproduction, Imperial College London, London, United Kingdom
| | | | - Nikos Stratakis
- ISGlobal, Barcelona, Spain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Arthur Tenenhaus
- University Paris-Saclay, CNRS, CentraleSupélec, Laboratoire des Signaux et Systèmes, Gif-sur-Yvette, France
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Rebecca C. Wilson
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Remy Slama
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
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13
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Nordenstam F. Prenatal nicotine exposure was associated with long-term impact on the cardiovascular system and regulation-Review. Acta Paediatr 2021; 110:2536-2544. [PMID: 33982809 DOI: 10.1111/apa.15914] [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: 01/31/2021] [Revised: 05/02/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this structured review was to discuss knowledge of nicotine use during pregnancy and long-term effects on children's cardiovascular function. METHODS PubMed and MEDLINE were searched for original papers that covered various forms of nicotine exposure during pregnancy and this identified 314 papers published in English from inception of the databases to 1 March 2021. The research focus was prenatal exposure that had long-term effects on the cardiovascular system. The search was expanded from the reference list of the selected papers, which identified another 17 papers. RESULTS The 34 original papers that were included covered 172,696 subjects from foetuses to 19 years of age. Cardiovascular autonomic dysfunction was discussed in 12 of the papers and 16 studies reported on blood pressure. The remaining studies covered structural or functional changes in arterial wall or heart. There were convincing data on autonomic dysfunction and increased blood pressure. Some data were conflicting and problems with misclassification of exposure were evident. CONCLUSION Prenatal nicotine exposure was associated with long-term developmental changes in the cardiovascular system and regulation. There were no safe periods, doses or nicotine products during pregnancy and women should abstain when planning a pregnancy.
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Affiliation(s)
- Felicia Nordenstam
- Department of Women´s and Child´s Health Pediatric Cardiology Unit Karolinska University HospitalKarolinska Institute Stockholm Sweden
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14
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Song Q, Sun D, Zhou T, Li X, Ma H, Liang Z, Wang H, Cardoso MA, Heianza Y, Qi L. Perinatal exposure to maternal smoking and adulthood smoking behaviors in predicting cardiovascular diseases: A prospective cohort study. Atherosclerosis 2021; 328:52-59. [PMID: 34091070 DOI: 10.1016/j.atherosclerosis.2021.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Little is known about the associations between perinatal exposure to maternal smoking and cardiovascular disease (CVD) incidence in offspring, and whether such associations are modified by adulthood and genetically determined smoking behaviors. METHODS A total of 414,588 participants without CVD at baseline were included from the UK Biobank in 2006-2010 and followed up through 2018. Cox-proportional hazard models were used to examine the association of perinatal maternal smoking with CVD, and both multiplicative and additive interaction analyses were performed to investigate the modification effects of own smoking behaviors. RESULTS During a median follow-up of 8.93 years, we observed 10,860 incident CVD events, including 7006 myocardial infarction (MI) and 4147 stroke. We found that perinatal exposure to maternal smoking was associated with increased risks of CVD (HR: 1.10; 95% CI: 1.05-1.14), MI (1.10; 1.05-1.16) and stroke (1.10; 1.03-1.18). In addition, we observed significant interactions between perinatal exposure to maternal smoking and adulthood exposure to own smoking on CVD and MI on both the multiplicative and additive scales (all p < 0.05). The attributable proportions due to additive interaction between perinatal and adulthood exposure to smoking were 14% (9%-19%) for CVD and 16% (10%-22%) for MI, respectively. Perinatal exposure to maternal smoking also showed an interaction with genetically determined smoking on MI (p < 0.05), but no interactions were found on the total CVD and stroke. CONCLUSIONS Our results indicate that perinatal exposure to maternal smoking is associated with increased risks of CVD events, and such relations are modified by adulthood smoking behaviors.
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Affiliation(s)
- Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; Maternal-Fetal Medicine Institute, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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15
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Kruger R, Gafane-Matemane LF, Kagura J. Racial differences of early vascular aging in children and adolescents. Pediatr Nephrol 2021; 36:1087-1108. [PMID: 32444927 DOI: 10.1007/s00467-020-04593-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/19/2022]
Abstract
The prevalence of non-communicable disease (NCDs) is rising globally, with a large burden recorded in sub-Saharan countries and populations of black race/ethnicity. Accelerated vascular deterioration, otherwise known as early vascular aging (EVA), is the underlying factor for highly prevalent NCDs such as hypertension. The etiology of EVA is multifactorial with a central component being arterial stiffness with subsequent development of hypertension and cardiovascular complications. Although arterial stiffness develops with increasing age, many children and adolescents are subjected to the premature development of arterial stiffness, due to genetic or epigenetic predispositions, lifestyle and behavioral risk factors, and early life programming. Race/ethnic differences in pediatric populations have also been reported with higher aortic stiffness in black (African American) compared with age-matched white (European American) counterparts independent of blood pressure, body mass index, or socioeconomic status. With known evidence of race/ethnic differences in EVA, the pathophysiological mechanisms underlying graded differences in the programming of EVA are still sparse and rarely explored. This educational review aims to address the early life determinants of EVA in children and adolescents with a particular focus on racial or ethnic differences.
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Affiliation(s)
- Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
| | - Lebo Francina Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Juliana Kagura
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Taylor K, Thomas R, Mumme M, Golding J, Boyd A, Northstone K, Caputo M, A Lawlor D. Ascertaining and classifying cases of congenital anomalies in the ALSPAC birth cohort. Wellcome Open Res 2021; 5:231. [PMID: 33628950 PMCID: PMC7871361 DOI: 10.12688/wellcomeopenres.16339.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 02/02/2023] Open
Abstract
Congenital anomalies (CAs) are structural or functional disorders that occur during intrauterine life. Longitudinal cohort studies provide unique opportunities to investigate potential causes and consequences of these disorders. In this data note, we describe how we identified cases of major CAs, with a specific focus on congenital heart diseases (CHDs), in the Avon Longitudinal Study of Parents and Children (ALSPAC). We demonstrate that combining multiple sources of data including data from antenatal, delivery, primary and secondary health records, and parent-reported information can improve case ascertainment. Our approach identified 590 participants with a CA according to the European Surveillance of Congenital Anomalies (EUROCAT) guidelines, 127 of whom had a CHD. We describe the methods that identified these cases and provide statistics on subtypes of anomalies. The data note contains details on the processes required for researchers to access these data.
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Affiliation(s)
- Kurt Taylor
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
| | - Richard Thomas
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Mark Mumme
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Jean Golding
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Andy Boyd
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Northstone
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Massimo Caputo
- Department of Translational Science, Bristol Medical School, University of Bristol, Bristol, BS2 8DZ, UK
- Bristol NIHR Biomedical Research Center, University of Bristol, Bristol, BS1 2NT, UK
| | - Deborah A Lawlor
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
- Bristol NIHR Biomedical Research Center, University of Bristol, Bristol, BS1 2NT, UK
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17
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Dieleman LA, van Peet PG, Vos HMM. Gender differences within the barriers to smoking cessation and the preferences for interventions in primary care a qualitative study using focus groups in The Hague, The Netherlands. BMJ Open 2021; 11:e042623. [PMID: 33514579 PMCID: PMC7849885 DOI: 10.1136/bmjopen-2020-042623] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/21/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to contribute to better aligned cessation care for women. DESIGN Qualitative study using focus groups. SETTING Regularly smoking female and male adults were recruited from four different general practices in The Hague (The Netherlands). PARTICIPANTS A total of 11 women and nine men participated. Participants included were regular smokers with a minimum age of 18 and sufficient command of the Dutch language, who were willing to talk about smoking cessation. Inclusion ended when saturation was reached for both women and men. Participants were selected by means of purposeful sampling, whereby looking at age, educational level and experience with quitting. RESULTS The main barriers to smoking cessation in women were psychological factors, such as emotion and stress, compared with environmental factors in men. Women indicated they were in need of support and positivity, and both women and men expressed the desire for assistance without judgement. Contrary to men, women were not drawn to restrictions and (dis)incentives. CONCLUSION When counselling smokers, in women the focus should be on perceived internal problems, as opposed to more external obstacles in men. Contrary to men, female smokers seem to prefer non-coercive interventions, such as a group intervention offering support and positivity. Future research should focus on these gender differences, and how they could improve treatment in primary care.
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Affiliation(s)
| | - Petra G van Peet
- Department of Public Health and Primary Care, LUMC, Leiden, The Netherlands
| | - Hedwig M M Vos
- Department of Public Health and Primary Care, LUMC, Leiden, The Netherlands
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18
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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [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: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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19
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Zhang H, Yu L, Wang Q, Tao Y, Li J, Sun T, Zhang Y, Zhang H. In utero and postnatal exposure to environmental tobacco smoke, blood pressure, and hypertension in children: the Seven Northeastern Cities study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:618-629. [PMID: 31140839 DOI: 10.1080/09603123.2019.1612043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
To evaluate the association of environmental tobacco smoke (ETS) exposure with hypertension and blood pressure (BP) in children, a sample of 9,354 children, aged 5-17 years, was studied from seven northeastern cities of China in 2012-2013. The results showesd that significant associations were observed for hypertension with ETS exposure in utero [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.18-1.57], with current major ETS exposure from fathers (1.38, 1.21-1.57) or anyone (1.26, 1.12-1.42), and with intensity of ETS exposure greater than 1 cigarette per day (ORs ranged from 1.20 to 1.35). For SBP, significant associations were only observed in children with major ETS exposure from father and with cigarettes smoking >10/day. When stratified by sex, more significant associations were found in girls than in boys. In conclusion, prenatal and postnatal ETS exposure was significantly associated with increased odds of hypertension in children, especially in girls.
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Affiliation(s)
- Haishan Zhang
- Department of Cardiology, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Lujiao Yu
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Qi Wang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Ye Tao
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Jing Li
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Tingting Sun
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Yousheng Zhang
- General Hospital of Northern Theater Command, Liaoning Provincial Military Clinic , Shenyang, China
| | - Haiyan Zhang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
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20
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Taylor K, Thomas R, Mumme M, Golding J, Boyd A, Northstone K, Caputo M, A Lawlor D. Ascertaining and classifying cases of congenital anomalies in the ALSPAC birth cohort. Wellcome Open Res 2020; 5:231. [PMID: 33628950 PMCID: PMC7871361 DOI: 10.12688/wellcomeopenres.16339.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 02/02/2023] Open
Abstract
Congenital anomalies (CAs) are structural or functional disorders that occur during intrauterine life. Longitudinal cohort studies provide unique opportunities to investigate potential causes and consequences of these disorders. In this data note, we describe how we identified cases of major CAs, with a specific focus on congenital heart diseases (CHDs), in the Avon Longitudinal Study of Parents and Children (ALSPAC). We demonstrate that combining multiple sources of data including data from antenatal, delivery, primary and secondary health records, and parent-reported information can improve case ascertainment. Our approach identified 590 participants with a CA according to the Euro Registers of Congenital Anomalies (EUROCAT) guidelines, 127 of whom had a CHD. We describe the methods that identified these cases and provide statistics on subtypes of anomalies. The data note contains details on the processes required for researchers to access these data.
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Affiliation(s)
- Kurt Taylor
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
| | - Richard Thomas
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Mark Mumme
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Jean Golding
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Andy Boyd
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Northstone
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Avon Longitudinal Study of Parents and Children (ALSPAC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Massimo Caputo
- Department of Translational Science, Bristol Medical School, University of Bristol, Bristol, BS2 8DZ, UK
- Bristol NIHR Biomedical Research Center, University of Bristol, Bristol, BS1 2NT, UK
| | - Deborah A Lawlor
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
- Bristol NIHR Biomedical Research Center, University of Bristol, Bristol, BS1 2NT, UK
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21
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Zhao B, Johnston FH, O'Sullivan T, Williamson GJ, Melody S, Dalton M, Venn A, Negishi K. Early life exposure to coal mine fire and tobacco smoke affect subclinical vascular function. Arch Dis Child 2020; 105:539-544. [PMID: 31862698 DOI: 10.1136/archdischild-2019-317528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/21/2019] [Accepted: 12/01/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate whether vascular health in young children was associated with exposure to a 6-week episode of coal mine fire smoke or environmental tobacco smoke (ETS) in a retrospective cohort study. METHODS Three years after a coal mine fire in Victoria, Australia, we investigated the vascular health of children either in utero (n=75) or aged <2 years (postnatal exposure, n=96) at the time of the fire. The outcomes were the carotid intima-media thickness (IMT) and pulse wave velocity (PWV). The mean and peak daily particulate matter <2.5 µm in diameter (PM2.5) exposures were estimated based on their daily locations throughout the fire period. Multivariable linear regression models were used to test for associations between the fire-related PM2.5 and outcomes adjusted for relevant covariates including ETS. RESULTS In the postnatal-exposure group, each 10 µg/m³ increase in mean PM2.5 level was independently positively associated with PWV (β=0.116, p=0.028). When these two groups were combined, there was an association between mean PM2.5 and increased PWV in those children who had ETS exposure (β=0.148, p=0.033) or whose mothers smoked (β=0.151, p=0.011), but not in those not exposed to ETS or maternal smoking. CONCLUSIONS Three years after a coal mine fire, infants aged up to 2 years at the time of exposure have increases in vascular stiffness. Although no adverse effects were observed in the in uterus exposure group, further follow-up study is needed to elucidate the long-term effects of coal mine fire smoke exposure.
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Affiliation(s)
- Bing Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Tierney O'Sullivan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Shannon Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Marita Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kazuaki Negishi
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia .,Faculty of Medicine and Health, Nepean Clinical School, Charles Perkins Centre Nepean, University of Sydney, Penrith, New South Wales, Australia
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22
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Nordenstam F, Norman M, Wickström R. Blood Pressure and Heart Rate Variability in Preschool Children Exposed to Smokeless Tobacco in Fetal Life. J Am Heart Assoc 2019; 8:e012629. [PMID: 31615305 PMCID: PMC6898855 DOI: 10.1161/jaha.119.012629] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background Maternal smoking during pregnancy has been associated with higher blood pressure and autonomic imbalance in the offspring. However, it has been difficult to determine the selective prenatal and postnatal contributions as children frequently have been exposed to smoking both before and after birth. The specific role of nicotine is also unclear. We aimed to determine whether exclusive prenatal exposure to nicotine from maternal use of smokeless tobacco (Swedish snus) in pregnancy was associated with blood pressure and autonomic heart rate control in their children. Methods and Results We measured oscillometric blood pressures in forty 5‐ to 6‐year‐old children with snus exposure in fetal life (n=21) and in tobacco‐free controls (n=19). Taking the child′s age and height into account, snus‐exposed children had 4.2 (95% CI, 0.2–8.1) mm Hg higher systolic blood pressure than controls (P=0.038). The corresponding sex‐, age‐, and height‐standardized systolic blood pressure centiles were 61 and 46 (95% CI of the difference, 2–28) (P=0.029). Heart rate variability was tested in 30 of the children. The spectral heart rate variability variable low‐frequency/high‐frequency ratio was higher (median, 0.69; interquartile range, 0.45–1.21) in snus‐exposed children than in controls (median, 0.21; interquartile range, 0.32–0.57; P=0.034). Conclusions Prenatal snus exposure was associated with higher systolic blood pressure and altered heart rate variability at 6 years of age. These findings may indicate adverse prenatal programming of nicotine, but implications for cardiovascular health in later life remain to be studied. Meanwhile, women should be recommended to abstain from all types of tobacco and nicotine products during pregnancy. See Editorial Watanabe and Parikh
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Affiliation(s)
- Felicia Nordenstam
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden.,Pediatric Cardiology Unit Karolinska University Hospital Stockholm Sweden
| | - Mikael Norman
- Department of Neonatal Medicine Karolinska University Hospital Stockholm Sweden.,Division of Pediatrics Department of Clinical Science, Intervention and Technology, Karolinska Institutet Stockholm Sweden
| | - Ronny Wickström
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden.,Neuropediatric Unit Karolinska University Hospital Stockholm Sweden
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23
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Cabral M, Fonseca MJ, González-Beiras C, Santos AC, Correia-Costa L, Barros H. Maternal Smoking: A Life Course Blood Pressure Determinant? Nicotine Tob Res 2019; 20:674-680. [PMID: 28575495 DOI: 10.1093/ntr/ntx117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/30/2017] [Indexed: 01/03/2023]
Abstract
Introduction Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children. Methods We evaluated 4295 of Generation XXI children, recruited at birth in 2005-2006 and reevaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records. At 4-year follow-up, interviews were performed and children's BP measured. Linear regression models were fitted to estimate the association between maternal smoking and children's BP. Results Children of smoking mothers presented significantly higher BP levels. After adjustment for maternal education, gestational hypertensive disorders, and child's body mass index, children exposed during pregnancy to maternal smoking presented a higher systolic BP (SBP) z-score (β = 0.08, 95% confidence interval [CI] 0.04 to 0.14). In crude models, maternal smoking was associated with higher SBP z-score at every assessed period. However, after adjustment, an attenuation of the association estimates occurred (β = 0.08, 95% CI 0.03 to 0.13 before conception; β = 0.07, 95%CI 0.02 to 0.12; β = 0.04, 95%CI -0.02 to 0.10; and β = 0.06, 95%CI 0.00 to 0.13 for the first, second, and third pregnancy trimesters, respectively; and β = 0.07, 95%CI 0.02 to 0.12 for current maternal smoking). No significant association was observed for diastolic BP z-score levels. Conclusion Maternal smoking before, during, and after pregnancy was independently associated with systolic BP z-score in preschool children. This study provides additional evidence to the public health relevance of maternal smoking cessation programs if early cardiovascular health of children is envisaged. Implications Using observational longitudinal data from the birth cohort Generation XXI, this study showed that exposure to maternal smoking-before pregnancy, during pregnancy, and 4 years after delivery-was associated with a systolic BP-raising effect in children at the age of 4. The findings of this study add an important insight into the need to support maternal smoke-free environments in order to provide long-term cardiovascular benefit, starting as early as possible in life.
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Affiliation(s)
- Maria Cabral
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | - Maria J Fonseca
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | | | - Ana C Santos
- EPIUnit, Institute of Public Health, University of Porto, Portugal
| | | | - Henrique Barros
- EPIUnit, Institute of Public Health, University of Porto, Portugal
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24
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Ntarladima AM, Vaartjes I, Grobbee DE, Dijst M, Schmitz O, Uiterwaal C, Dalmeijer G, van der Ent C, Hoek G, Karssenberg D. Relations between air pollution and vascular development in 5-year old children: a cross-sectional study in the Netherlands. Environ Health 2019; 18:50. [PMID: 31096974 PMCID: PMC6524285 DOI: 10.1186/s12940-019-0487-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/26/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Air pollution has been shown to promote cardiovascular disease in adults. Possible mechanisms include air pollution induced changes in arterial wall function and structure. Atherosclerotic vascular disease is a lifelong process and childhood exposure may play a critical role. We investigated whether air pollution is related to arterial wall changes in 5-year old children. To this aim, we developed an air pollution exposure methodology including time-weighted activity patterns improving upon epidemiological studies which assess exposure only at residential addresses. METHODS The study is part of an existing cohort study in which measurements of carotid artery intima-media thickness, carotid artery distensibility, elastic modulus, diastolic and systolic blood pressure have been obtained. Air pollution assessments were based on annual average concentration maps of Particulate Matter and Nitrogen Oxides at 5 m resolution derived from the European Study of Cohorts for Air Pollution Effects. We defined children's likely primary activities and for each activity we calculated the mean air pollution exposure within the assumed area visited by the child. The exposure was then weighted by the time spent performing each activity to retrieve personal air pollution exposure for each child. Time spent in these activities was based upon a Dutch mobility survey. To assess the relation between the vascular status and air pollution exposure we applied linear regressions in order to adjust for potential confounders. RESULTS Carotid artery distensibility was consistently associated with the exposures among the 733 5-years olds. Regression analysis showed that for air pollution exposures carotid artery distensibility decreased per standard deviation. Specifically, for NO2, carotid artery distensibility decreased by - 1.53 mPa- 1 (95% CI: -2.84, - 0.21), for NOx by - 1.35 mPa- 1 (95% CI: -2.67, - 0.04), for PM2.5 by - 1.38 mPa- 1 (95% CI: -2.73, - 0.02), for PM10 by - 1.56 mPa- 1 (95% CI: -2.73, - 0.39), and for PM2.5absorbance by - 1.63 (95% CI: -2.30, - 0.18). No associations were observed for the rest outcomes. CONCLUSIONS The results of this study support the view that air pollution exposure may reduce arterial distensibility starting in young children. If the reduced distensibility persists, this may have clinical relevance later in life. The results of this study further stress the importance of reducing environmental pollutant exposures.
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Affiliation(s)
- Anna-Maria Ntarladima
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands.
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands.
| | - Ilonca Vaartjes
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
| | - Diederick E Grobbee
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
| | - Martin Dijst
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
- Luxembourg Institute of Socio-Economic Research LISER, Esch-sur-Alzette, Luxemburg, UK
| | - Oliver Schmitz
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
| | - Cuno Uiterwaal
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geertje Dalmeijer
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cornelis van der Ent
- Department of Pediatric Pulmonology, and Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Hoek
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Derek Karssenberg
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
- Global Geo Health Data Center, Utrecht University, Utrecht, The Netherlands
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25
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Gać P, Poręba M, Pawlas K, Sobieszczańska M, Poręba R. Influence of environmental tobacco smoke on morphology and functions of cardiovascular system assessed using diagnostic imaging. Inhal Toxicol 2019; 29:518-529. [PMID: 29458307 DOI: 10.1080/08958378.2017.1409847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exposure to tobacco smoke is a significant problem of environmental medicine. Tobacco smoke contains over one thousand identified chemicals including numerous toxicants. Cardiovascular system diseases are the major cause of general mortality. The recent development of diagnostic imaging provided methods which enable faster and more precise diagnosis of numerous diseases, also those of cardiovascular system. This paper reviews the most significant scientific research concerning relationship between environmental exposure to tobacco smoke and the morphology and function of cardiovascular system carried out using diagnostic imaging methods, i.e. ultrasonography, angiography, computed tomography and magnetic resonance imaging. In the forthcoming future, the studies using current diagnostic imaging methods should contribute to the reliable documentation, followed by the wide-spreading knowledge of the harmful impact of the environmental tobacco smoke exposure on the cardiovascular system.
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Affiliation(s)
- Paweł Gać
- a Department of Hygiene , Wroclaw Medical University , Wrocław , Poland.,b Department of Radiology and Diagnostic Imaging , 4th Military Hospital , Wroclaw , Poland
| | - Małgorzata Poręba
- c Department of Pathophysiology , Wroclaw Medical University , Wroclaw , Poland
| | - Krystyna Pawlas
- a Department of Hygiene , Wroclaw Medical University , Wrocław , Poland
| | | | - Rafał Poręba
- e Department of Internal Medicine, Occupational Diseases and Hypertension , Wroclaw Medical University , Wroclaw , Poland
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26
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Hopman P, Springvloet L, de Josselin de Jong S, van Laar M. Quit-smoking counselling in Dutch midwifery practices: Barriers to the implementation of national guidelines. Midwifery 2018; 71:1-11. [PMID: 30623790 DOI: 10.1016/j.midw.2018.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 12/12/2018] [Accepted: 12/22/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although smoking during pregnancy can have severe health consequences for the (unborn) child, 9% of Dutch pregnant women smoke at any time during their pregnancy. Midwives in the Netherlands are a responsible party in the provision of quit-smoking counselling for pregnant women by means of the 7-step `V-MIS' intervention, but in practice the implementation appears to be suboptimal. The purpose of the present study was to assess the provision of quit-smoking counselling by midwives, and to clarify the nature and extent of any existing barriers and needs in the provision of quit-smoking counselling in Dutch midwifery settings. METHODS An online questionnaire to the target population of Dutch midwives (N ≈ 3150) was set out in the spring of 2016. The questionnaire included items on the provision of quit-smoking counselling for pregnant women, and on possible barriers and needs regarding the provision of this counselling. Descriptive statistics were used to analyse weighed data from 135 midwives representative for the Dutch setting in terms of age, function, and region. RESULTS Eighty-one percent of the midwives inquire about smoking profile (V-MIS step 1) but only 10% go through all the V-MIS counselling steps (i.e. up to discussing postnatal passive smoking and smoke free breastfeeding, step 7). Although 74% of the midwives regard it as their task to provide quit-smoking guidance to pregnant women, 77% perceive referral to a professional as a useful strategy (mostly to the GP; 74%). For 61% of the midwives, their clients' lack of motivation undermines the provision of quit-smoking counselling. Other hindering factors are the perceived lack of free brochures (54%), simple tools or gadgets (51%), and financial consequences for the midwife (37%) and/or the client (22%). CONCLUSION The smoking cessation intervention strategy currently imposed in Dutch midwifery practices (V-MIS) is being used by midwives, however its implementation may considerably benefit from strengthening skills in motivational interviewing techniques, provision of supporting materials, and structural embedding of GP referral. Based on the study's findings, practical recommendations are made to facilitate the provision of quit-smoking counselling in (international) midwifery settings.
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Affiliation(s)
- Petra Hopman
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands.
| | - Linda Springvloet
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands
| | - Sanne de Josselin de Jong
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands
| | - Margriet van Laar
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), da Costakade 45, Utrecht, VS 3521, the Netherlands; Netherlands Expertise Centre for Tobacco Control, Utrecht, the Netherlands
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Oldereid NB, Wennerholm UB, Pinborg A, Loft A, Laivuori H, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:320-389. [PMID: 29471389 DOI: 10.1093/humupd/dmy005] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children. OBJECTIVE AND RATIONALE The aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes. SEARCH METHODS PubMed, Embase and Cochrane databases up to January 2017 were searched. Paternal factors examined included paternal age and life-style factors such as body mass index (BMI), adiposity and cigarette smoking. The outcome variables assessed were short-term outcomes such as preterm birth, low birth weight, small for gestational age (SGA), stillbirth, birth defects and chromosomal anomalies. Long-term outcome variables included mortality, cancers, psychiatric diseases/disorders and metabolic diseases. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed. OUTCOMES The search included 14 371 articles out of which 238 met the inclusion criteria, and 81 were included in quantitative synthesis (meta-analyses). Paternal age and paternal life-style factors have an association with adverse outcome in offspring. This is particularly evident for psychiatric disorders such as autism, autism spectrum disorders and schizophrenia, but an association is also found with stillbirth, any birth defects, orofacial clefts and trisomy 21. Paternal height, but not BMI, is associated with birth weight in offspring while paternal BMI is associated with BMI, weight and/or body fat in childhood. Paternal smoking is found to be associated with an increase in SGA, birth defects such as congenital heart defects, and orofacial clefts, cancers, brain tumours and acute lymphoblastic leukaemia. These associations are significant although moderate in size, with most pooled estimates between 1.05 and 1.5, and none exceeding 2.0. WIDER IMPLICATIONS Although the increased risks of adverse outcome in offspring associated with paternal factors and identified in this report represent serious health effects, the magnitude of these effects seems modest.
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Affiliation(s)
- Nan B Oldereid
- Livio IVF-klinikken Oslo, Sørkedalsveien 10A, 0369 Oslo, Norway
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, SE 416 85 Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Loft
- Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Teiskontie 35, FI-33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, FI-33520 Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, FI-00290 Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Tukhomankatu 8, FI-00290 Helsinki, Finland
| | - Max Petzold
- Swedish National Data Service and Health Metrics Unit, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Norwegian University of Science and Technology, Trondheim NO-7010, Norway.,Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Burroughs Peña MS, Swett K, Kaplan RC, Perreira K, Daviglus M, Kansal MM, Cai J, Giachello AL, Gellman MD, Velazquez EJ, Rodriguez CJ. Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL. Open Heart 2018; 5:e000831. [PMID: 30402256 PMCID: PMC6203071 DOI: 10.1136/openhrt-2018-000831] [Citation(s) in RCA: 8] [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: 04/06/2018] [Revised: 07/22/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022] Open
Abstract
Objective To describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function. Methods Participants (n=1069; 68 % female; age 45–74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education). Results SHS exposure in childhood only was associated with reduced E/A velocity ratio (β=−0.06 (SE 0.02), p=0.008). SHS exposure in adolescence/adult only was associated with increased left ventricular ejection fraction (LVEF) (1.2 (0.6), p=0.04), left atrial volume index (1.7 (0.8), p=0.04) and decreased isovolumic relaxation time (−0.003 (0.002), p=0.03). SHS exposure in childhood and adolescence/adult was associated with worse left ventricular global longitudinal strain (LVGLS) (two-chamber) (0.8 (0.4), p= 0.049). Compared with individuals who do not live with a tobacco smoker, individuals who currently live with at least one tobacco smoker had reduced LVEF (−1.4 (0.6), p=0.02), LVGLS (average) (0.9 (0.40), p=0.03), medial E′ velocity (−0.5 (0.2), p=0.01), E/A ratio (−0.09 (0.03), p=0.003) and right ventricular fractional area change (−0.02 (0.01), p=0.01) with increased isovolumic relaxation time (0.006 (0.003), p=0.04). Conclusions Past and current household exposure to SHS was associated with abnormalities in cardiac systolic and diastolic function. Reducing household SHS exposure may be an opportunity for cardiac dysfunction prevention to reduce the risk of future clinical heart failure.
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Affiliation(s)
| | - Katrina Swett
- Department of Medicine, Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Krista Perreira
- Deparment of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Martha Daviglus
- Institute for Minority Health Research, Unverisity of Illinois School of Medicine, Chicago, Illinois, USA
| | - Mayank M Kansal
- Department of Medicine, School of Medicine, University of Illinois, Chicago, Illinois, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aida L Giachello
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern Univerisity, Chicago, Illinois, USA
| | - Marc D Gellman
- Department of Psychology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Eric J Velazquez
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Carlos J Rodriguez
- Department of Medicine, Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Ludwig‐Walz H, Schmidt M, Günther ALB, Kroke A. Maternal prepregnancy BMI or weight and offspring's blood pressure: Systematic review. MATERNAL & CHILD NUTRITION 2018; 14:e12561. [PMID: 29171150 PMCID: PMC6865974 DOI: 10.1111/mcn.12561] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/31/2017] [Accepted: 10/05/2017] [Indexed: 12/13/2022]
Abstract
Emerging evidence suggests that maternal prepregnancy body mass index or weight (MPBW) may be associated with offspring's blood pressure (BP). Therefore, we conducted a systematic review-following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement-to assess and judge the evidence for an association between MPBW with offspring's later BP. Five data bases were searched without limits. Risk of bias was assessed using the "Tool to Assess Risk of Bias in Cohort Studies," and an evidence grade was allocated following the World Cancer Research Fund criteria. Of 2,011 publications retrieved, 16 studies (all cohort studies) were included in the systematic review; thereof, 5 studies (31%) were rated as good-quality studies. Overall, data from 63,959 participants were enclosed. Systolic BP was analysed in 15 (5 good quality), diastolic BP in 12 (3 good quality), and mean arterial pressure in 3 (no good quality) studies. Five good-quality studies of MPBW with offspring's systolic BP as the outcome and 1 good-quality study with offspring's diastolic BP as the outcome observed a significant association. However, after adding offspring's anthropometry variables to the statistical model, the effect attenuated in 4 studies with systolic BP to nonsignificance, the study with diastolic BP remained significant. No good-quality studies were found with respect to offspring's later mean arterial pressure. In conclusion, this systematic review found suggestive, but still limited, evidence for an association between MPBW with offspring's later BP. The available data suggest that the effect might be mainly mediated via offspring's anthropometry.
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Affiliation(s)
- Helena Ludwig‐Walz
- Department of Nutritional, Food and Consumer SciencesFulda University of Applied SciencesFuldaGermany
| | - Milan Schmidt
- Department of Nutritional, Food and Consumer SciencesFulda University of Applied SciencesFuldaGermany
| | - Anke L. B. Günther
- Department of Nutritional, Food and Consumer SciencesFulda University of Applied SciencesFuldaGermany
| | - Anja Kroke
- Department of Nutritional, Food and Consumer SciencesFulda University of Applied SciencesFuldaGermany
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Raghuveer G, White DA, Hayman LL, Woo JG, Villafane J, Celermajer D, Ward KD, de Ferranti SD, Zachariah J. Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e336-e359. [PMID: 27619923 PMCID: PMC5207215 DOI: 10.1161/cir.0000000000000443] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although public health programs have led to a substantial decrease in the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure are by no means a thing of the past. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke (SHS), with children of minority ethnic backgrounds and those living in low-socioeconomic-status households being disproportionately affected (68% and 43%, respectively). Children are particularly vulnerable, with little control over home and social environment, and lack the understanding, agency, and ability to avoid SHS exposure on their own volition; they also have physiological or behavioral characteristics that render them especially susceptible to effects of SHS. Side-stream smoke (the smoke emanating from the burning end of the cigarette), a major component of SHS, contains a higher concentration of some toxins than mainstream smoke (inhaled by the smoker directly), making SHS potentially as dangerous as or even more dangerous than direct smoking. Compelling animal and human evidence shows that SHS exposure during childhood is detrimental to arterial function and structure, resulting in premature atherosclerosis and its cardiovascular consequences. Childhood SHS exposure is also related to impaired cardiac autonomic function and changes in heart rate variability. In addition, childhood SHS exposure is associated with clustering of cardiometabolic risk factors such as obesity, dyslipidemia, and insulin resistance. Individualized interventions to reduce childhood exposure to SHS are shown to be at least modestly effective, as are broader-based policy initiatives such as community smoking bans and increased taxation. PURPOSE The purpose of this statement is to summarize the available evidence on the cardiovascular health consequences of childhood SHS exposure; this will support ongoing efforts to further reduce and eliminate SHS exposure in this vulnerable population. This statement reviews relevant data from epidemiological studies, laboratory-based experiments, and controlled behavioral trials concerning SHS and cardiovascular disease risk in children. Information on the effects of SHS exposure on the cardiovascular system in animal and pediatric studies, including vascular disruption and platelet activation, oxidation and inflammation, endothelial dysfunction, increased vascular stiffness, changes in vascular structure, and autonomic dysfunction, is examined. CONCLUSIONS The epidemiological, observational, and experimental evidence accumulated to date demonstrates the detrimental cardiovascular consequences of SHS exposure in children. IMPLICATIONS Increased awareness of the adverse, lifetime cardiovascular consequences of childhood SHS may facilitate the development of innovative individual, family-centered, and community health interventions to reduce and ideally eliminate SHS exposure in the vulnerable pediatric population. This evidence calls for a robust public health policy that embraces zero tolerance of childhood SHS exposure.
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Lifelong Cardiovascular Adverse Effects of Childhood Tobacco Smoke Exposure. CURRENT CARDIOVASCULAR RISK REPORTS 2016. [DOI: 10.1007/s12170-016-0508-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gishti O, Jaddoe VWV, Felix JF, Reiss I, Steegers E, Hofman A, Ikram MK, Gaillard R. Impact of maternal smoking during pregnancy on microvasculature in childhood. The Generation R Study. Early Hum Dev 2015; 91:607-11. [PMID: 26298032 DOI: 10.1016/j.earlhumdev.2015.07.009] [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] [Received: 01/23/2015] [Revised: 07/23/2015] [Accepted: 07/28/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fetal exposure to maternal smoking is associated with an adverse cardiovascular risk profile in later life. Early microvasculature adaptations might be part of the underlying mechanisms for these associations. AIMS The aim of this study was to examine the influence of maternal smoking during pregnancy on retinal vessel calibers in children. STUDY DESIGN We performed a population-based prospective cohort study among 3564 school-age children. Maternal smoking patterns during pregnancy were assessed by questionnaires. OUTCOME MEASURES At the median age of 6.0 years (95% range 5.8, 8.0 years), we measured childhood retinal vessel calibers from retinal photographs. RESULTS No differences were observed in childhood retinal arteriolar and venular calibers among offspring from mothers who smoked in the first trimester and mothers who continued smoking throughout pregnancy, as compared to mothers who did not smoke during pregnancy. Also, no dose-dependent associations of the number of cigarettes smoked during pregnancy with childhood retinal vessel calibers were present. CONCLUSION Maternal smoking during pregnancy did not influence childhood retinal arteriolar and venular calibers. The mechanisms linking fetal smoke exposure with cardiovascular risk factors in later life may include other mechanisms than structural microvasculature adaptations.
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Affiliation(s)
- Olta Gishti
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Janine F Felix
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irwin Reiss
- Department of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Eric Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mohammad Kamran Ikram
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Singapore Eye Research Institute, Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore; Memory Aging & Cognition Centre (MACC), National University Health System, Singapore
| | - Romy Gaillard
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Punwasi RV, Monnereau C, Hofman A, Jaddoe VW, Felix JF. The Influence of Known Genetic Variants on Subclinical Cardiovascular Outcomes in Childhood. ACTA ACUST UNITED AC 2015; 8:596-602. [DOI: 10.1161/circgenetics.114.000915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 04/15/2015] [Indexed: 11/16/2022]
Abstract
Background—
Genome-wide association studies have identified single-nucleotide polymorphisms (SNPs) for subclinical cardiovascular outcomes in adults. We examined the influence of these variants on the same outcomes in childhood.
Methods and Results—
In a population-based prospective cohort study among 4137 children, we examined the associations of SNPs, individually and incorporated in genetic risk scores, which were identified in adults for cardiac (2 SNPs for left ventricular end-diastolic diameter and 5 SNPs for aortic root diameter) and blood pressure outcomes (29 SNPs for systolic and diastolic blood pressure, 22 SNPs for mean arterial pressure, and 10 SNPs for pulse pressure) with the same outcomes in children (median age of 6.0 years [95% range, 4.5–8.7]). Weighted and unweighted risk scores for aortic root diameter were associated with childhood aortic root diameter (difference per additional average risk allele 0.09 mm [95% CI: 0.05, 0.13]). Weighted and unweighted risk scores for pulse pressure were associated with childhood pulse pressure (difference per additional average risk allele 0.22 mm Hg [95% CI: 0.08, 0.35] and 0.18 mm Hg [95% CI: 0.05, 0.31], respectively), but not with childhood systolic or diastolic blood pressure or mean arterial pressure. The risk scores for blood pressure and mean arterial pressure were not associated with any of the childhood blood pressure outcomes.
Conclusions—
Genetic risk scores based on SNPs for aortic root diameter and pulse pressure in adults are associated with the same outcomes in children. SNPs related to cardiovascular outcomes in adulthood at least partly influence cardiovascular development from early life onwards.
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Affiliation(s)
- Rani V.G. Punwasi
- From the The Generation R Study Group (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), Department of Epidemiology (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), and Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (R.V.G.P., C.M., V.W.V.J., J.F.F.)
| | - Claire Monnereau
- From the The Generation R Study Group (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), Department of Epidemiology (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), and Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (R.V.G.P., C.M., V.W.V.J., J.F.F.)
| | - Albert Hofman
- From the The Generation R Study Group (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), Department of Epidemiology (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), and Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (R.V.G.P., C.M., V.W.V.J., J.F.F.)
| | - Vincent W.V. Jaddoe
- From the The Generation R Study Group (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), Department of Epidemiology (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), and Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (R.V.G.P., C.M., V.W.V.J., J.F.F.)
| | - Janine F. Felix
- From the The Generation R Study Group (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), Department of Epidemiology (R.V.G.P., C.M., A.H., V.W.V.J., J.F.F.), and Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (R.V.G.P., C.M., V.W.V.J., J.F.F.)
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Kooijman MN, Bakker H, Franco OH, Hofman A, Taal HR, Jaddoe VWV. Fetal Smoke Exposure and Kidney Outcomes in School-Aged Children. Am J Kidney Dis 2015; 66:412-20. [PMID: 25641064 DOI: 10.1053/j.ajkd.2014.12.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/06/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fetal smoke exposure may result in developmental adaptations that permanently affect the developing kidney. In this study, the associations of maternal and paternal smoking during pregnancy with childhood kidney size and function were assessed. STUDY DESIGN Prospective cohort study from fetal life onward. SETTING & PARTICIPANTS This study was conducted in a group of 5,622 children in Rotterdam, the Netherlands. PREDICTORS Maternal and paternal smoking were assessed during pregnancy by questionnaires. OUTCOMES & MEASUREMENTS At a median age of 6.0 (5th-95th percentile, 5.6-7.9) years, we measured childhood kidney volumes, estimated glomerular filtration rate (eGFR), and albumin-creatinine ratio. RESULTS The confounder model, which included size at birth, shows that compared with children from mothers who did not smoke during pregnancy, those from mothers who continued smoking during pregnancy had smaller combined kidney volumes at the age of 6 years. The strongest effect estimate was observed for mothers who smoked 5 or more cigarettes per day during pregnancy (difference for combined kidney volume, -2.80 [95% CI, -5.15 to -0.45] cm(3)). Similarly, continued maternal smoking during pregnancy also was associated with a lower eGFR in childhood (difference, -2.25 [95% CI, -3.70 to -0.79] mL/min/1.73 m(2)). First-trimester-only smoking was associated with a higher risk of increased albumin-creatinine ratio (OR, 1.45; 95% CI, 1.05-2.01). Among mothers who did not smoke during pregnancy, paternal smoking was associated with smaller childhood combined kidney volume (difference, -1.78 [95% CI, -3.48 to -0.07] cm(3)), but not with childhood kidney function measures. LIMITATIONS Smoking behavior was measured with questionnaires. Follow-up measurements were available for only 70% of the children. CONCLUSIONS Continued maternal smoking during pregnancy is associated with smaller combined kidney volume and lower eGFR in school-aged children. Stronger effect estimates for maternal versus paternal smoking suggest that intrauterine adaptive responses may play a role as underlying mechanisms.
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Affiliation(s)
- Marjolein N Kooijman
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands
| | - Hanneke Bakker
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands
| | - Albert Hofman
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands
| | - H Rob Taal
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam-Sophia's Children's Hospital, the Netherlands.
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35
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Ferrie JE. On the cause of offence. Int J Epidemiol 2013. [DOI: 10.1093/ije/dyt206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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