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Wu Y, Hao X, Zhu K, Zheng C, Guan F, Zeng P, Wang T. Long-term adverse influence of smoking during pregnancy on height and body size of offspring at ten years old in the UK Biobank cohort. SSM Popul Health 2023; 24:101506. [PMID: 37692834 PMCID: PMC10492214 DOI: 10.1016/j.ssmph.2023.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background To explore the long-term relationship between maternal smoking during pregnancy and early childhood growth in the UK Biobank cohort. Methods To estimate the effect of maternal smoking during pregnancy on offspring height and body size at ten years old, we performed binary logistic analyses and reported odds ratios (OR) as well as 95% confidence intervals (95%CIs). We also implemented the cross-contextual comparison study to examine whether such influence could be repeatedly observed among three different ethnicities in the UK Biobank cohort (n = 22,140 for White, n = 7094 for South Asian, and n = 5000 for Black). In particular, we conducted the sibling cohort study in White sibling cohort (n = 9953 for height and n = 7239 for body size) to control for unmeasured familial confounders. Results We discovered that children whose mothers smoked during pregnancy had greater risk of being shorter or plumper at age ten in the full UK Biobank White cohort, with 15.3% (95% CIs: 13.0%∼17.7%) higher risk for height and 32.4% (95%CIs: 29.5%∼35.4%) larger risk for body size. Similar associations were identified in the South Asian and Black ethnicities. These associations were robust and remained significant in the White sibling cohort (12.6% [95%CIs: 5.0%∼20.3%] for height and 36.1% [95%CIs: 26.3%∼45.9%] for body size) after controlling for family factors. Conclusion This study robustly confirms that maternal smoking during pregnancy can promote height deficit and obesity for offspring at ten years old. Our findings strongly encourage mothers to quit smoking during pregnancy for improving growth and development of offspring.
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Affiliation(s)
- Yuxuan Wu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Xingjie Hao
- Department of Biostatistics and Epidemiology, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kexuan Zhu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Chu Zheng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Fengjun Guan
- Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
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2
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The effectiveness of PROMISE minimal smoking cessation intervention strategy to improve the adherence to smoking cessation counselling during pregnancy: A stepped-wedge cluster randomized controlled trial. Midwifery 2022; 111:103364. [DOI: 10.1016/j.midw.2022.103364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/08/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
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3
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Blond K, Carslake D, Gjærde LK, Vistisen D, Sørensen TIA, Smith GD, Baker JL. Instrumental variable analysis using offspring BMI in childhood as an indicator of parental BMI in relation to mortality. Sci Rep 2021; 11:22408. [PMID: 34789785 PMCID: PMC8599489 DOI: 10.1038/s41598-021-01352-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/19/2021] [Indexed: 01/11/2023] Open
Abstract
Childhood BMI shows associations with adult mortality, but these may be influenced by effects of ill health in childhood on BMI and later mortality. To avoid this, we used offspring childhood BMI as an instrumental variable (IV) for own BMI in relation to mortality and compared it with conventional associations of own childhood BMI and own mortality. We included 36,097 parent–offspring pairs with measured heights and weights from the Copenhagen School Health Records Register and register-based information on death. Hazard ratios (HR) were estimated using adjusted Cox regression models. For all-cause mortality, per zBMI at age 7 the conventional HR = 1.07 (95%CI: 1.04–1.09) in women and 1.02 (95%CI: 0.92–1.14) in men, whereas the IV HR = 1.23 (95%CI: 1.15–1.32) in women and 1.05 (95%CI: 0.94–1.17) in men. Per zBMI at age 13, the conventional HR = 1.11 (95%CI: 1.08–1.15) in women and 1.03 (95%CI: 0.99–1.06) in men, whereas the IV HR = 1.30 (95%CI: 1.19–1.42) in women and 1.15 (95%CI: 1.04–1.29) in men. Only conventional models showed indications of J-shaped associations. Our IV analyses suggest that there is a causal relationship between BMI and mortality that is positive at both high and low BMI values.
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Affiliation(s)
- Kim Blond
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - David Carslake
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Line Klingen Gjærde
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, The Capital Region, Copenhagen, Denmark
| | | | - Thorkild I A Sørensen
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Public Health, Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - George Davey Smith
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
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4
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Smart SJ, Nikaj AN, Yu L, Li H, Yan F, Zhang J. Association between maternal smoking during pregnancy and offspring overweight in U.S.-born children. Pediatr Obes 2021; 16:e12717. [PMID: 32924334 DOI: 10.1111/ijpo.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The criticism of the literature on smoking during pregnancy and offspring overweight was the confounding from postnatal factors. Interaction between gestational age and prenatal maternal smoking has not yet assessed. METHODS We used the Third National Health and Nutrition Examination Survey (1988-1994), linked with natality files of US-born singletons aged 2 to 6 years. A body mass index in the 85th percentile or higher were considered overweight, including obesity. Gestational age was dichotomized as preterm (<37 weeks, n = 240) or full-term (n = 2125). Smoking status during pregnancy was ascertained by a questionnaire-based interview during National Health and Nutrition Examination Survey. RESULTS The prevalence of offspring overweight and obesity combined was 17.3% (SE = 1.3%). And 24.0% (1.3%) of mothers smoked while pregnant. A significant interaction was observed between maternal smoking and gestational age. In preterm children, a higher prevalence of overweight (34.3% [6.7%]) was found among the offspring of smoking mothers compared to non-smoking mothers (15.8% [3.6%]). After adjustment for socio-demographics, prenatal and postnatal factors, in preterm born offspring, the odds ratio of being born to smoking mothers was 2.46 (95% confidence intervals: 1.13-5.37) among children with overweight/obesity compared to children with healthy weight born to non-smoking mothers. In full-term children, the OR of being born to smoking mothers was 0.72 (0.50-1.03) among offspring with overweight/obesity relative to offspring with healthy weight born to non-smoking mothers. CONCLUSIONS Maternal smoking during pregnancy was strongly associated with offspring overweight and obesity in preterm births after control for postnatal factors. Preterm children of smoking mothers should be prioritized for obesity prevention.
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Affiliation(s)
- Shirley J Smart
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Aurela N Nikaj
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Lili Yu
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Hongxia Li
- Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China.,Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Fei Yan
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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5
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Taylor EJ, Wilding S, Ziauddeen N, Godfrey KM, Berrington A, Alwan NA. Change in modifiable maternal characteristics and behaviours between consecutive pregnancies and offspring adiposity: A systematic review. Obes Rev 2020; 21:e13048. [PMID: 32469161 PMCID: PMC7116176 DOI: 10.1111/obr.13048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
Causal evidence links modifiable maternal exposures during the periconceptional period with offspring obesity. The interconception period may be an important time to intervene. We systematically identified studies examining change in modifiable maternal exposures between pregnancies and offspring adiposity. We searched for longitudinal studies published between 1990 and 2019, which included measurements taken on at least two occasions in the period from 1 year prior to the conception of the first birth to the time of the second birth, and which included a measure of adiposity in second, or higher order, siblings. Age, ethnicity and genetics were not considered modifiable; all other factors including length of the interpregnancy interval were. Eleven studies satisfied the inclusion criteria. Higher interpregnancy weight gain or loss, maternal smoking inception, mothers smoking in their first pregnancy and quitting, increasing the number of cigarettes smoked and longer interpregnancy intervals were positively associated with adiposity in second or higher order children. Vaginal birth after caesarean delivery was protective. Further research is needed to ascertain whether the risk of adiposity is fixed based on first pregnancy exposures or if interpregnancy change alters the risk for a subsequent child. This can inform the type and effectiveness of interventions for mothers prior to a subsequent pregnancy.
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Affiliation(s)
- Elizabeth J Taylor
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sam Wilding
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nida Ziauddeen
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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6
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Weinheimer C, Wang H, Comstock JM, Singh P, Wang Z, Locklear BA, Goodwin KL, Maschek JA, Cox JE, Baack ML, Joss-Moore LA. Maternal Tobacco Smoke Exposure Causes Sex-Divergent Changes in Placental Lipid Metabolism in the Rat. Reprod Sci 2020; 27:631-643. [PMID: 32046449 PMCID: PMC7539808 DOI: 10.1007/s43032-019-00065-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/01/2019] [Indexed: 12/30/2022]
Abstract
Maternal tobacco smoke exposure (MTS) affects fetal acquisition of long-chain polyunsaturated fatty acids (LCPUFA) and increases the risk of obesity and cardio-metabolic disease in the offspring. Alterations in fetal LCPUFA acquisition in maternal smoking are mediated by the placenta. The handling of LCPUFA by the placenta involves protein-mediated transfer and storage. Molecular mediators of placental LCPUFA handling include PPARγ and the fatty acid transport proteins. We previously demonstrated, in a rat model, that MTS results in programming of adult-onset obesity and metabolic disease in male, but not female, offspring. In this study, we test the hypothesis that in utero MTS exposure alters placental structure, placental LCPUFA handling, and fetal fatty acid levels, in a sex-divergent manner. We exposed pregnant rats to tobacco smoke from embryonic day 11 to term gestation. We measured placental and fetal fatty acid profiles, the systolic/diastolic ratio (SD ratio), placental histology, and expression of molecular mediators in the placenta. Our primary finding is that MTS alters fatty acid profiles in male, but not female fetuses and placenta, including increasing the ratio of omega-6 to omega-3 fatty acids. MTS also increased SD ratio in male, but not female placenta. In contrast, the expression of PPARγ and FATPs was upregulated in female, but not male placenta. We conclude that MTS causes sex-divergent changes in placental handling of LCPUFA in the rat. We speculate that our results demonstrate an adaptive response to MTS by the female placenta.
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Affiliation(s)
- Claudia Weinheimer
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Haimei Wang
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | | | - Purneet Singh
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Zhengming Wang
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Brent A Locklear
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Kasi L Goodwin
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - J Alan Maschek
- Health Science Center Cores, University of Utah Health Sciences Center, Salt Lake City, UT, USA
- Department of Biochemistry, University of Utah, Salt Lake City, UT, USA
| | - James E Cox
- Health Science Center Cores, University of Utah Health Sciences Center, Salt Lake City, UT, USA
- Department of Biochemistry, University of Utah, Salt Lake City, UT, USA
| | | | - Lisa A Joss-Moore
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
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7
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Björnholm L, Nikkinen J, Kiviniemi V, Niemelä S, Drakesmith M, Evans JC, Pike GB, Richer L, Pausova Z, Veijola J, Paus T. Prenatal exposure to maternal cigarette smoking and structural properties of the human corpus callosum. Neuroimage 2019; 209:116477. [PMID: 31874257 DOI: 10.1016/j.neuroimage.2019.116477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022] Open
Abstract
Alterations induced by prenatal exposure to nicotine have been observed in experimental (rodent) studies. While numerous developmental outcomes have been associated with prenatal exposure to maternal cigarette smoking (PEMCS) in humans, the possible relation with brain structure is less clear. Here we sought to elucidate the relation between PEMCS and structural properties of human corpus callosum in adolescence and early adulthood in a total of 1,747 youth. We deployed three community-based cohorts of 446 (age 25-27 years, 46% exposed), 934 (age 12-18 years, 47% exposed) and 367 individuals (age 18-21 years, 9% exposed). A mega-analysis revealed lower mean diffusivity in the callosal segments of exposed males. We speculate that prenatal exposure to maternal cigarette smoking disrupts the early programming of callosal structure and increases the relative portion of small-diameter fibres.
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Affiliation(s)
- L Björnholm
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - J Nikkinen
- Department of Radiotherapy, Oulu University Hospital, Oulu, Finland; MIPT/MRC, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - V Kiviniemi
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Oulu Functional Neuroimaging, MIPT/MRC, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - S Niemelä
- Department of Psychiatry, University of Turku, Turku, Finland; Addiction Psychiatry Unit, Department of Psychiatry, Hospital District of Southwest Finland, Finland
| | - M Drakesmith
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - J C Evans
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - G B Pike
- Department of Radiology and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - L Richer
- Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Z Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - J Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - T Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada.
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8
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Bovbjerg ML, Pillai S. Current Resources for Evidence-Based Practice, September 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:568-582. [PMID: 31442383 DOI: 10.1016/j.jogn.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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9
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Hawkins SS, Baum CF, Rifas-Shiman SL, Oken E, Taveras EM. Examining Associations between Perinatal and Postnatal Risk Factors for Childhood Obesity Using Sibling Comparisons. Child Obes 2019; 15:254-261. [PMID: 30883194 PMCID: PMC6622557 DOI: 10.1089/chi.2018.0335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: One of the major criticisms of observational studies examining risk factors for childhood obesity is unmeasured confounding. We examined the associations between breastfeeding initiation, cesarean delivery, prenatal smoking, and gestational diabetes mellitus (GDM) with childhood obesity using both a traditional observational approach and a sibling-pair design with family fixed effects. Methods: We used data from the Linked the Collecting Electronic Nutrition Trajectory Data Using e-Records of Youth (CENTURY) Study, a clinical database created through the linkage of well-child visits with children's birth certificates, with obesity measured at 2 (N = 55,058) and 5 (N = 43,894) years of age. We conducted three sets of regression models: (1) full sample to examine the adjusted association between each risk factor and obesity with clustering by family; (2) rerun only among siblings with clustering by family; and (3) fixed effects analysis among siblings. Results: Across risk factors, 30%-39% of children had siblings. In the full sample, breastfeeding initiation was associated with a lower BMI z-score, while cesarean delivery and smoking during pregnancy were associated with a higher BMI z-score. Effect sizes were consistent in models with siblings only. However, in the fixed effects models, the coefficients attenuated and were no longer significant for each of these risk factors. We found no association between GDM and child BMI z-score in any of the models. Results were consistent for childhood obesity as a dichotomous measure and at 5 years of age. Conclusions: Our findings suggest that unmeasured genetic, environmental, and familial factors are likely confounding associations between breastfeeding, cesarean delivery, prenatal smoking, and GDM with childhood obesity in observational studies.
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Affiliation(s)
- Summer Sherburne Hawkins
- School of Social Work, Boston College, Chestnut Hill, MA.,Address correspondence to: Summer Sherburne Hawkins, PhD, MS, School of Social Work, Boston College, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Christopher F. Baum
- School of Social Work, Boston College, Chestnut Hill, MA.,Department of Economics, Boston College, Chestnut Hill, MA.,Department of Macroeconomics, German Institute for Economic Research (DIW Berlin), Berlin, Germany
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
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