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Beetch M, Alejandro EU. Placental mTOR Signaling and Sexual Dimorphism in Metabolic Health across the Lifespan of Offspring. CHILDREN 2021; 8:children8110970. [PMID: 34828683 PMCID: PMC8619510 DOI: 10.3390/children8110970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022]
Abstract
Robust evidence of fetal programming of adult disease has surfaced in the last several decades. Human and preclinical investigations of intrauterine insults report perturbations in placental nutrient sensing by the mechanistic target of rapamycin (mTOR). This review focuses on pregnancy complications associated with placental mTOR regulation, such as fetal growth restriction (FGR), fetal overgrowth, gestational diabetes mellitus (GDM), polycystic ovarian syndrome (PCOS), maternal nutrient restriction (MNR), preeclampsia (PE), maternal smoking, and related effects on offspring birthweight. The link between mTOR-associated birthweight outcomes and offspring metabolic health trajectory with a focus on sexual dimorphism are discussed. Both human physiology and animal models are summarized to facilitate in depth understanding. GDM, PCOS and fetal overgrowth are associated with increased placental mTOR, whereas FGR, MNR and maternal smoking are linked to decreased placental mTOR activity. Generally, birth weight is reduced in complications with decreased mTOR (i.e., FGR, MNR, maternal smoking) and higher with increased mTOR (GDM, PCOS). Offspring display obesity or a higher body mass index in childhood and adulthood, impaired glucose and insulin tolerance in adulthood, and deficiencies in pancreatic beta-cell mass and function compared to offspring from uncomplicated pregnancies. Defining causal players in the fetal programming of offspring metabolic health across the lifespan will aid in stopping the vicious cycle of obesity and type II diabetes.
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Wojtyla C, Wojtyla-Buciora P, Ciebiera M, Orzechowski S, Wojtyla A. The effect of active and passive maternal smoking before and during pregnancy on neonatal weight at birth. Arch Med Sci 2021; 17:352-360. [PMID: 33747270 PMCID: PMC7959047 DOI: 10.5114/aoms.2018.79629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/17/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Smoking during pregnancy is a risk factor for adverse pregnancy outcomes. Data on the correlation between passive maternal smoking and pregnancy outcomes remain limited. We investigated the effect of active smoking and environmental tobacco smoke (ETS) during pregnancy on neonatal birthweight, including the risk for low birthweight (LBW). MATERIAL AND METHODS The study was conducted between 2010 and 2012. A group of 8625 women were surveyed during postpartum hospitalization. Outcome measures included mean birthweight of newborns. Additionally, odds ratios with confidence intervals were calculated to investigate the risk for LBW in active and passive smoking groups of mothers. RESULTS Lower birthweight (46 g - 307 g; p < 0.05) and a higher risk for LBW (OR = 1.35, 95% CI: 1.05-1.75; p < 0.05) were observed in all infants born to smoking mothers. A negative effect of ETS in pregnancy on the reduction of mean birthweight was also found. Additionally, we analyzed the cumulative effect of active and passive smoking on neonatal birthweight. A statistically significant reduction in neonatal weight at birth was found in a group of women who smoked actively and passively during pregnancy (130 g; p < 0.05). CONCLUSIONS Smoking is associated with decreased birthweight and in a group of active smoking mothers increased risk for LBW. This effect is dose-dependent and is also present in a group of women who smoked before pregnancy. There is also a cumulative effect of active smoking and ETS causing decreased neonatal birthweight and increased risk for low birthweight.
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Affiliation(s)
- Cezary Wojtyla
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
- Department of Oncological Gynecology and Obstetrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Paulina Wojtyla-Buciora
- Faculty of Medicine, State University of Applied Sciences, Kalisz, Poland
- Department of Physiology, University of Medical Sciences, Poznan, Poland
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Stanisław Orzechowski
- Department of Nursing, Faculty of Health Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Wojtyla
- Faculty of Medicine, State University of Applied Sciences, Kalisz, Poland
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Fetal exposure to maternal active and secondhand smoking with offspring early-life growth in the Healthy Start study. Int J Obes (Lond) 2018; 43:652-662. [PMID: 30341407 DOI: 10.1038/s41366-018-0238-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/18/2018] [Accepted: 08/13/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies have modeled the association between fetal exposure to tobacco smoke and body mass index (BMI) growth trajectories, but not the timing of catch-up growth. Research on fetal exposure to maternal secondhand smoking is limited. OBJECTIVES To explore the associations between fetal exposure to maternal active and secondhand smoking with body composition at birth and BMI growth trajectories through age 3 years. METHODS We followed 630 mother-child pairs enrolled in the Healthy Start cohort through age 3 years. Maternal urinary cotinine was measured at ~ 27 weeks gestation. Neonatal body composition was measured using air displacement plethysmography. Child weight and length/height were abstracted from medical records. Linear regression models examined the association between cotinine categories (no exposure, secondhand smoke, active smoking) with weight, fat mass, fat-free mass, and percent fat mass at birth. A mixed-effects regression model estimated the association between cotinine categories and BMI. RESULTS Compared to unexposed offspring, birth weight was significantly lower among offspring born to active smokers (-343-g; 95% CI: -473, -213), but not among offspring of women exposed to secondhand smoke (-47-g; 95% CI: -130, 36). There was no significant difference in the rate of BMI growth over time between offspring of active and secondhand smokers (p = 0.58). Therefore, our final model included a single growth rate parameter for the combined exposure groups of active and secondhand smokers. The rate of BMI growth for the combined exposed group was significantly more rapid (0.27 kg/m2 per year; 95% CI: 0.05, 0.69; p < 0.01) than the unexposed. CONCLUSIONS Offspring prenatally exposed to maternal active or secondhand smoking experience rapid and similar BMI growth in the first three years of life. Given the long-term consequences of rapid weight gain in early childhood, it is important to encourage pregnant women to quit smoking and limit their exposure to secondhand smoke.
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Veisani Y, Jenabi E, Delpisheh A, Khazaei S. Effect of prenatal smoking cessation interventions on birth weight: meta-analysis. J Matern Fetal Neonatal Med 2017; 32:332-338. [PMID: 28889768 DOI: 10.1080/14767058.2017.1378335] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Smoking is preventable factor for pregnancy outcomes such as low birth weight (LBW). In this study, we assessed the effects of smoking cessation in pregnancy period on the birth weight in Randomized Controlled Trial studies (RCTs). METHODS International databases of Pub Med, Scopus, and Web of Science, by the MeSH heading and/or additional terms, were searched to assess relevant studies in systematic possess. I2 statistics was used to assess of heterogeneity. Pooled effects size was obtained by random effects model. Meta-regression was used to explore of heterogeneity using Stata software version 12 (Stata Corp, College Station, TX). RESULTS A total 16 RCTs, 6192 women were enrolled to assess of smoking cessation in pregnancy period on the birth weight. Relative risk (RR) of not smoking at the end of pregnancy in intervention group was 2.47 (95% CI: 1.73-3.20). The odds ratio (OR) for effect of smoking cessation on LBW was 0.65 (95% CI: 0.42-0.88) and standardized mean difference (SMD) was significantly increased in the intervention group, 0.28 (95% CI: 0.05-0.50). CONCLUSIONS Results of this study approve results of previous RCTs that smoking cessation in pregnancy is a good practical action to prevention of LBW in infants.
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Affiliation(s)
- Yousef Veisani
- a Psychosocial Injuries Research Center , Ilam University of Medical Sciences , Hamadan , Iran
| | - Ensiyeh Jenabi
- b Department of Midwifery, Tuyserkan Branch , Islamic Azad University , Tuyserkan , Iran
| | - Ali Delpisheh
- c Department of Clinical Epidemiology , Ilam University of Medical Sciences , Ilam , Iran
| | - Salman Khazaei
- d Department of Epidemiology , School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran , Hamadan , Iran
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Chan YL, Saad S, Al-Odat I, Zaky AA, Oliver B, Pollock C, Li W, Jones NM, Chen H. Impact of maternal cigarette smoke exposure on brain and kidney health outcomes in female offspring. Clin Exp Pharmacol Physiol 2016; 43:1168-1176. [DOI: 10.1111/1440-1681.12659] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/17/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Yik L Chan
- School of Life Sciences; Faculty of Science; University of Technology Sydney; Broadway NSW Australia
| | - Sonia Saad
- Kolling Institute of Medical Research; University of Sydney; St Leonards NSW Australia
| | - Ibrahim Al-Odat
- School of Life Sciences; Faculty of Science; University of Technology Sydney; Broadway NSW Australia
| | - Amgad A Zaky
- Kolling Institute of Medical Research; University of Sydney; St Leonards NSW Australia
| | - Brian Oliver
- School of Life Sciences; Faculty of Science; University of Technology Sydney; Broadway NSW Australia
| | - Carol Pollock
- Kolling Institute of Medical Research; University of Sydney; St Leonards NSW Australia
| | - Weihong Li
- Department of Science and Technology; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - Nicole M Jones
- Department of Pharmacology; School of Medical Sciences; University of New South Wales; Broadway NSW Australia
| | - Hui Chen
- School of Life Sciences; Faculty of Science; University of Technology Sydney; Broadway NSW Australia
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Ivorra C, García-Vicent C, Ponce F, Ortega-Evangelio G, Fernández-Formoso JA, Lurbe E. High cotinine levels are persistent during the first days of life in newborn second hand smokers. Drug Alcohol Depend 2014; 134:275-279. [PMID: 24268547 DOI: 10.1016/j.drugalcdep.2013.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/17/2013] [Accepted: 10/20/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND Despite the adverse effects of maternal smoking during pregnancy on the newborn's health are well-known, in the pediatric population, a high prevalence exists that is very much affected by second hand smoke (SHS). This study aims to investigate the impact of maternal smoking habits during pregnancy on cotinine levels in newborns during the first days of life. The high association between cotinine concentration in maternal and umbilical cord blood (UCB) has been previously reported, but the levels of blood cotinine that remain in infants born to smokers is unknown. METHODS Cotinine concentration was measured in UCB, in maternal and newborn peripheral blood. Data from UCB sample dyads of ninety mothers and from seventy-one newborns were analyzed. RESULTS Cotinine levels were significantly different among non-smokers (9.9 ± 5.9 ng/ml), moderate (67.3 ± 7.4 ng/ml), and heavy smokers (137.7 ± 19.5 ng/ml) (p<0.0001). Significant correlations were found between maternal and UCB cotinine (r=0.748; p<0.001), and between UCB and newborn plasma cotinine at 48 h after birth (r=0.541; p<0.001). The smokers exposed their infants to cotinine with a median of 31.7 ± 8.6 ng/ml (moderate) or 59.1 ± 13.3 ng/ml (heavy smokers) until at least, 48 h after birth. Reduced birth weight and length were significantly related with UCB cotinine levels. CONCLUSIONS A positive association between UCB and plasmatic cotinine in newborns was found. The high cotinine levels detected in newborns from smoker mothers indicates that their infants are subjected to elevated SHS from birth. These results can help to reinforce the awareness of the adverse effects of smoking during pregnancy.
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Affiliation(s)
- Carmen Ivorra
- Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain.
| | - Consuelo García-Vicent
- Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBERER, Instituto de Salud Carlos III, Madrid, 28049, Spain.
| | - Francisco Ponce
- Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain.
| | - Graciela Ortega-Evangelio
- Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain.
| | | | - Empar Lurbe
- Cardiovascular Risk Unit, Hospital General, University of Valencia, Department of Pediatrics, Avenida Tres Cruces 2, Valencia, 46014, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, 28049, Spain.
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The independent effects of second hand smoke exposure and maternal body mass index on the anthropometric measurements of the newborn. BMC Public Health 2013; 13:1058. [PMID: 24209496 PMCID: PMC4226006 DOI: 10.1186/1471-2458-13-1058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/07/2013] [Indexed: 12/19/2022] Open
Abstract
Background Exposure to tobacco smoke during pregnancy, whether as active smoking or by exposure to secondhand smoke (SHS), is associated with adverse pregnancy outcomes including low birth weight (LBW) and small for gestational age infants due to the effect of tobacco on the anthropometric measurements of the newborn. This effect might be masked by maternal obesity as it increases fetal weight. The objectives of this study were to estimate the independent effects of maternal exposure to SHS and maternal body mass index (BMI) on the anthropometric measurements and on the prevalence of macrosomia and LBW among term infants. Methods Data were collected from women in the postnatal ward following delivery. Participants were stratified into six groups based on the BMI (underweight <18 kg/m2, non-obese 18–29.9 kg/m2, and obese ≥30 kg/m2) and the SHS exposure status (exposed and non- exposed), to examine the independent effects of BMI and SHS on infants’ anthropometry. Multiple regression analysis was used to explore the independent associations between the six groups and the risk of delivering a macrosomic or LBW infant. Results Infants of women exposed to SHS had significantly reduced anthropometric measurements compared to infants of unexposed women. The odds of delivering a macrosomic baby increased to 9-fold for women with BMI of ≥30 kg/m2 compared to non-obese women; odds ratio (OR) 9.18, 95% Confidence Interval (CI) (1.01, 9.37); p = 0.04, this risk was attenuated to 1.5-fold in women exposed to SHS, OR 1.53, 95% CI (1.19, 12.1); p < 0.0001. The odds of delivering an LBW infant were more than doubled in underweight women compared to non-obese women, OR 2.15, 95% CI (1.001, 4.57); p = 0.034, and were further increased to almost 3-fold for women who were exposed to SHS, OR 2.71, 95% CI (1.82,4.045); p = 0.02. Conclusion Exposure to SHS was associated with reduced anthropometric measurements of the newborn and increased rate of LBW infants, irrespective of maternal BMI. Maternal obesity was associated with increased risk of delivering a macrosomic infant; conversely maternal underweight was associated with increased risk of delivering an LBW infant.
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Wahabi HA, Alzeidan RA, Fayed AA, Mandil A, Al-Shaikh G, Esmaeil SA. Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women. BMC Public Health 2013; 13:341. [PMID: 23587116 PMCID: PMC3641009 DOI: 10.1186/1471-2458-13-341] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/11/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults' diseases including obesity, diabetes and hypertension.The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns' anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. METHOD This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns' anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. RESULTS Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2-68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. CONCLUSION The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.
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Affiliation(s)
- Hayfaa A Wahabi
- Sheikh Bahamdan Research Chair of Evidence-Based Healthcare and Knowledge Translation, College of Medicine, King Saud University, P.O. Box 102799, Riyadh 11685, Kingdom of Saudi Arabia.
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