Nutrition During Pregnancy: Findings from the NICHD Fetal Growth Studies – Singleton Cohort

Abstract Background Accumulating evidence indicates that maternal diets are important for optimizing maternal and offspring health. Existing research lacks comprehensive profiles of maternal diets throughout pregnancy, especially in a racially/ethnically diverse obstetrical population. Objective To characterize diets in a longitudinal U.S. pregnancy cohort by trimester, race/ethnicity, and pre-pregnancy body mass index (BMI). Methods Data were obtained from pregnant women in the NICHD Fetal Growth Studies - Singleton cohort (2009–2013). A Food Frequency Questionnaire (FFQ) at 8–13 weeks gestation assessed periconception and first trimester diet (n = 1615). Automated, self-administered, 24-hour dietary recalls targeted at 16–22, 24–29, 30–33, and 34–37 weeks gestation assessed second and third trimester diets (n = 1817 women/6791 recalls). Healthy Eating Index-2010 (HEI) assessed diet quality (i.e., adherence to U.S. Dietary Guidelines). Variations in weighted energy-adjusted means for foods and nutrients were examined by trimester, self-identified race/ethnicity, and self-reported pre-pregnancy BMI. Results Mean (95% confidence interval) HEI was 65.9 (64.9,67.0) during periconception to first trimester assessed with an FFQ, and 51.6 (50.8,52.4) and 51.5 (50.7,52.3) during the second trimester and third trimester, respectively, assessed using 24-hour recalls. No significant differences were observed between second and third trimester in macronutrients, micronutrients, foods, or HEI components (P ≥ 0.05). Periconception to first trimester HEI was highest among Asian/Pacific Islander [67.2 (65.9,68.6)] and lowest among non-Hispanic Black [58.7 (57.5,60.0)] women and highest among women with normal weight [67.2 (66.1,68.4)] and lowest among women with obesity [63.5 (62.1,64.9)]. Similar rankings were observed in the second/third trimesters. Conclusions Most pregnant women in this cohort reported dietary intakes that, on average, did not meet U.S. Dietary Guidelines for non-pregnant individuals. Also, diet differed across race/ethnic groups and by pre-pregnancy BMI with lowest overall dietary quality in all trimesters among non-Hispanic Black women and women with obesity. No meaningful changes in dietary intake were observed between the second and third trimesters.

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Pregnant Women Living with Obesity: A Cross-Sectional Observational Study of Dietary Quality and Pregnancy Outcomes

Nutrients ◽

10.3390/nu13051652 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1652

Author(s):

Margaret Charnley ◽

Lisa Newson ◽

Andrew Weeks ◽

Julie Abayomi

Keyword(s):

Pregnant Women ◽

Maternal Obesity ◽

Maternal Nutrition ◽

Saturated Fatty Acids ◽

Poor Quality ◽

Dietary Quality ◽

Obstetric Outcomes ◽

Dietary Intakes ◽

Singleton Pregnancy ◽

Cross Sectional

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

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Radioimmunoassay of plasma ouabain in healthy and pregnant individuals

Journal of Endocrinology ◽

10.1677/joe.0.1650669 ◽

2000 ◽

Vol 165 (3) ◽

pp. 669-677 ◽

Cited By ~ 28

Author(s):

O Vakkuri ◽

SS Arnason ◽

A Pouta ◽

O Vuolteenaho ◽

J Leppaluoto

Keyword(s):

Pregnant Women ◽

Human Plasma ◽

High Performance ◽

Chemical Nature ◽

Solid Phase ◽

Plasma Concentrations ◽

First Trimester ◽

Plasma Samples ◽

Third Trimester ◽

Endogenous Substances

Ouabain was recently isolated from human plasma, bovine hypothalamus and bovine adrenal in attempts to identify endogenous substances inhibiting the cell membrane sodium pump. A number of radioimmunoassays have been developed in order to study the clinical significance of ouabain. The results have been controversial with regard to the presence and chemical nature of plasma ouabain-like immunoreactivity. We have now measured ouabain in healthy and pregnant individuals using solid-phase extraction of plasma samples followed by a new radioimmunoassay with the extraordinary sensitivity of at least 2 fmol/tube (5 pmol/l). Plasma extracts, a previously isolated human plasma ouabain-like compound and bovine hypothalamic inhibitory factor displaced the tracer in parallel and eluted identically with ouabain in high-performance liquid chromatography. Plasma ouabain immunoreactivity was found to be much lower than reported previously: 12.6+/-1.3 pmol/l in healthy men (mean+/-s.e., n=20) and 9.4+/-0.7 pmol/l in women (n=14). In pregnant women (n=28) plasma ouabain concentration was 16.3+/-4.0 pmol/l during the first trimester, 18.8+/-4.3 pmol/l during the second trimester and 24.3+/-4.0 pmol/l during the third trimester (all P<0.01 compared with non-pregnant women). Plasma ouabain 3-5 days after the delivery was 13.6+/-1.1 pmol/l (n=10, P<0.05-0.01 compared with second and third trimesters). The pregnancy-related changes in the plasma concentrations of ouabain resembled those of cortisol. Therefore cortisol was measured from the same plasma samples and a significant positive correlation was found (r=0.512, P=0.006). The similar profiles of plasma ouabain and cortisol during pregnancy and their rapid decreases postpartum are consistent with the adrenal cortical origin of ouabain and also show that the secretions of these hormones are possibly under the control of same factors.

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Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

Environmental Health ◽

10.1186/s12940-021-00747-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Chalana M. Sol ◽

Charissa van Zwol - Janssens ◽

Elise M. Philips ◽

Alexandros G. Asimakopoulos ◽

Maria-Pilar Martinez-Moral ◽

...

Keyword(s):

Birth Outcomes ◽

Fetal Growth ◽

Head Circumference ◽

Lower Risk ◽

First Trimester ◽

Population Based ◽

Third Trimester ◽

Bisphenol S ◽

Fetal Head ◽

Urine Concentrations

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.

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Abstract MP42: Adherence To Healthy Dietary Patterns In Pregnancy And Placental Dna Methylation- An Epigenome Wide Association Study

Circulation ◽

10.1161/circ.143.suppl_1.mp42 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Cuilin Zhang ◽

Jing Wu ◽

Marion Ouidir ◽

Stefanie Hinkle ◽

Fasil Ayele

Keyword(s):

Dna Methylation ◽

Dietary Patterns ◽

First Trimester ◽

Healthy Eating Index ◽

Nervous System Development ◽

Dietary Quality ◽

Analysis Tool ◽

Linear Regression Models ◽

Cpg Sites ◽

In Pregnancy

Background: Accumulating evidence support the intergenerational impacts of diet in pregnancy. The underlying mechanisms, however, remain unclear. Placental epigenetic mechanisms may be involved although data from human epidemiological studies are sparse. We aimed to investigate associations of dietary quality in pregnancy with epigenome-wide placental DNA methylation in a multiracial pregnancy cohort. Methods: DNA methylation was measured using the Illumina Infinium Human Methylation450 Beadchip on placentas obtained at delivery from 301 pregnant women who participated in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort. Dietary information during periconception and early first trimester was collected using food frequency questionnaires, and diet in the second and third trimester was collected using a 24-hour dietary recall during four study visits. Scores for adherence to three healthy dietary patterns, alternate Healthy Eating Index (aHEI), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH), were calculated. For associations of each dietary pattern score with methylation, we conducted analyses using robust linear regression models after the adjustment for age, pre-pregnancy body mass index, race/ethnicity, physical activity, total energy intakes, and population stratification. Genes annotating the top significant CpG sites (false discovery rate (FDR) adjusted P<0.05) were queried for enrichment of functional pathways using the Ingenuity Pathway Analysis tool. Results: Adherence to aHEI was significantly associated with methylation of 8 CpG sites, with the most significant association manifested in cg16724319- MDH1B (P=1.9x10 -10 ). Adherence to aMED was related to methylation of 14 CpG sites, with the most significant association manifested in cg07835181- CLCN7 (P=1.7x10 -11 ). DASH was significantly related to 33 CpG sites, with the most significant association manifested in cg26292547- REV3L (P=4.4x10 -10 ). Further, genes annotating the significant CpG sites were enriched in pathways related to cardiovascular and nervous system development and function, cancer, organismal injury and abnormalities, and reproductive system diseases. Conclusion: Findings from the epigenome wide study suggest that overall dietary quality in pregnancy is associated with placental DNA methylation changes at different loci potentially related to cardiovascular, neurological, reproductive, and cancer phenotypes.

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Abstract P108: Metabolic Profile Of Diet Quality In The Multi-Ethnic Study Of Atherosclerosis

Circulation ◽

10.1161/circ.143.suppl_1.p108 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Meghana Gadgil ◽

Alexis F Wood ◽

Ibrahim Karaman ◽

Goncalo Gomes Da Graca ◽

Ioanna Tzoulaki ◽

...

Keyword(s):

Cardiovascular Disease ◽

Diet Quality ◽

Spectral Feature ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Elastic Net ◽

Dietary Quality ◽

Spectral Features ◽

Ethnic Study ◽

Diet Score

Introduction: Poor dietary quality is a well-known risk factor for diabetes and cardiovascular disease (CVD), however metabolites marking adherence to U.S. dietary guidelines are unknown. Our goal was to determine a pattern of metabolites associated with the Healthy Eating Index-2015 (HEI-2015). We hypothesize that there will be metabolites positively and negatively associated with the HEI-2015 score, including those previously linked to diabetes and CVD. Methods: Sample: 2269 adult men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study without known cardiovascular disease or diabetes. Data/specimens: Fasting serum specimens, diet and demographic questionnaires at baseline. Metabolomics: Untargeted 1 H NMR CPMG spectroscopy (600 MHz) annotated by internal and external reference data sets. Statistical analysis: Metabolome-wide association study (MWAS) using linear regression models specifying each spectral feature as the outcome in separate models, HEI-2015 score as the predictor, and adjustment for age, sex, race, and study site, accounting for multiple comparisons. Elastic net regularized regression was used to select an optimal subset of features associated with HEI-2015 score. Separately, hierarchical clustering defined discrete groups of correlated NMR features also tested for association with HEI-2015 score. Results: MWAS identified 1914 spectral features significantly associated with the HEI-2015 diet score. After elastic net regression, 35 metabolomic spectral features remained associated with HEI-2015 diet score. Cluster analysis identified seven clusters, three of which were significantly associated with HEI-2015 score after Bonferroni correction. (Table) Conclusions: Cholesterol moieties, proline betaine, proline/glutamate and fatty acyls chains were significantly associated with higher diet quality in the MESA cohort. Further analysis may clarify the link between dietary quality, metabolites, and pathogenesis of diabetes and CVD.

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Lower Healthy Eating Index-2005 dietary quality scores in older women with rheumatoid arthritis v. healthy controls

Public Health Nutrition ◽

10.1017/s136898001000008x ◽

2010 ◽

Vol 13 (8) ◽

pp. 1170-1177 ◽

Cited By ~ 17

Author(s):

Megan E Grimstvedt ◽

Kathleen Woolf ◽

Brandy-Joe Milliron ◽

Melinda M Manore

Keyword(s):

Rheumatoid Arthritis ◽

Nutritional Status ◽

Older Women ◽

Healthy Eating ◽

Healthy Eating Index ◽

High Risk Group ◽

Dietary Guidelines ◽

Dietary Quality ◽

Healthy Controls ◽

Cross Sectional

AbstractObjectiveTo assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.DesignCross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.SettingArizona, USA.SubjectsOlder (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).ResultsThere were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).ConclusionsThis is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.

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Changes in fatty acid levels (saturated, monounsaturated and polyunsaturated) during pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04251-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Estefania Aparicio ◽

Carla Martín-Grau ◽

Carmen Hernández-Martinez ◽

Nuria Voltas ◽

Josefa Canals ◽

...

Keyword(s):

Fatty Acids ◽

Arachidonic Acid ◽

Fatty Acid ◽

Docosahexaenoic Acid ◽

Serum Concentration ◽

Eicosapentaenoic Acid ◽

Pregnant Women ◽

First Trimester ◽

Third Trimester ◽

Total N

Abstract Background During pregnancy a high amount of fatty acids (FA) is necessary to meet foetus demands, which vary during gestation. The present study describes the changes in maternal fatty acid concentrations during pregnancy in a sample of pregnant women. Methods This is a longitudinal study of 479 pregnant women who were monitored from the first trimester to third trimester of pregnancy. Data on maternal characteristics were recorded and a serum sample was collected in each trimester. The fatty acid profile (saturated (SFA: total, lauric acid, myristic acid, palmitic acid, stearic acid), monounsaturated (MUFA: total, palmitoleic acid, oleic acid) and polyunsaturated fatty acids (PUFA: total omega-6 (n-6), linoleic acid, dihomo-γ-linolenic acid, arachidonic acid (AA), total omega-3 (n-3), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)) was analysed with a gas chromatography-mass spectrometry combination. Results From the first trimester to third trimester of pregnancy, a significant increase in total SFA, total MUFA and total n-6 PUFA was found. (p < 0.001). Nevertheless, the serum concentration of arachidonic acid (AA), eicosapentaenoic acid (EPA) and total n-3 PUFA decreased during gestation (p < 0.001). A statistically non-significant result was observed for the docosahexaenoic acid (DHA) serum concentration between the first and third trimesters of pregnancy. Significant correlations were observed between each total fatty acid concentrations of the first and third trimesters. Conclusion The circulating serum concentration of SFA, MUFA and n-6 PUFA increases during pregnancy, whereas essential fatty acids such as AA and EPA decrease, and DHA remains unchanged. Further research is necessary to understand the role played by FA throughout gestation.

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Biomarkers in the Hypothalamus-pituitary-adrenal Axis Were Associated with Maternal Psychosocial Stress and Choline Intake and Status During Pregnancy (P11-011-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-011-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Chauntelle Jack-Roberts ◽

Patricia Maples ◽

Anjana Saxena ◽

Mudar Dalloul ◽

John Kral ◽

...

Keyword(s):

Hpa Axis ◽

Psychosocial Stress ◽

Healthy Eating Index ◽

Dietary Quality ◽

Nutrition Status ◽

Dietary Intakes ◽

Omega 3 ◽

Gestational Length ◽

Negatively Associated ◽

Neighborhood Stress

Abstract Objectives Maternal psychosocial stress during pregnancy can lead to heightened activity of the hypothalamus-pituitary-adrenal (HPA) axis, increasing the risk of pre-term birth, intrauterine restriction, and preeclampsia. Maternal dietary intakes and nutrition status modify epigenetic marks in the placental and fetal HPA axis, which may then counter the negative influence of maternal stress. This study aims to determine the correlation of maternal psychosocial stress and nutrient intakes with biomarkers of HPA axis activity in human pregnancies. Methods Pregnant women (n = 60) were recruited to this observational study. Psychosocial stress survey, dietary recalls and blood samples were obtained in the 3rd trimester. Placentas and cord blood were retrieved at delivery. Results Maternal financial stress, neighborhood stress, and anxiety were positively or tended to be positively associated with maternal blood cortisol levels (P = 0.01-0.08), although none of the psychosocial stress measurements were correlated with placental corticotropin-releasing hormone (CRH), glucocorticoid receptor (NR3C1), or 11β-hydroxysteroid dehydrogenase (11BHSD) expression. Placental NR3C1 expression was positively associated with birth weight (r = 0.42, P = 0.02) while placental CRH was negatively associated with gestational length (r = –0.45, P = 0.01). Overall dietary quality as measured by the Healthy Eating Index (HEI) was not associated with psychosocial stress or related biomarkers, while intakes of the methyl donor choline (r = 0.46, P = 0.04) and omega-3 fatty acids (r = 0.47, P = 0.03) were positively associated with placental NR3C1 expression. Placental choline content was also positively associated with NR3C1 expression (r = 0.39, P = 0.04) and negatively associated with maternal neighborhood stress (r = –0.72, P = 0.02). Conclusions In summary, these data suggest that maternal psychosocial stress may adversely affect HPA axis functioning during pregnancy, whereas choline and other nutrients have the potential to counteract some of the impacts of psychosocial stress. Funding Sources CUNY Interdisciplinary Research Grant.

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Thrombin Generation in Chinese Pregnant Women and the Effect of Insulin Use on Thrombin Generation in Patients with GDM

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619863492 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986349

Author(s):

Feng Dong ◽

Longhao Wang ◽

Chengbin Wang

Keyword(s):

Blood Glucose ◽

Pregnant Women ◽

Thrombin Generation ◽

First Trimester ◽

Normal Pregnancy ◽

Third Trimester ◽

Control Blood Glucose ◽

Normal Ranges ◽

Increased Risk ◽

Significant Difference

Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis. Calibrated automated thrombogram (CAT) is a test to monitor the thrombin generation (TG), a laboratory marker of thrombosis risk, and increases during normal pregnancy, but it is still unclear whether TG is related to the use of insulin in pregnant women with gestational diabetes mellitus (GDM). We performed thrombin generation by CAT on 135 normal pregnant women, including 43 in first trimester, 32 in second trimester, 60 in third trimester, respectively; 68 pregnant women with GDM were also enrolled, 19 patients with GDM using insulin to control blood glucose and 49 patients control their blood glucose through diet and exercise with noninsulin treatment. The overall CAT parameters were calculated using descriptive statistics method with mean ± standard deviation. Mean endogenous thrombin potential, peak thrombin generation, and StartTail time increased significantly with the pregnancy. There was no significant difference in TG test parameters except StartTail time( P = .003) in insulin-treated GDM group when compared to those without insulin in the GDM group. The normal ranges for CAT parameters in pregnant women were determined. Thrombin generation increased significantly in first trimester and remains stable in second and third trimester. The use of insulin in patient with GDM did not affect thrombin generation test. Our study helps to establish the reference range of thrombin generation in Chinese normal pregnant population and provide more basis to predict the risk of thrombus complicating during pregnancy.

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Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Journal of Clinical Medicine ◽

10.3390/jcm9113504 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3504

Author(s):

Małgorzata Lewandowska ◽

Barbara Więckowska ◽

Lidia Sztorc ◽

Stefan Sajdak

Keyword(s):

Smoking Cessation ◽

Birth Weight ◽

Cigarette Smoking ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Odds Ratio ◽

Maternal Obesity ◽

First Trimester ◽

Third Trimester ◽

The Mean

Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.

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