The joint effect of maternal smoking during pregnancy and maternal pre-pregnancy overweight on infants’ term birth weight

Introduction: Maternal smoking during pregnancy is an established risk factor for adverse perinatal outcomes. However, data on the intergenerational impact of maternal smoking during pregnancy on offspring’s long-term risk of adulthood disease are limited. Hypothesis: We assessed the hypothesis that maternal smoking during pregnancy may be associated with risk of gestational diabetes mellitus (GDM) in the offspring. Methods: The analytical population was composed of 10138 parous women in the Nurses' Health Study II cohort whose mothers participated in the Nurses’ Mothers’ Cohort Study; 819 of the nurses developed GDM. Data on maternal and paternal smoking during pregnancy and associated covariates were recalled by the nurses’ mothers. GDM diagnosis was self-reported by nurse participants and was validated by medical record review in a previous study. We used logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: We observed a significant association between maternal heavy smoking during pregnancy and risk of GDM in the offspring. The multivariable-adjusted ORs (95% CIs) of GDM among women whose mothers did not smoke during pregnancy, continued smoking 1-14, 15-24, and ≥ 25 cigarettes/day were 1.00 (reference), 1.13 (0.91-1.42), 1.17 (0.88-1.55), and 1.74 (1.03-2.95) (P for trend = 0.04), respectively. Further adjustment for the nurses’ birth weight, adult life variables and body mass index during various periods of life only slightly changed the association. No significant association was observed between paternal smoking during the pregnancy period and the risk of GDM. We further examined the joint effect of both maternal and paternal smoking during pregnancy on the risk of GDM. The nurses whose parents both smoked during pregnancy ≥ 15 cigarettes/day had an OR (95% CI) of 1.25 (0.94-1.66), compared with those whose parents did not smoke during pregnancy or smoked < 15 cigarettes/day. In an analysis on the joint effect of maternal smoking during pregnancy and the nurse’s smoking during adulthood, we found that the nurses who ever smoked during adulthood and their mothers ever smoked during the pregnancy with them had a significantly higher risk of GDM (OR 1.40, 95% CI 1.08-1.81), compared to the nurses neither themselves nor the mothers smoked. Conclusions: In conclusion, maternal heavy smoking (≥ 25 cigarettes/day) during pregnancy is significantly associated with higher risk of gestational diabetes in the offspring. Further studies are warranted to confirm our findings and to elucidate the underlying mechanisms.

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Prenatal smoking and childhood behavior problems: is the association mediated by birth weight?

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174416000039 ◽

2016 ◽

Vol 7 (3) ◽

pp. 273-281 ◽

Cited By ~ 3

Author(s):

S. E. Parker ◽

B. R. Collett ◽

M. L. Speltz ◽

M. M. Werler

Keyword(s):

Birth Weight ◽

Behavior Problems ◽

Child Behavior ◽

Maternal Smoking ◽

Behavioral Outcomes ◽

Attention Problems ◽

Prenatal Smoking ◽

Teacher Report ◽

Smoking During Pregnancy ◽

Maternal Smoking During Pregnancy

Maternal smoking during pregnancy is associated with both reduced birth weight and adverse neurobehavioral outcomes. The aim of this study was to investigate longitudinal associations between maternal smoking during pregnancy and childhood behavioral outcomes, and to determine the role of birth weight in mediating such associations. The study included 489 mother–child pairs. Prenatal exposures were assessed via maternal interviews conducted on average 1 year after delivery and child behavior assessments were completed at 5–12 years of age using the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). Maternal smoking during pregnancy was associated with externalizing and total behavior problems according to both mother and teacher report. Maternal smoking was also associated with the following percentage increases in scores: 41% (CBCL) and 44% (TRF) for aggressive behavior and 65% (CBCL) and 47% (TRF) for attention problems. Associations with behavior problems were attenuated or no longer observed for mothers that quit smoking in early pregnancy. The proportion of the total effect of maternal smoking on behavioral outcomes explained by differences in birth weight was small and ranged from 6.6% for externalizing behavior on the CBCL to 20.1% for rule-breaking behavior on the CBCL. Our results suggest that birth weight differences explain only a small proportion of the magnitude of association between maternal smoking during pregnancy and selected behavioral outcomes.

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Etiology of individual differences in birth weight of twins as a function of maternal smoking during pregnancy

Twin Research ◽

10.1375/twin.1.3.123 ◽

1998 ◽

Vol 1 (3) ◽

pp. 123-130 ◽

Cited By ~ 27

Author(s):

Caroline GM van Baal ◽

Dorret I Boomsma

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Maternal Smoking ◽

Structural Equation ◽

Smoking During Pregnancy ◽

Intrauterine Growth ◽

Equation Modelling ◽

Maternal Smoking During Pregnancy ◽

Lower Variability ◽

Genetic And Environmental Factors

AbstractBirth weight is in large extent influenced by gestational age. In addition genetic and environmental factors determine intrauterine growth and birth weight. The contributions of these factors may be influenced by maternal smoking during pregnancy. We examined birth weight and maternal smoking in a sample of 2930 twin pairs from the Netherlands Twin Register using structural equation modelling. Gestational age accounted for 27–44% of the variance in birth weight. A lower variability of birth weight and a lower association of birth weight with gestational age was found in twins whose mothers smoked during pregnancy. The variance not associated with gestational age was independent of maternal smoking during pregnancy. A systematic smaller part of the variability in birth weight was associated with variability in gestational age in second born twins compared to first born twins. The heritability of interindividual differences in birth weight was modest (10% for twins with non-smoking mothers and 11% for twins with smoking mothers). Common environmental influences other than gestational age accounted for a slightly larger part of the variance not associated with gestational age (17–20%).

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Maternal smoking and congenital malformations

Fetal and Maternal Medicine Review ◽

10.1017/s0965539502000141 ◽

2002 ◽

Vol 13 (1) ◽

pp. 63-86 ◽

Cited By ~ 13

Author(s):

Karin Källén

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Premature Birth ◽

Maternal Smoking ◽

Congenital Malformations ◽

Perinatal Outcome ◽

Neonatal Death ◽

Smoking During Pregnancy ◽

Small Head ◽

Maternal Smoking During Pregnancy

Since the first report by Simpson (1957) of the association between premature birth and maternal smoking, the research on the consequences of maternal smoking during pregnancy on perinatal outcome has been intense. Even if some of the findings have been contradictory, it is now evident that maternal smoking is associated with pre-term birth and low birth weight, low birth weight for gestational age, small head circumference, low Apgar score at 5 min, stillbirth and neonatal death.

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