Comparison of the key modifiable factors in the first 1000 days predicting subsequent overweight and obesity in pre-school children in Tehran: A case control study

Background & Objective: The identification of pediatric obesity predictors in the early stages of life is warranted, as it can influence the development of effective strategies to prevent metabolic disorders. Methods: In this case-control study, we assessed nine risk factors for pediatric obesity, namely a birth weight >4000 grams, an exclusive breastfeeding period <4 months, the introduction of solid food at <4 months, maternal overweight, or obesity before pregnancy, maternal smoking during pregnancy, the presence of gestational diabetes, paternal overweight and obesity, and paternal smoking. In order to identify the most relevant predictors of pediatric obesity, we employed a multiple logistic regression model with R2 cox snell by adjusting confounders. Results: In the randomly selected 509 preschool children from Tehran, children exposed to gestational diabetes had the maximum predicted probability of obesity [4.36 (1.94-9.80) %] among the analyzed risk factors. %]. The introduction of solid food at <4 months of age increased the risk of obesity by 2.98 [1.77-4.97%]. The odds ratio of childhood obesity were associated with maternal overweight and obesity [2.72(1.60-4.60) %], maternal smoking [2.21 (1.18-4.11) %], and excessive gestational weight gain [1.89 (1.23-2.91) %]. Paternal smoking and high birth weight increased the risk of pediatrics obesity >1.8 times [1.15-2.94], and > 1.5 times (1.015-2.43) respectively. There was no association between the paternal body mass index, the exclusive breastfeeding time, and the risk of pediatric obesity. Conclusion: Among early risk factors, probably gestational diabetes can be considered as the most important predictor for the risk of pediatric obesity.

P–718 Paternal smoking in the preconception period is associated with an increased risk of spontaneous miscarriage in a dose-dependent manner: a systematic review and meta-analysis

Study question What is the association between paternal lifestyle factors in the preconception period and the risk of spontaneous miscarriage? Summary answer: Preconception paternal cigarette smoking is associated with an increased risk of spontaneous miscarriage, while no associations were found with paternal alcohol consumption and obesity. What is known already Although maternal lifestyle risk factors for miscarriage are well-established, studies on potentially contributing paternal factors remain sparse. Recently, a significant association was found between advanced paternal age and spontaneous miscarriage. Biological evidence indicates that smoking, excessive alcohol consumption and obesity may lead to sperm oxidative DNA damage, being a known risk factor for miscarriage. Study design, size, duration: Systematic review and meta-analysis. Participants/materials, setting, methods PubMed and Embase databases were searched in August 2020. Paternal factors examined were: cigarette smoking, alcohol consumption and Body Mass Index (BMI). A qualitative risk of bias assessment was performed for all included studies. Meta-analysis was performed if sufficient data was available from studies that controlled for maternal factors. PRISMA guidelines for systematic reviews were followed. Main results and the role of chance The systematic search included 3386 articles of which 11 articles met the inclusion criteria. In a meta-analysis of eight studies, paternal smoking of &gt; 10 cigarettes per day in the preconception period was found to be associated with an increased risk of spontaneous miscarriage, after adjustment for maternal smoking status (1–10 cigarettes per day: 1.01, 95% CI 0.97–1.06; 11–20 cigarettes per day: 1.12, 95% CI 1.08–1.16; &gt;20 cigarettes per day: 1.23, 95% CI 1.17–1.29). Based on five available studies, no clear association was found between paternal alcohol consumption and spontaneous miscarriage. No studies were retrieved that evaluated the association between paternal BMI and spontaneous miscarriage. Limitations, reasons for caution Investigating the relation between paternal lifestyle factors and spontaneous miscarriage is challenging and prone to different forms of bias, especially in retrospective studies. Wider implications of the findings: Awareness of the association between heavy paternal smoking in the preconception period and the risk of spontaneous miscarriage should be raised. More well-designed studies are needed to further investigate the effects of other paternal lifestyle factors on the risk of spontaneous miscarriage. Trial registration number Not applicable

P-718 Paternal smoking in the preconception period is associated with an increased risk of spontaneous miscarriage in a dose-dependent manner: a systematic review and meta-analysis

Study question What is the association between paternal lifestyle ­factors in the preconception period and the risk of spontaneous miscarriage? Summary answer Preconception paternal cigarette smoking is associated with an increased risk of spontaneous miscarriage, while no associations were found with paternal alcohol consumption and obesity. What is known already Although maternal lifestyle risk factors for miscarriage are well-established, studies on potentially contributing paternal factors remain sparse. Recently, a significant association was found between advanced paternal age and spontaneous miscarriage. Biological evidence indicates that smoking, excessive alcohol consumption and obesity may lead to sperm oxidative DNA damage, being a known risk factor for miscarriage. Study design, size, duration Systematic review and meta-analysis. Participants/materials, setting, methods PubMed and Embase databases were searched in August 2020. Paternal factors examined were: cigarette smoking, alcohol consumption and Body Mass Index (BMI). A qualitative risk of bias assessment was performed for all included studies. Meta-analysis was performed if sufficient data was available from studies that controlled for maternal factors. PRISMA guidelines for systematic reviews were followed. Main results and the role of chance The systematic search included 3386 articles of which 11 articles met the inclusion criteria. In a meta-analysis of eight studies, paternal smoking of &gt; 10 cigarettes per day in the preconception period was found to be associated with an increased risk of spontaneous miscarriage, after adjustment for maternal smoking status (1-10 cigarettes per day: 1.01, 95% CI 0.97-1.06; 11-20 cigarettes per day: 1.12, 95% CI 1.08-1.16; &gt;20 cigarettes per day: 1.23, 95% CI 1.17-1.29). Based on five available studies, no clear association was found between paternal alcohol consumption and spontaneous miscarriage. No studies were retrieved that evaluated the association between paternal BMI and spontaneous miscarriage. Limitations, reasons for caution Investigating the relation between paternal lifestyle factors and spontaneous miscarriage is challenging and prone to different forms of bias, especially in retrospective studies. Wider implications of the findings Awareness of the association between heavy paternal smoking in the preconception period and the risk of spontaneous miscarriage should be raised. More well-designed studies are needed to further investigate the effects of other paternal lifestyle factors on the risk of spontaneous miscarriage. Trial registration number not applicable

Preconceptional smoking alters spermatozoal miRNAs of murine fathers and affects offspring’s body weight

Background Active smoking has been reported among 7% of teenagers worldwide, with ages ranging from 13 to 15 years. An epidemiological study suggested that preconceptional paternal smoking is associated with adolescent obesity in boys. We developed a murine adolescent smoking model before conception to investigate the paternal molecular causes of changes in offspring’s phenotype. Method Male and female C57BL/6J mice were exposed to increasing doses of mainstream cigarette smoke (CS) from onset of puberty for 6 weeks and mated with room air (RA) controls. Results Thirteen miRNAs were upregulated and 32 downregulated in the spermatozoa of CS-exposed fathers, while there were no significant differences in the count and morphological integrity of spermatozoa, as well as the proliferation of spermatogonia between CS- and RA-exposed fathers. Offspring from preconceptional CS-exposed mothers had lower body weights (p = 0.007). Moreover, data from offspring from CS-exposed fathers suggested a potential increase in body weight (p = 0.062). Conclusion We showed that preconceptional paternal CS exposure regulates spermatozoal miRNAs, and possibly influences the body weight of F1 progeny in early life. The regulated miRNAs may modulate transmittable epigenetic changes to offspring, thus influence the development of respiratory- and metabolic-related diseases such as obesity, a mechanism that warrants further studies for elaborate explanations.

Prenatal exposure to paternal smoking and likelihood for autism spectrum disorder

Genetics, environment, and their interactions impact autism spectrum disorder etiology. Smoking is a suspected autism spectrum disorder risk factor due to biological plausibility and high prevalence. Using two large epidemiological samples, we examined whether autism spectrum disorder was associated with prenatal paternal smoking in a Discovery sample ( N = 10,245) and an independent Replication sample ( N = 29,773). Paternal smoking was retrospectively assessed with questionnaires. Likelihood of having autism spectrum disorder was estimated with the Autism Spectrum Screening Questionnaire at three levels: low (<10), intermediate (10–14), and high (⩾15). Ordinal regression was used to examine the relationship between prenatal paternal smoking and likelihood of having autism spectrum disorder, adjusting for confounders. A total of 36.5% of Discovery sample fathers and 63.3% of Replication sample fathers smoked during the pregnancy period; 7% of the Replication sample smoker fathers smoked during the pre-conception period but quit during pregnancy period. Discovery sample prenatal paternal smoking significantly increased the likelihood of having autism spectrum disorder in their offspring (adjusted odds ratio=1.27). This was confirmed in the Replication sample with adjusted odds ratio of 1.15 among smoking pre-conception period + pregnancy period fathers; 14.4% and 11.1% increased high likelihood of autism spectrum disorder was attributable to prenatal paternal smoking in Discovery sample and Replication sample, respectively. Smoking prevention, especially in pregnancy planning, may decrease autism spectrum disorder risk in offspring. Lay abstract What is Already Known about This Subject: Genetics, (including de novo mutations), environmental factors (including toxic exposures), and their interactions impact autism spectrum disorder etiology. Paternal smoking is a candidate risk for autism spectrum disorder due to biological plausibility, high prevalence, and potential intervention. What This Study Adds: This original study and its replication confirms that paternal factors can substantially contribute to autism spectrum disorder risk for their offspring. It specifically indicates that paternal smoking both before and during pregnancy contributes significantly to autism spectrum disorder risk. Implications for practice, research, or policy: Smoking prevention, especially in pregnancy planning, may decrease autism spectrum disorder risk in offspring.

The Association Between Tobacco Exposure During Pregnancy and Newborns’ Birth Weight in DKI Jakarta Community Members

Low birth weight (LBW), a major determinant of neonate morbidity and mortality, remains a global public health concern. Intrauterine exposure to tobacco has been discerned as an important risk factor for LBW. This study aims to investigate the association between parental smoking during pregnancy and LBW. An analytical cross-sectional study was conducted from December 2019 - July 2020 on a random sample of parents with child aged 0-5 years old from 5 health centers in DKI Jakarta, Indonesia. A total of 145 subjects met the criteria and were analysed. Data analysis was carried out using IBM SPSS Statistics software. In the study, 11% of infants were born with LBW. The prevalence of smoking in fathers and mothers were 55.2% and 3.4%, respectively. Paternal smoking status was significantly associated with LBW (p < 0.05). Although not statistically significant, there was a dose-response relationship between paternal number of cigarettes/day and duration of smoking with LBW. Maternal smoking status (p = 0.448) was not closely associated with LBW, which might be due limited number of actively smoking mothers. From multivariate logistic regression, paternal smoking status, premature delivery, birth order and inadequate food intake during pregnancy were significant predictors of LBW (p < 0.05).