Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities

Background Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. Methods A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Results Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Conclusions Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette–waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.

Hypomethylation in FASTKD1 detected in the association between in utero tobacco exposure and conduct problem in a New Zealand longitudinal study

Despite the known adverse effects of in utero tobacco exposure on offspring health, maternal tobacco use during pregnancy remains prevalent and is a major driver of health inequalities. One such health inequality is the development of conduct problem (CP) in exposed offspring which may be mediated by methylation changes that persist into adulthood. Here we apply a genome-wide approach to probe the association between maternal tobacco use during pregnancy and CP outcomes in exposed offspring. We examined maternal tobacco use during pregnancy (in utero exposure) in the Christchurch Health and Development Study, a longitudinal birth cohort studied for over 40 years. We then evaluated the interaction between methylation effects of in utero exposure and CP score. When modelling this interaction between in utero exposure and CP score we detected nominal DNA methylation differences, at FASTKD1 which has roles in early development. Our observations are consistent with DNA methylation mediating the development of CP following in utero tobacco exposure. In addition, we detected nominal significance in FRMDA4 and MYO1G between individuals exposed to tobacco in utero and those that were unexposed, however these did not reach significance after adjustment for multiple testing. However due to limited power in our analysis, further studies are needed to investigate the interaction between in utero tobacco exposure and high CP health outcomes.

Epigenetic signatures associated with the observed link between maternal tobacco use during pregnancy, and offspring conduct problems in childhood and adolescence

BackgroundMetastable epialleles (MEs) are loci at which epigenetic regulation is established during development and subsequently maintained throughout life. Consequently, individuals can have the same genetic sequence, yet their epigenetic regulation of the underlying sequence can vary. MEs can be independent of genetic variation and may be induced by environmental exposures. Maternal tobacco smoking during pregnancy can alter offspring DNA methylation, hence there is potential for MEs to be induced during development in response to maternal tobacco smoking during pregnancy. Furthermore, associations between maternal tobacco use during pregnancy and conduct problems (CP) in offspring exposed to tobacco smoke in utero, have been observed. However, currently, we do not know what molecular mechanism may link these associations.ResultsWe investigated the observed link between maternal tobacco use during pregnancy and CP outcomes in exposed offspring. Individuals who were exposed to tobacco in utero via maternal smoking, and unexposed individuals, both with and without CP, were selected from the Christchurch Health and Development Study (CHDS), a longitudinal birth cohort studied for over 40 years in New Zealand. Bisulfite-based amplicon sequencing (BSAS) was used to investigate DNA methylation differences and potential MEs between the groups at high risk loci. We identified nominally significant differential DNA methylation at specific CpG sites in individuals with CP who were exposed to tobacco in utero. This differential methylation appears to be specific to in utero tobacco exposure, and interacts with CP. Given its association with the in utero environment we hypothesise that these methylation changes may represent MEs.ConclusionWe conclude that environmentally-induced DNA methylation differences may play a role in the observed link between maternal smoking during pregnancy and childhood/adolescent CP, potentially via the generation of MEs. Larger sample sizes and a genome-wide approach are required to investigate this association further.

Maternal tobacco use and risk for congenital anomalies

Background: Over a period of decades non genetic causes are controlled and mortality and morbidity is considerable reduced due to malformation. Although 50% of causes for malformation are unknown origin, but, with primary prevention 50% of birth defects could be prevented. Research for finding the risk factors are continuous and such results would help to implement preventive strategies to improve maternal and child health.Methods: This is cross sectional; hospital based study, conducted in Krishna Hospital Karad, included all the Pregnant Mother diagnosed to have congenital birth defected foetus through antenatal examinations, delivered baby with diagnoses of congenital malformation, who were admitted at tertiary care hospital Karad.Results: Total 283 cases were diagnosed with birth defects. Parent’s history for tobacco use states that 16 (5.7%) mothers and 149 (53%) of fathers of malformed babies used tobacco. Among these 16 (5%) tobacco user mothers, maximum babies 5 (1.7 %) babies had born with neural tube defect and among fathers 149 (53%) maximum babies 41 (14%) circulatory system defect.Conclusions: There is a need to make the rural women aware about hazardous effects of use of mishri through health education sessions to wean them out of this addiction, which is passed from one generation to the next as a tradition at an early age.

Striving to Meet Healthy People 2020 Objectives: Trend Analysis of Maternal Smoking

Objectives: We examined trends in prevalence rates of smoking and smoking cessation during pregnancy among women in the United States to assess achievement of Healthy People 2020 prevention targets. Methods: We assessed the smoking habits of 30 667 mothers whose children were born between 1985 and 2014 and who were sampled by the National Health and Nutrition Examination Survey, 1999-2014. Sampled participants were children aged 0-15 at the time of interview; however, an adult proxy—usually the biological mother—responded on the child’s behalf and reported information about maternal tobacco use during pregnancy. We calculated prevalence rates, adjusted odds ratios (aORs), and predicted annual increase or decrease of smoking and quitting smoking during pregnancy, adjusting for mother’s age at delivery and income level and child’s race/ethnicity and sex. Results: The average annual prevalence of smoking at any time during pregnancy decreased from 25.7% (95% confidence interval [CI], 15.3%-36.0%) in 1985 to 10.1% (95% CI, 7.1%-13.0%) in 2014 ( P < .001), and quitting smoking at any time during the index pregnancy increased from 36.6% (95% CI, 20.3%-52.9%) in 1985 to 54.9% (95% CI, 44.4%-65.4%) in 2008 ( P = .002). The adjusted annual risk of smoking during pregnancy decreased significantly by 3% (aOR = 0.97; 95% CI, 0.95-0.98; P < .001). The prevalence rate of smoking in the year 2020 extrapolated from the current trend would be 6.1%. Conclusions: Smoking during pregnancy in the United States is declining. However, renewed public health measures are needed to achieve the Healthy People 2020 objectives of preventing smoking among pregnant women in the United States.