Abstract
Introduction: Maternal smoking during pregnancy is a well-established risk factor for childhood obesity. However, the relationship between maternal smoking and other childhood cardiovascular disease (CVD) risk factors is unclear. The objective of the study was to assess these associations in fifth grade children. Methods: The study used longitudinally linked data from three cross-sectional datasets (the WV Birth Score Project, the Birth certificate at birth, and the Coronary Artery Risk Detection in Appalachian Communities Project in fifth grade West Virginian children who were born full term (N=19,583). The main outcome variables included fifth-grade CVD risk factors (e.g., systolic blood pressure [SBP], diastolic blood pressure and lipid levels including total cholesterol, high-density lipoprotein cholesterol [HDL], low-density lipoprotein cholesterol, log transformed triglyceride [log-TG]), which were significantly correlated with maternal smoking during pregnancy at the bivariate level. Each significant dependent variable was regressed on the main exposure variable with additional covariates (child’s age, sex, race, maternal education at child’s birth, family history of CVD, and birth weight). Childhood body mass index (BMI) was added to the regression model to assess for its role as a potential mediator. Results: The significant CVD risk factors associated with maternal smoking during pregnancy included SBP: r=0.02, p= 0.002; HDL: r=-0.06 p<0.0001, and TG: r=0.06, p<0.0001. The results of multiple regression analysis showed significant association between maternal smoking during pregnancy and TG and HDL, which attenuated but remained statistically significant after assessing for BMI as a potential mediator. The association was not significant for SBP (Table 1). Conclusion: Our results showed that maternal smoking during pregnancy was an independent risk factor for higher TG and lower HDL after adjusting for covariates and the relationship is partially mediated by the childhood current BMI.
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