Abstract
While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at 35th week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at 35th week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (β=-0.077, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342 g (T1) 3,296 g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500 g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.
Highlights
Active maternal smoking has well-characterized adverse effects on several outcomes, including infertility, sudden infant death syndrome (SIDS), and child growth and development (Surgeon General’s Report, 2006)
We aimed to examine the effect of environmental tobacco smoke (ETS) exposure, assessed by maternal hair nicotine levels at 35th week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW)
Maternal body weight and body mass index (BMI) before pregnancy and at delivery were higher in the T3 group than in the other groups, but the gestational age was higher in the T1 group
Summary
Active maternal smoking has well-characterized adverse effects on several outcomes, including infertility, sudden infant death syndrome (SIDS), and child growth and development (Surgeon General’s Report, 2006). An association between passive maternal smoking during pregnancy and low birth weight (LBW) has been suggested, as birth weight has been found to be 25-75 g lower in the off-spring of mothers with ETS exposure (Misra and Nguyen, 1999; Leonardi-Bee et al, 2008; Salmasi et al, 2010). While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at 35th week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed
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