Abstract
n-3 Highly unsaturated fatty acids (HUFA), are essential components of neuronal membranes and mediate a range of complex bioactive properties including gene expression, myelination, cell-signalling and dopaminergic function. Deficits in n-3 HUFA have been linked to increased risks for addictive disorders, thus we posited that lower fish consumption would be associated with greater risks for perinatal smoking among 9640 mothers enroled in the Avon Longitudinal Study of Parents and Children. We used univariable and multivariable regression models to examine relationships between self-reported prenatal dietary intakes of n-3 HUFA-rich foods (fish and shellfish) and maternal smoking; outcomes included cessation and the number of cigarettes smoked per d. Both before and during pregnancy, there was consistent evidence (P<0·001) of protective fish intake-smoking associations; relative to mothers reporting no fish consumption, those who reported some fish consumption (<340 g/week) and high fish consumption (340 g+/week) at 32 weeks of gestation showed lower likelihoods of smoking (adjusted P values <0·001). Respective OR for these relationships were 0·87 (95% CI 0·77, 0·97) and 0·73 (95% CI 0·61, 0·86). Although the prevalence of smoking diminished, from a high of 31·6% (pre-pregnancy) to a low of 18·7% (second trimester), the magnitude of fish intake-smoking associations remained stable following adjustment for confounders. These observations suggest that greater fish or n-3 HUFA consumption should be evaluated as an intervention to reduce or prevent smoking in randomised clinical trials.
Highlights
Maternal smoking during pregnancy is a common and well recognised risk factor for a range of adverse health and developmental outcomes and of significant interest to public health policies and practices[1], including alterations in genetically programmed brain development during fetal life[2]
The Avon Longitudinal Study of Parents and Children (ALSPAC) reported that women who smoked during the first trimester of pregnancy were 55 % less likely than their non-smoking peers to breastfeed and 40 % less likely to participate in employment, education or training-based opportunities[4]
N-3 Highly unsaturated fatty acids (HUFA) are biophysically and biochemically essential components of neuronal membranes that are critical for healthy brain development and optimal neurological function[27]
Summary
Maternal smoking during pregnancy is a common and well recognised risk factor for a range of adverse health and developmental outcomes and of significant interest to public health policies and practices[1], including alterations in genetically programmed brain development during fetal life[2]. Adverse perinatal smoking-associated outcomes include alterations in maternal and child brain structure and function which in turn adversely impact behaviour; infants born to mothers who smoke during pregnancy present with smaller head circumferences[11], structural alterations in the amygdala[12], and volumetric reductions in cortical grey matter, the corpus callosum and frontal, temporal and parietal lobes[13]. A second report found in a cross-sectional observation study lower levels on n-3 HUFA among smokers compared with controls and, in a randomised controlled trial of sixty-three participants for smoking reduction, found a reduction in nicotine dependence ratings, but no difference in serum cotinine and self-report consumption[28]. We could identify no prior publications exploring any relationships between maternal fish or n-3 consumption and smoking behaviours, before, during or after pregnancy. We used data collected with standardised and validated protocols on 9640 mothers from the ALSPAC longitudinal cohort study: [1] was greater fish consumption associated with lower risks of smoking, at pre-conception and in each trimester?, [2] was greater fish consumption associated with greater likelihood of cessation of smoking, after conception, during each trimester?, and [3] was greater fish consumption associated with lower risks of smoking relapse between second and third trimesters, after pre-partum cessation? We sought to identify and adjust for confounding variables such as socioeconomic status that could underlie associations between greater fish consumption and healthier smoking behaviours
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