Abstract

Smoking by women is associated with adverse pregnancy outcomes such as spontaneous abortion, preterm delivery, low birth weight, infertility, and prolonged time to pregnancy. Anogenital distance (AGD) is a sensitive biomarker of prenatal androgen and antiandrogen exposure. We investigated the effect of smoking and passive smoke exposure during pregnancy on anogenital distance in offspring at 4 years in the INMA-Asturias cohort (Spain). Women were interviewed during pregnancy to collect information on tobacco consumption, and anogenital distance was measured in 381 children: Anoscrotal distance in boys and anofourchetal distance in girls. We also measured maternal urinary cotinine levels at 32 weeks of pregnancy. We constructed linear regression models to analyze the association between prenatal smoke exposure and anogenital distance and adjusted the models by relevant covariates. Reported prenatal smoke exposure was associated with statistically significant increased anogenital index (AGI), both at week 12 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) and at week 32 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) in male children, suggesting altered androgenic signaling.

Highlights

  • Tobacco use and passive smoking during pregnancy can exert multiple effects on offspring, which may persist into adulthood [1,2]

  • Among the women who reported smoking at the beginning of pregnancy, the average number of cigarettes consumed per day was 13

  • The use of a valid cut-off point is important in a reliable marker of tobacco smoking such as urinary cotinine that can discriminate nonsmokers from regular or occasional smokers during pregnancy are crucial issues

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Summary

Introduction

Tobacco use and passive smoking during pregnancy can exert multiple effects on offspring, which may persist into adulthood [1,2]. Some constituents of tobacco or cigarette smoke have endocrine-disrupting properties [8]. Adverse pregnancy outcomes such as spontaneous abortion [9], preterm delivery [10], and low birth weight [11] can result from maternal smoking, as well as female infertility [12]. Cigarette smoking rates among women and during pregnancy vary by region and similar differences apply to passive smoke exposures, sometimes termed environmental tobacco smoke [15,16,17,18]

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