Association Of Maternal Smoking Research Articles

Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study.

Observational studies have described associations of maternal smoking during pregnancy with intellectual disability (ID) in the exposed offspring. Whether these results reflect a causal effect or unmeasured confounding is still unclear. Using a UK-based prospectively collected birth cohort (the Avon Longitudinal Study of Parents and Children) of 13,479 children born between 1991 and 1992, we assessed the relationship between maternal smoking at 18 weeks' gestation and offspring risk of ID, ascertained through multiple sources of linked information including primary care diagnoses and education records. Using confounder-adjusted logistic regression, we performed observational analyses and a negative control analysis that compared maternal with partner smoking in pregnancy under the assumption that if a causal effect were to exist, maternal effect estimates would be of greater magnitude than estimates for partner smoking if the two exposures suffer from comparable biases. In observational analysis, we found an adjusted odds ratio for ID of 0.75 (95% CI = 0.49-1.13) for any maternal smoking and 0.97 (95% CI = 0.71-1.33) per 10-cigarette increase in number of cigarettes smoked per day. In negative control analysis, comparable effect estimates were found for any partner smoking (OR = 0.94; 95% CI = 0.63-1.40) and number of cigarettes smoked per day (OR = 0.94; 95% CI = 0.74-1.20). The results are not consistent with a causal effect of maternal smoking during pregnancy on offspring ID.

The impact of maternal smoking during pregnancy and the age of smoking initiation on incident dementia: A prospective cohort study.

The impact of early-life tobacco exposure on dementia has remained unknown. Using the UK Biobank, the associations of maternal smoking during pregnancy (MSDP) and age of smoking initiation (ASI) with the onset time of all-cause dementia were estimated with accelerated failure time models. The effects of MSDP and ASI on brain structure and their genetic correlation to Alzheimer's disease (AD) were analyzed. A Mendelian randomization (MR) analysis was conducted. The time ratios for smokers starting in childhood, adolescence, and adulthood (vs never smokers) were 0.87 (0.76 to 0.99), 0.92 (0.88 to 0.96), and 0.95 (0.89 to 1.01). MSDP and smoking in adolescence altered many brain regions, including the hippocampus. In genetic analysis, MSDP was genetically and causally linked to AD, and a younger ASI was genetically correlated to a higher AD risk. Early-life smoking accelerated dementia onset and was genetically correlated to AD. MSDP demonstrated genetic and causal linkage to AD risks. Unlike the commonly used Cox proportional hazards model, this article uses a parametric survival analysis method - the accelerated failure model - to explore the relationship between exposure to onset time. It can be used as an alternative method when the proportional hazards assumption is not met. Genetic analyses including genetic correlation study and MR analysis and brain structure analyses were conducted to support our findings and explore the potential mechanisms. The study reveals the relationship between different smoking initiation periods and the onset time of dementia and shows that earlier smoking exposure has a more significant impact on dementia. It emphasizes the importance of preventing early smoking. In the future, more research focusing on the relationship between early exposure and dementia is called for to provide more detailed prevention measures for dementia that cover all age groups.

THE ASSOCIATION BETWEEN SMOKING DURING PREGNANCY AND HYPERTENSIVE DISORDERS OF PREGNANCY : A SYSTEMATIC REVIEW

Background: Smoking is known to have an adverse effect on various health prognosis, and affects obstetric outcomes, such as stillbirth, preterm birth, and low birth weight during pregnancy. Conversely, the effect of smoking on hypertension during pregnancy is still unclear, with recent studies suggesting the effect differs by ethnicity. The aim: This study aims to show the association between smoking during pregnancy and hypertensive disorders of pregnancy. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 101 articles, whereas the results of our search on SagePub brought up 117 articles. The results of the search conducted for the last year of 2013 yielded a total 53 articles for PubMed and 70 articles for SagePub. The result from title screening, a total 11 articles for PubMed and 17 articles for SagePub. In the end, we compiled a total of 10 papers. We included five research that met the criteria. Conclusion: The association of maternal smoking during pregnancy with blood pressure and hypertension suggests that maternal smoking during pregnancy may have a long-term efect on children’s BP. Tis information should be transmitted to pregnant women and healthcare workers to decrease the risk of adverse cardio-metabolic outcomes.

The Association of Maternal Smoking and Drinking Changes During Pregnancy and Postpartum Breastfeeding Pattern and Duration.

Objectives: To conduct a secondary data analysis of how changes in smoking and drinking during pregnancy impact status of any breastfeeding and breastfeeding duration in a national cohort. Materials and Methods: A cross-sectional study was conducted using Pregnancy Risk Assessment Monitoring System (PRAMS) data between 2009 and 2017 (n = 334,203). Univariate and multivariate analyses were conducted on the status of any breastfeeding and breastfeeding duration. Results: A dose-dependent inverse relationship was found in which women who smoked the same or more or resumed smoking during pregnancy showed the lowest likelihood and shortest duration of breastfeeding, followed by reduced smokers, quitters, and nonsmokers. Women with a history of alcohol use were significantly more likely to breastfeed compared with women without a history of alcohol use. Conclusions: The profile of smoking change during pregnancy impacts the likelihood and duration of breastfeeding in a dose-dependent and inverse manner. No such relationship was found with drinking change during pregnancy. Public Health Implications: Significant public health efforts should focus on implementing and sustaining evidence-based interventions for prenatal smoking cessation and educating providers and maternal populations on the adverse effect of postpartum alcohol exposure.

The association of maternal smoking and other sociobehavioral factors with dental caries in toddlers: A cross-sectional study.

Severe early childhood caries (S-ECC) is a form of dental caries in toddlers, which can strongly affect general health and quality of life. Studies on factors that can contribute to the development of caries immediately after tooth eruption are sparse. The aim of this study was to assess the role of sociobehavioural factors and pre- and postnatal exposure to tobacco smoke in the aetiology of dental caries in children up to 3 years old. A cross-sectional study was conducted between 2011 and 2017 to assess oral health and teething in urban children 0-4 years of age. The number of teeth and surfaces with white spot lesions (d1,2), as well as decayed (d), missing (m), and filled (f) teeth classified according to ICDAS II was evaluated in a dental office setting. d1,2dmft and d1,2dmfs were calculated. Severe early childhood caries was diagnosed for d1,2dmfs > 0. Parents completed a self-administered questionnaire on socioeconomic factors, maternal health, course of pregnancy, child's perinatal parameters, hygiene and dietary practices, as well as maternal smoking during and after pregnancy. Data on children aged 12-36 months were collected and analysed statistically using the t-test, Spearman rank correlations and Poisson regression. Significance level was set at 0.05. Dental caries was found in 46% of 496 children aged 12-36 months. Mean d1,2dmft and d1,2dmfs were 2.62 ± 3.88 and 4.46 ± 8.42, respectively. Tobacco smoking during and after pregnancy was reported by 8.9% and 24.8% of women, respectively. Spearman's rank correlation analysis confirmed a relationship between S-ECC and parental education, maternal smoking, bottle feeding, avoiding springy foods, number of meals, and the age of tooth brushing initiation. Pre- and postnatal exposure to tobacco smoke increased the risk of S-ECC especially in children in age 19-24 months. Maternal smoking was correlated with the level of education and dietary practices. Our study confirmed that prenatal smoking is associated with increased risk of severe-early childhood caries (S-ECC) while the association with post-natal smoking is also evident, the increase in risk is not statistically clear. Both maternal smoking and the child's tooth decay are associated with poor parental education and other improper oral health behaviours. The positive impact of quitting smoking on the oral health in children should be part of anti-smoking advice.

Association of Maternal Smoking during Pregnancy with Neurophysiological and ADHD-Related Outcomes in School-Aged Children.

Data of a longitudinal cohort study were analyzed to investigate the association between prenatal tobacco exposure and electroencephalographical (EEG) power spectrum in healthy, school-aged children as well as its relationship with attention deficit hyperactivity disorder (ADHD)-related symptoms. Group comparisons (exposed, non-exposed) were performed to test whether prenatal tobacco exposure was associated with brain activity and ADHD symptoms, with adjustments made for covariates including child's sex, child's age, maternal age, maternal smoking habit before pregnancy, alcohol consumption during pregnancy, gestation age, and maternal psychopathology. Tobacco-exposed children showed higher brain activity in the delta and theta frequency bands. This effect was independent of the considered covariates. However, the effects on hyperactivity were found to significantly depend on maternal age and alcohol consumption during pregnancy, but not on the amount of exposure. In summary, smoking during pregnancy significantly affected the resting-state brain activity in children, independent of socio-demographic factors, indicating potential long-lasting effects on brain development. Its impact on ADHD-related behavior was shown to be influenced by socio-demographic confounding factors, such as maternal alcohol consumption and the age of the mother.

Interactions among maternal smoking, breastfeeding, and offspring genetic factors on the risk of adult-onset hypertension

BackgroundPrevious studies have reported that maternal smoking during pregnancy and breastfeeding may affect the occurrence of hypertension, but whether early life factors modify the impact of the offspring’s genetic risk on hypertension is still unknown. The aim of this study was to investigate the relationships among maternal smoking and breastfeeding with adult-onset hypertension and the modified impact of offspring genetic susceptibility.MethodsThis study included 437,185 participants from the UK Biobank who were initially free of hypertension and provided a prospective cohort of individuals aged 40 to 69 years. The association of maternal smoking during pregnancy and breastfeeding with hypertension was examined by using the Cox regression model. Then, a polygenic risk score (PRS) for hypertension was used to test the gene–environmental interaction on hypertension.ResultsDuring a median follow-up period of 8.7 years, a total of 68,148 cases of hypertension were identified in this study. The hazard ratios (HRs) and 95% confidence intervals (CIs) of hypertension for maternal smoking and breastfeeding were 1.11 (1.09, 1.13) and 0.96 (0.94, 0.98), respectively. However, no evidence of an interaction between maternal smoking and breastfeeding was observed. Across all levels of genetic risk, including high genetic risk, maternal smoking and nonbreastfeeding had higher hypertension hazards than nonmaternal smoking and breastfeeding, respectively. The adjusted HRs (95% CIs) of hypertension were 1.80 (1.73, 1.87) in those who had high genetic predisposition plus maternal smoking and 1.67 (1.60–1.74) in those with nonbreastfeeding and high genetic risk. There were significant additive interactions between maternal smoking or breastfeeding and genetic factors on the incidence of hypertension.ConclusionsMaternal smoking and nonbreastfeeding were associated with a higher risk of hypertension in adulthood and may attenuate the risk of hypertension related to genetic factors. These results suggested that adherence to nonmaternal smoking and breastfeeding was associated with a lower risk of hypertension among participants with all gradients of genetic risk.

889Association of maternal smoking during pregnancy and early-childhood with adult insomnia symptoms

Abstract Background Evidence regarding the association between perinatal smoking and insomnia symptoms in adulthood is limited. Using the UK 1970 Birth Cohort Study, we determined the association of maternal smoking during pregnancy and early-childhood with insomnia symptoms at 42 years. Methods Participants were followed from birth (1970; N = 9020; male, 48%) and age 5 (1975; N = 8050; male, 47.9%) to 42 years (2012). Data on maternal smoking was collected at birth and age 5; difficulties initiating or maintaining sleep (DIMS) and DIMS plus daytime symptoms (tiredness, irritability, depression and nervousness) [DIMS plus] at age 42. We used a direct acyclic graph to select confounders. A log-binomial logistic regression, adjusted for confounders, was used to estimate the association. Missing data were imputed via multiple imputation. Results The prevalence of DIMS and DIMS plus was 32% and 25%, respectively. There was a 25% [odds ratio (OR)=1.25; 95% confidence interval (CI): 1.12-1.38)] and 23% [OR = 1.23; 95% CI: 1.09-1.38] increase in odds of DIMS and DIMS plus among participants whose mothers smoked during pregnancy compared to those whose mother did not. A 24% [OR = 1.24; 95% CI: 1.12-1.37] and 18% [OR = 1.18; 95% CI: 1.05-1.33] increase in odds of DIMS and DIMS plus respectively, was observed among participants who had smoking mothers at age 5. Intensity and duration of smoking had a dose-response relationship with insomnia symptoms. Conclusions Maternal smoking during pregnancy and early-childhood is associated with increased risk of adult insomnia symptoms. Key messages This study suggests that reducing maternal smoking may reduce the risk of adult insomnia.

Microbiome profiles are associated with cognitive functioning in 45-month-old children

Prenatal, perinatal, and postnatal factors have been shown to shape neurobiological functioning and alter the risk for mental disorders later in life. The gut microbiome is established early in life, and interacts with the brain via the brain-immune-gut axis. However, little is known about how the microbiome relates to early-life cognitive functioning in children. The present study, where the fecal microbiome of 380 children was characterized using 16S rDNA and metagenomic sequencing aimed to investigate the association between the microbiota and cognitive functioning of children at the age of 45 months measured with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III).Overall the microbiome profile showed a significant association with cognitive functioning. A strong correlation was found between cognitive functioning and the relative abundance of an unidentified genus of the family Enterobacteriaceae. Follow-up mediation analyses revealed significant mediation effects of the level of this genus on the association of maternal smoking during pregnancy and current cigarette smoking with cognitive function. Metagenomic sequencing of a subset of these samples indicated that the identified genus was most closely related to Enterobacter asburiae. Analysis of metabolic potential showed a nominally significant association of cognitive functioning with the microbial norspermidine biosynthesis pathway.Our results indicate that alteration of the gut microflora is associated with cognitive functioning in childhood. Furthermore, they suggest that the altered microflora might interact with other environmental factors such as maternal cigarette smoking. Interventions directed at altering the microbiome should be explored in terms of improving cognitive functioning in young children.

Associations of maternal smoking and drinking with fetal growth and placental abruption

ObjectiveTo investigate pregnant women from the Safe Passage Study for the individual and combined effects of smoking and drinking during pregnancy on the prevalence of clinical placental abruption. Study designThe aim of the original Safe Passage Study was to investigate the association of alcohol use during pregnancy with stillbirths and sudden infant deaths. Recruitment for this longitudinal study occurred between August 2007 and October 2016. Information on smoking and drinking was collected prospectively at up to 4 occasions during pregnancy where a modified timeline follow-back method was used to assess the exposure to alcohol. Placentas were examined histologically in a subset of pregnant women. For this study we examined the effects of smoking and drinking on fetal growth and the prevalence rate of placental abruption. High smoking constituted of 10 or more cigarettes per day and high drinking of four or more binge drinking episodes or 32 and more standard drinks during pregnancy. Placental abruption was diagnosed in two ways, by the clinical picture or the macroscopic and microscopic examination of the placenta. ResultsWhen compared to the non-drinking/non-smoking group, the high drinking/high smoking group were significantly older, had a higher gravidity, had a lower household income and booked later for prenatal care; fewer of them were employed and had toilet and running water facilities in their houses. Clinical placental abruption was diagnosed in 49 (0.87 %) of 5806 pregnancies. Histological examination was done in 1319 placentas; macroscopic and microscopic diagnosis of placental abruption was made in 8.2 % and 11.9 % of placentas respectively. These 49 cases were then correlated with seven smoking/drinking patterns during pregnancy. When compared to rates for no smoking/no drinking (0.11 %) and low smoking/no drinking (0.55 %), the prevalence rate of placental abruption was significantly higher (p < .005) in the low smoking/low drinking group (1.25 %). There was also a significant relationship between low maternal employment and methamphetamine use with placental abruption. ConclusionAs many conditions and habits are associated with placental abruption, it is impossible to single out one specific cause but concomitant drinking and smoking seem to increase the risk of placental abruption.

Maternal smoking during pregnancy affects adult onset of asthma in offspring: a follow up from birth to age 46 years.

Environmental tobacco smoke (ETS) exposure increases asthma risk in children. There is limited knowledge of prenatal ETS for adult-onset asthma. To determine the association between prenatal ETS and adult onset asthma. The questionnaire and clinical data of 5200 people, free of physician-diagnosed asthma by 31 years of age, who were included in the Northern Finland Birth Cohort 1966 Study was used. The association of maternal smoking during the last 3 months of pregnancy with onset of physician-diagnosed asthma and with lung function in adult offspring was studied using adjusted multivariate regression analyses. The cumulative incidence of physician-diagnosed asthma between the ages of 31 and 46 years was 5.1% among men and 8.8% among women. Gestational smoke exposure was associated with adult-onset asthma among offspring (adjusted OR 1.54, 95% CI 1.04-2.29), namely among offspring who reported either past non-diagnosed asthma (OR 9.63, 95% CI 2.28-40.67) or past cough with wheeze (3.21, 95% CI 1.71-6.05). A significant association was detected between gestational smoke exposure and the offspring's forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio at 31 years of age. In offspring with the haplotype rs11702779-AA of RUNX1, gestational smoke exposure was associated with adult-onset asthma (5.53, 95% CI 2.11-14.52, adjusted p-value for interaction 0.10). Maternal smoking during pregnancy is associated with the cumulative incidence of asthma in offspring between the ages of 31 and 46 years. The association was accentuated in offspring who at age 31, reported having past respiratory problems and/or who had haplotype rs11702779-AA. A reduction in FEV1/FVC ratio was also observed at age 31 years in offspring with gestational smoke exposure. These results could reflect the early vulnerability of offspring's airways to ETS and its putative long-term effects.

Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers

BackgroundDespite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health outcomes in adult male and female ever smokers. MethodsRespiratory health outcomes were assessed in 10,610 participants of the European Community Respiratory Health Survey (ECRHS) I who reported a history of ever smoking by questionnaire. The associations of maternal smoking in utero, maternal smoking during childhood, age of smoking debut and pack-years of smoking with respiratory symptoms, obstructive diseases and bronchial hyperreactivity were analysed using generalized linear regression, non-linearity between age of smoking debut and outcomes were assessed by Generalized additive mixed models. ResultsRespiratory symptoms and asthma were more frequent in adults if their mother smoked during pregnancy, and, in men, also if mother smoked in childhood. Wheeze and ≥3 respiratory symptoms declined with later smoking debut among women [≤10 years: OR = 3.51, 95% CI 1.26, 9.73; 11–12 years: 1.57[1.01–2.44]; 13–15 years: 1.11[0.94–1.32] and ≤10 years: 3.74[1.56–8.83]; 11–12 years: 1.76[1.19–2.56]; 13–15 years: 1.12[0.94–1.35], respectively]. Effects of increasing number of packyears were pronounced in women (Chronic Obstructive Pulmonary Disease (COPD): OR/10 packyears women: 1.33 [1.18, 1.50], men: 1.14 [1.04, 1.26] pinteraction = 0.01). ConclusionsAmong ever smokers, smoking exposure in each stage of the lifespan show persistent harmful effects for adult respiratory health, while women appeared to be more vulnerable to an early age of smoking debut and amount of smoking in adulthood.

Outcome of pregnancy subsequent to abruptio placentae

Introduction: The process of child bearing is a beautiful experience for a woman but unfortunately it is fraught with some unpredictable dangers. One of them is an abruptio placenta which is defined as “the premature separation of a normally implanted placenta, before the delivery of the fetus. It occurs in up to 1.0% of all pregnancy and can be associated with severe maternal and fetal complications. Material and Methods: The study done on antenatal patients of Sultania Zanana Hospital, Bhopal from 1stapril 2008 to 31st march 2009. Patients clinically diagnosed as abruptio placentae were included in the study and were followed throughout their stay in the hospital. Result: The study showed the incidence of abruptio placenta to be 1.6%. It was found 1.8 times more commonly in multigravida than primigravida patients. Incidence was found much higher in patients with PIH, Pre-eclempsia and eclempsia (4.35%?). The association of maternal smoking and placental abruption has been well documented and in our study 9.6% of patients were found to be smokers. The incidence of abruptio placentae was 2.3% among multifetal gestation which is 1.43 times the incidence in general population. Preterm deliveries showed an increased incidence of abruptio placentae. Mortality rate of babies in our study was 52.05%. Conclusion: This study denoted that high parity, younger age,,PIH, pre-eclempsia, eclempsia, multifetal gestation and smoking are the major risk factors for abruptio placentae. Thus proper antenatal care, proper booking, screening of high risk factors, timely referral are the various pillars need to be strengthened in our population to reduce the occurrence and the complication arising out of this catastrophe.

Association of maternal smoking during pregnancy with aerobic fitness of offspring in young adulthood: a prospective cohort study.

We evaluated the association of maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and maternal smoking with aerobic fitness in young men aged 19-20years. A 19-year prospective cohort study. Data from the Northern Finland Birth Cohort 1986 (NFBC1986) and the Sodankylä Jaeger Brigade, Finland, in 2005-6. Mothers and the 508 offspring in the NFBC1986 who entered military service at the Sodankylä Jaeger Brigade in 2005. Associations of weight, 12-minute running test (Cooper test), and muscle fitness index (MFI) of offspring on entry to military service were evaluated with antenatal factors, including maternal smoking, pre-pregnancy BMI, and GWG. Aerobic and muscle fitness of the offspring were evaluated by the Cooper test and MFI. Maternal smoking during pregnancy was associated with lower aerobic fitness of male adolescents, measured by the Cooper test (2356m; 95% confidence interval, 95% CI 2265-2446m), compared with the offspring of mothers who did not smoke during pregnancy (2537m, 95% CI 2499-2574m). This association was independent of the BMIs of both the mother and the offspring, GWG, and the smoking and physical activity of offspring (regression coefficient -140.6m, 95%CI -273.1 to -8.0m). High maternal pre-pregnancy BMI and excessive GWG were also associated with lower aerobic fitness of the offspring; however, this association was mediated via the weight of the offspring. Maternal smoking during pregnancy may have a negative impact on the aerobic fitness of the offspring. Study shows that young men have lower aerobic fitness if their mothers smoked during pregnancy.

Parental smoking during pregnancy and total and abdominal fat distribution in school-age children: the Generation R Study

Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children. We performed a population-based prospective cohort study among 5243 children followed from early pregnancy onward in the Netherlands. Information about parental smoking was obtained by questionnaires during pregnancy. At the median age of 6.0 years (90% range: 5.7-7.4), we measured anthropometrics, total fat and android/gynoid fat ratio by dual-energy X-ray absorptiometry, and preperitoneal and subcutaneous abdominal fat were measured by ultrasound. The associations of maternal smoking during pregnancy were only present among girls (P-value for sex interaction<0.05). Compared with girls from mothers who did not smoke during pregnancy, those from mothers who smoked during the first trimester only had a higher android/gynoid fat ratio (difference 0.23 (95% confidence interval (CI): 0.09-0.37) s.d. scores (SDS). Girls from mothers who continued smoking throughout pregnancy had a higher body mass index (difference: 0.24 (95% CI: 0.14-0.35) SDS), total fat mass (difference: 0.23 (95% CI: 0.14-0.33) SDS), android/gynoid fat ratio (difference: 0.34 (95% CI: 0.22-0.46) SDS), subcutaneous abdominal fat (difference: 0.22 (95% CI: 0.11-0.33) SDS) and preperitoneal abdominal fat (difference: 0.20 (95% CI: 0.08-0.31) SDS). Similar associations with body fat distribution outcomes were observed for paternal smoking during pregnancy. Both continued maternal and paternal smoking during pregnancy may be associated with an increased risk of childhood overweight. The corresponding odds ratios were 1.19 (95% CI: 0.98-1.46) and 1.32 (1.10-1.58), respectively. Maternal and paternal smoking during pregnancy are associated with an adverse body and abdominal fat distribution and increased risk of overweight in children. Similar effects of maternal and paternal smoking suggest that direct intrauterine mechanisms and common family-based lifestyle-related factors explain the associations.

Association of Maternal Smoking With Child Cotinine Levels

Introduction:Our aim was to understand the strength of association between parental smoking and child environmental tobacco smoke (ETS) exposure in order to inform the development of future tobacco control policies. ETS was measured using child cotinine levels below the active smoking threshold. Methods:Participants were drawn from the Avon Longitudinal Study of Parents and Children and included 3,128 participants at age 7 years and 1,868 participants at age 15 years. The primary outcome was cotinine levels of nonsmoking children, to investigate the relationship between maternal smoking and child cotinine levels. The secondary outcome was cotinine levels of all individuals to investigate the relationship between child smoking and child cotinine levels. Maternal and child smoking behavior was assessed by self-report questionnaire. We adjusted for several sociodemographic variables.Results:We found an association between maternal smoking and child cotinine at age 7 years (mean cotinine = 1.16ng/ml serum, ratio of geometric means = 3.94, 95% CI = 2.86–5.42) and at age 15 years (mean cotinine = 0.94ng/ml serum, ratio of geometric means = 5.26, 95% CI = 3.06–9.03), after adjustment for potential confounders. Conclusions:The magnitude of this association for children whose mothers were heavy smokers was comparable with the quantity of half the levels of cotinine observed among children who were irregular (i.e., nonweekly) active smokers, and it was greater than five times higher than that seen in nonsmoking children whose mothers didn’t smoke. This provides further evidence for the importance of public health interventions to reduce smoking exposure in the home.

Association of Maternal Smoking During Pregnancy With Infant Hospitalization and Mortality Due to Infectious Diseases

Maternal smoking is associated with infant respiratory infections and with increased risk of low birth weight infants and preterm birth. This study assesses the association of maternal smoking during pregnancy with both respiratory and nonrespiratory infectious disease (ID) morbidity and mortality in infants. We conducted 2 retrospective case-control analyses of infants born in Washington State from 1987 to 2004 using linked birth certificate, death certificate and hospital discharge records. One assessed morbidity--infants hospitalized due to IDs within 1 year of birth (47,404 cases/48,233 controls). The second assessed mortality--infants who died within 1 year due to IDs (627 cases/2730 controls). Maternal smoking was associated with both hospitalization (adjusted odds ratio [AOR] = 1.52; 95% confidence interval [CI]: 1.46, 1.58) and mortality (AOR = 1.51; 95% CI: 1.17, 1.96) due to any ID. In subgroup analyses, maternal smoking was associated with hospitalization due to a broad range of IDs including both respiratory (AOR = 1.69; 95% CI: 1.63, 1.76) and nonrespiratory IDs (AOR = 1.27; 95% CI: 1.20, 1.34). Further stratification by birth weight and gestational age did not appreciably change these estimates. In contrast, there was no association of maternal smoking with ID infant mortality when only low birth weight infants were considered. Maternal smoking was associated with a broad range of both respiratory and nonrespiratory ID outcomes. Despite attenuation of the mortality association among low birth weight infants, ID hospitalization was found to be independent of both birth weight and gestational age. These findings suggest that full-term infants of normal weight whose mothers smoked may suffer an increased risk of serious ID morbidity and mortality.

729: Deconstructing trends in perinatal ethnic disparities in Hawaii

ethnic disparities in Hawaii Timothy Dye, Hyeong Jun Ahn, John Chen, Marjorie Mau, Donald Hayes, Dena Towner John A. Burns School of Medicine, University of Hawaii, Obstetrics, Gynecology, and Women’s Health, Honolulu, HI, John A. Burns School of Medicine, University of Hawaii, Biostatistics, Honolulu, HI, John A. Burns School of Medicine, University of Hawaii, Native Hawaiian Health, Honolulu, HI, Hawaii State Department of Health, Family Services Division, Honolulu, HI OBJECTIVE: US OMB Directive 15 (OMB15) outlines requirements for reporting race/ethnicity. Oftentimes a range of distinct ethnicities are aggregated (e.g. “Asians”) in OMB15, perhaps masking important differences. These aggregations are particularly significant in Hawaii, a multiracial/multiethnic state significantly impacted by OMB15. This study’s purpose was to examine perinatal risk trends in Hawaii (HI) and among its ethnicities. STUDY DESIGN: Average Annual Percent Change (AAPC) in neonatal mortality rate (NNMR) and low birthweight (LBW) by state/ethnicity from 1969-2009 was computed using National Center for Health Statistics’ data. Birthweight distribution (BWD) reflecting LBW ( 2500 grams) and VLBW ( 1500 grams), and birthweight-specific mortality rate (BWSM) were generated from HI Department of Health (DOH) published data. RESULTS: HI’s NNMR declined 10 percent faster than did the US NNMR during the 1970s-80s (Table). Similarly, HI’s LBW/VLBW rates declined more rapidly than did US rates. In the 1990s, however, HI’s NNMR declined less rapidly than did the US and HI’s VLBW rate increased faster. These patterns worsened in the 2000s. Three concerning trends emerge. First, the Filipino LBW rate remains highest in Hawaii, 3/4ths higher than the white rate (Figure). Secondly, the Japanese NNMR rapidly increased throughout the 2000s, at a rate almost double that of Hawaiians, for instance (Table). Additionally, the Japanese LBW/VLBW rates increased much faster through the 2000s than they did in other ethnicities. Thirdly, the NNMR among Native Hawaiians remained at 50 percent higher than other ethnicities (Figure). This excess Native Hawaiian mortality is associated with higher BWSM (i.e. higher mortality among LBWs) when compared with other ethnic groups, rather than a skewed BWD. CONCLUSION: OMB15 aggregations mask important perinatal differences among Hawaii’s ethnicities. These patterns suggest that a range of strategies may be required to sufficiently address perinatal-related disparities. (NCRR U54RR026136/ NIMHD U54MD007584). 730 Association of parent smoking during pregnancy with offspring cardio-metabolic risk factors at age 17 Uri Dior, Yechiel Friedlander, Liron Kogan, Shani Shulman, Hagit Hochner Hadassah Medical Center and Hebrew University-Hadassah Medical School, Department of Obstetrics and Gynecology, Jerusalem, Israel, Hebrew University School of Public Health, Epidemiology unit, Jerusalem, Israel OBJECTIVE: Accumulating evidence demonstrates an association of maternal smoking during pregnancy with adverse metabolic neonatal outcomes. However, less is known about the influence of maternal or paternal smoking on cardio-metabolic risk factors in adolescence. Hence, we examined the association of maternal and paternal smoking during pregnancy with offspring weight, height, Body Mass Index (BMI), systolic and diastolic blood pressure (BP) at age 17. STUDY DESIGN: We used a population-based cohort of 11,729 births in Western Jerusalem during 1974-76, with available archival data on maternal, paternal and birth characteristics. Measurements at age 17 were assessed at military induction examinations. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with offspring cardio-metabolic outcomes, after controlling for potential confounders. RESULTS: Maternal smoking during pregnancy, independent of paternal smoking and confounders (including socioeconomic status, maternal prepregnancy BMI and gestational weight gain, and offspring gender and birthweight) was positively associated with offspring’s height, weight and BMI at age 17 (all p-values 0.001, Table). For example, mean weight of offspring of smoking mothers was 1.5kg higher than weight of offspring whose mothers did not smoke. Paternal smoking was independently and positively associated with adolescent weight (p 0.001) and BMI (p 0.002) and negatively associated with systolic BP (p 0.02). An analysis examining whether smoking of at least one parent was associated with offspring outcomes yielded similar results. 3-yr combined low birthweight rate, birthweightspecific mortality rate (<2500 gr), and neonatal mortality rate by ethnicity, Hawaii 2007-2009 (Source: HI DoH) Average annual percent change (AAPC %) for selected perinatal outcomes, 1969-2009, USA, Hawaii, and Hawaii’s largest ethnic groups

Life Course Association of Maternal Smoking During Pregnancy and Offspring's Height: Data From the 1993 Pelotas (Brazil) Birth Cohort

PurposeTo evaluate the effect of (1) maternal smoking during pregnancy; and (2) partner smoking on offspring's height in infancy, childhood, and adolescence.MethodsAll hospital live births from 1993 (5,249) were identified, and these infants were followed up at several ages. Height for age, expressed as z-scores using the World Health Organization growth curves, was measured at all follow-up visits. Maternal smoking during pregnancy was collected retrospectively at birth and analyzed as number of cigarettes/day smoked categorized in four categories (never smoked, <10, 10–19, and ≥20 cigarettes/day). Partner smoking was analyzed as a dichotomous variable (No/Yes). Unadjusted and adjusted analyses were performed by use of linear regression.ResultsThe prevalence of self-reported maternal smoking during pregnancy was 33.5%. In the crude analysis, the number of cigarettes/day smoked by the mother during pregnancy negatively affected offspring's height in infancy, childhood, and adolescence. After adjustment for confounders and mediators, this association remained statistically significant, although the magnitude of the regression coefficients was reduced. Paternal smoking was not associated with offspring's height in the adjusted analyses.ConclusionsIn addition to the well-known harmful effects of smoking, maternal smoking during pregnancy negatively affects offspring's height. Public health policies aimed at continuing to reduce the prevalence of maternal smoking during pregnancy must be encouraged.

Maternal smoking during pregnancy and risk for childhood leukemia: A nationwide case–control study in Greece and meta‐analysis

Maternal smoking during pregnancy has been often implicated in the development of childhood leukemia with ambiguous results. Hence, we conducted a meta-analysis aiming to summarize current evidence and quantify any tentative impact. We retrieved one cohort (553 leukemias compared to 1,440,542 children), 20 case-control studies and also analyzed the updated Greek case-control dataset with unpublished data, yielding in total 11,092 cases and 25,221 controls. Odds ratios reported in the studies included ranged from 0.70 to 2.20 for acute lymphocytic (ALL) and from 0.60 to 2.17 for acute myelocytic leukemia (AML). The combined effect regarding the association of maternal smoking (any vs. no) and leukemia risk was 1.03 for ALL (95% CI = 0.95-1.12, random effects model) and 0.99 for AML (95% CI = 0.90-1.09, fixed effects model). The results remained unchanged when sensitivity analyses were undertaken of studies reporting same maternal smoking periods, those focusing only on childhood leukemia deaths or investigations which did not clearly define AML subtype. The findings of the meta-analysis challenge the limits of traditional epidemiology to provide sound inferences when point estimates of constituent studies range around the null. In particular, this study provides no support to a hypothesis linking maternal smoking during pregnancy with subsequent development of main childhood leukemia subtypes. Further investigations employing molecular and genetic epidemiology, however, might be needed in the hope to reveal even minimal risks pertaining individuals with specific susceptibility to tobacco compounds who sustain high environmental exposures prenatally or postnatally.