Children Of Nonsmoking Mothers Research Articles

Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark.

Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes. We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD. Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children. AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50-2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14-2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05-2.40), preterm birth (RR = 1.54, 95% CI: 1.19-2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76-3.94). This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history.

Indoor air pollution exposure and early childhood development in the Upstate KIDS Study

BackgroundLimited human studies have investigated the impact of indoor air pollution on early childhood neurodevelopment among the US population. We aimed to examine the associations between prenatal and postnatal indoor air pollution exposure and early childhood development in a population-based birth cohort. MethodsThis analysis included 4735 mother-child pairs enrolled between 2008 and 2010 in the Upstate KIDS Study. Indoor air pollution exposure from cooking fuels, heating fuels, and passive smoke during pregnancy, and at 12 and 36 months after birth were assessed by questionnaires. Five domains of child development were assessed by the Ages and Stages Questionnaire at 4, 8, 12, 18, 24, 30, and 36 months. Generalized estimating equations were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. ResultsExposure to unclean cooking fuels (natural gas, propane, or wood) throughout the study period was associated with increased odds of failing any development domain (OR = 1.28, 95% CI 1.07, 1.53), the gross motor domain (OR = 1.52, 95% CI: 1.09, 2.13), and the personal-social domain (OR = 1.36, 95% CI: 1.00, 1.85), respectively. Passive smoke exposure throughout the study period increased the odds of failing the problem-solving domain by 71% (OR = 1.71, 95% CI 1.01, 2.91) among children of non-smoking mothers. No association was found between heating fuel use and failing any or specific domains. ConclusionUnclean cooking fuel use and passive smoke exposure during pregnancy and early life were associated with developmental delays in this large prospective birth cohort.

Early childhood exposure to maternal smoking and obesity: A nationwide longitudinal survey in Japan.

Involuntary exposure to tobacco smoke is suspected to be one of the risks factors that are associated with obesity in children. The purpose of this study was to examine the relationship between early childhood exposure to tobacco smoke and the risk of obesity and overweight in Japan. This study utilized a nationwide, population-based longitudinal survey. The participants were restricted to 32 081 children who had available information on maternal smoking history as well as childhood height and weight. We conducted a binomial log-linear regression analysis with children of non-smoking mothers as the reference group. The children with mothers who were smokers had a higher risk of developing obesity or being overweight compared to the children with mothers who were nonsmokers. The risk ratios were 1.20 (95% confidence interval [CI]: 1.09-1.32) for overweight and 1.17 (95% CI: 0.95-1.44) for obesity. Early exposure to maternal smoking increases the risk of being overweight and having obesity during childhood. The increased risk is more pronounced among children with mothers, smoked heavily, or parents, who were smokers.

Impact of maternal risk factors on the structure and function of the heart in newborns

Abstract Introduction Maternal factors such as smoking during pregnancy, advanced age, and obesity are associated with increased risk of complex congenital heart defects in the offspring. It is unknown whether maternal risk factors may also cause subtle abnormalities in cardiac structure and function. Purpose To investigate whether the following maternal factors: advanced age, high body mass index (BMI), and smoking during pregnancy are associated with changes in left ventricle (LV) dimensions and systolic function in the newborn child. Methods Data was obtained as part of a population-based cohort study with prenatal inclusion and postnatal transthoracic echocardiography (TTE) of newborns within 60 days of birth. The TTE protocol included measurements of: Interventricular septal thickness at end-diastole (IVSd), LV posterior wall thickness at end-diastole (LVPWd), LV internal diameter at end-diastole (LVIDd) and LV internal diameter at end-systole (LVIDs). Fractional shortening (FS) was calculated by use of Teicholz's formula. Children of mothers with data available on age, BMI, and smoking status, respectively, were divided into the following groups depending on whether their mothers were: of young age &amp;lt;25 years, 25–29 years, 30–34 years (reference group), 35–39 years, and advanced age ≥40 years; underweight BMI &amp;lt;18.5, normal range BMI 18.5–24.9 (reference group), preobese BMI 25–29.9, and obese BMI ≥30; smoking or nonsmoking (reference group). Associations between different groups with each maternal risk factor and newborn LV parameters were analysed using a multiple linear regression model. Results Children of mothers with advanced age at the time of childbirth (n=1,411) had significantly smaller LVIDd and LVIDs (Table 1) compared to children of mothers in their early thirties (n=10,045). Children of preobese (n=4,707) and obese mothers (n=2,138) had significantly smaller LVIDd and LVIDs than children of mothers in the normal BMI range (n=17,654). Children of mothers who smoked during pregnancy (n=808) had significantly larger LVPWd than children of non-smoking mothers (n=24,072). A significant difference in FS was only seen in children of obese mothers. Subanalyses of the quantity of maternal smoking (available data in n=548 [67.8%] of mothers who smoked during pregnancy) showed that children of heavy smoking mothers (≥15 cigarettes/day, n=101), had significantly thicker IVSd and LVPWd compared with children of nonsmoking mothers, whereas no significant effect was identified in newborns of mothers smoking less than 15 cigarettes per day (Table 2). Conclusions Systematic population-based echocardiography of newborns showed that an increased maternal BMI and maternal age above 40 years were associated with smaller LV cavity dimensions in the offspring and that heavy smoking during pregnancy was associated with increased LV myocardial thickness. FS was only affected in children of obese mothers. The long-term effects of these novel findings are unknown. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Herlev-Gentofte Hospital Internal Funding for Cardiological Research andThe Novo Nordisk Foundation

Early childhood exposure to maternal smoking and behavioral development

We examined the association between early childhood exposure to maternal smoking and behavioral issues at 8 years old using a large nationwide population-based longitudinal survey in Japan that began in 2001. We included 46,737 children with information about maternal smoking taken from the 6-month survey. We used logistic regression analysis to examine the hypothesis. Early childhood exposure to maternal smoking increased the risk of behavioral problems related to attention and aggressive or disruptive behavior. The adjusted odds ratios (95% confidence intervals) were 1.37 (1.22–1.54) for inability to wait their turn during play and 1.40 (1.27–1.55) for destroying toys and, compared with children of nonsmoking mothers. Children of mothers who were heavy smokers were more likely to develop behavioral problems than others. Stopping early childhood exposure to maternal exposure can protect children’s neurodevelopment.

Impact of Maternal Smoking on Nonsyndromic Clefts: Sex-Specific Associations With Side and Laterality

To compare the incidence of right-sided versus left-sided, and unilateral versus bilateral, nonsyndromic clefting in the affected offspring of smoking and nonsmoking mothers. Self-report data on periconceptual and first trimester smoking behavior were collected from 842 mothers of children with nonsyndromic orofacial clefting. Differences in the incidence of left- versus right-sided clefts, and of unilateral versus bilateral clefts, were analyzed between the children of smoking and nonsmoking mothers. Interviews and clinical examinations took place at 8 specialist centers in Germany. Children with nonsyndromic clefts were recruited during the course of surgical or orthodontic treatment, or within the context of the annual control consultation. Patients with cleft palate only or missing data were excluded. The final cohort comprised 842 patients (540 males and 302 females) with unilateral or bilateral clefts. The respective mothers were interviewed. Side and laterality of nonsyndromic clefts were the main outcome measures. Children of smoking mothers more often had right-sided clefts than children of nonsmoking mothers (42% right-sided clefts in children of smoking mothers vs 31% of nonsmoking mothers). Children of smoking mothers more often had bilateral clefts than children of nonsmoking mothers (35% bilateral clefts in children of smoking mothers vs 29% of nonsmoking mothers). Sex-specific analyses confirmed substantially and statistically significant associations only for girls. The results suggest that maternal smoking is a sex-specific, exogenous determinant of laterality and side in nonsyndromic clefts.

Impact of parental smoking on temporary tooth decay in children

Цель — выяснить корреляцию интенсивности поражения временных зубов кариесом у 3-летних детей: как влияет курение родителей, матери в период беременности и пассивное курение, которое необходимо отнести к факторам риска развития кариеса временных зубов у их детей. Медицинским работникам педиатрической и стоматологической служб необходимо обратить внимание на выявленные факторы риска и использовать полученные данные в санитарно-просветительной работе для профилактики кариеса временных зубов у детей. Материалы и методы. Работа является кросс-секционным исследованием, которое включало анализ состояния органов и тканей рта у 309 детей в возрасте 3 лет, отобранных случайным образом, а также персональное очное анкетирование их родителей. Результаты. В результате статистической обработки материалов исследования выяснено, что среднеарифметическое значение количества пораженных поверхностей временных зубов на одного 3-летнего ребенка в семьях, где курит отец, почти в 2 раза превышает данный показатель в семьях с некурящими отцами. Курение матери приводит к тому, что средняя интенсивность кариеса поверхностей временных зубов у их детей в 2,2 раза выше, чем у детей некурящих матерей. Аналогичный показатель заболеваемости кариесом временных зубов у детей, чьи матери курили во время беременности, достигает 14, что в 4 раза превышает показатель у детей без данного фактора риска. При пассивном курении средняя интенсивность поражения поверхностей зубов кариесом достигает 7,31. При отсутствии пассивного курения аналогичный показатель не превышает 4,0. Исходя из данных однофакторного дисперсионного анализа можно утверждать, что степень влияния фактора курения матери на интенсивность кариеса временных зубов ее ребенка является значимой (p

Early childhood exposure to maternal smoking and Kawasaki Disease: A longitudinal survey in Japan

Kawasaki disease is the leading cause of acquired childhood heart disease in most developed countries, but the etiology of the disease is unknown. An aberrant immune response to some environmental triggers may play a role and involuntary exposure to tobacco smoke can alter immune functions. We thus prospectively examined the association between early childhood exposure to maternal smoking and the incidence of Kawasaki disease. We used a large, nationwide population-based longitudinal survey ongoing since 2010 and restricted participants to a total of 38,444 children for whom information on maternal smoking was available. Maternal smoking status was ascertained at 6months of age, and responses to questions about hospital admission for Kawasaki disease between the ages of 6 and 30months were used as outcome. We conducted binomial log-linear regression analyses adjusting for children's, parental, and residential factors with children of non-smoking mothers as our reference group. Maternal smoking increased the risk of admission, in particular for the period between 6 and 18months of age, in a dose-dependent manner. Compared with children of non-smoking mothers, the children of mothers who smoked had a risk ratio of 1.83 (95% confidence interval: 1.06, 3.35) for hospital admissions between 6 and 30months of age and a risk ratio of 2.69 (95% confidence interval: 1.56, 4.64) for hospital admissions between 6 and 18months of age. Early childhood exposure to maternal smoking may increase the risk of Kawasaki disease hospitalizations in childhood.

Is grand-parental smoking associated with adolescent obesity? A three-generational study.

Background/ObjectivesData from previous studies consistently suggest that maternal smoking is positively associated with obesity later in life. Whether this association persists across generations is unknown. We examined whether grand-parental smoking was positively associated with overweight status in adolescence.Subject/MethodsParticipants were grandmother-mother-child triads in the Nurses’ Health Study II (NHS II), the Nurses Mothers’ Cohort Study, and the Growing up Today Study (GUTS). Grandmothers provided information on their and their partner’s smoking during pregnancy with the child’s mother. Information on child's weight and height at ages 12 (N = 3094) and 17 (N = 3433) was obtained from annual or biennial GUTS questionnaires. We used logistic regression to estimate ORs of being overweight or obese, relative to normal weight.ResultsGrand-maternal smoking during pregnancy was not associated with overweight status in adolescence. After adjusting for covariates, the OR of being overweight or obese relative to normal weight at age 12 years in girls whose grandmothers smoked 15+ cigarettes daily during pregnancy was 1.21 (95% CI 0.74–1.98; ptrend = 0.31) and 1.07 (0.65–1.77; ptrend = 0.41) in boys. Grand-paternal smoking during pregnancy was associated with being overweight or obese at age 12 in girls only, but not at age 17 for either sex: the OR for being overweight or obese at age 12 was 1.38 (95% CI 1.01–1.89; ptrend = 0.03) in girls, and 1.31 (95% CI 0.97–1.76; ptrend = 0.07) in boys. Among children of non-smoking mothers, the OR for granddaughter obesity for grand-paternal smoking was attenuated and no longer significant [OR 1.28 (95% CI 0.87–1.89; ptrend = 0.18)].ConclusionsOur findings suggest that the association between maternal smoking and offspring obesity may not persist beyond the first generation. However, grand-paternal smoking may affect overweight status of the granddaughter, likely through the association between grand-paternal smoking and maternal smoking.

HEAVY METALS CONTENT IN NEWBORNS’ MECONIUM OF SMOKING MOTHERS

The aim of this study was to measure levels of toxic metals (lead, cadmium, nickel, chromium) in newborns' meconium samples of smoking mothers of the Arkhangelsk region. Heavy metal content was determined in the meconium with use of the inductive coupled plasma emission spectrometry and atomic absorption spectroscopy with the graphite furnace atomization technique. The prospective cohort study was conducted among 30 newborns of smoking women and 30 children of nonsmoking mothers. The levels of nickel and chromium in the newborns' meconium of the smoking women were higher than in the newborns' meconium of the nonsmoking mothers (0.36 ppm and 0.85 ppm, respectively). The mean concentrations of lead and cadmium in meconium in both children's groups were below the limit of quantification (0.25 ppm and 0.05 ppm, respectively). There was a significant correlation between the heavy metals content in the newborns' meconium and quantity of daily cigarettes of the smoking mothers. Body weight at birth was not correlated with the heavy metals content in the children's meconium, but there has been found impact of cadmium and nickel on the maximum decrease of the body weight in the early neonatal period.

Differences in BMI z -Scores between Offspring of Smoking and Nonsmoking Mothers: A Longitudinal Study of German Children from Birth through 14 Years of Age

Background: Children of mothers who smoked during pregnancy have a lower birth weight but have a higher chance to become overweight during childhood.Objectives: We followed children longitudinally to assess the age when higher body mass index (BMI) z-scores became evident in the children of mothers who smoked during pregnancy, and to evaluate the trajectory of changes until adolescence.Methods: We pooled data from two German cohort studies that included repeated anthropometric measurements until 14 years of age and information on smoking during pregnancy and other risk factors for overweight. We used longitudinal quantile regression to estimate age- and sex-specific associations between maternal smoking and the 10th, 25th, 50th, 75th, and 90th quantiles of the BMI z-score distribution in study participants from birth through 14 years of age, adjusted for potential confounders. We used additive mixed models to estimate associations with mean BMI z-scores.Results: Mean and median (50th quantile) BMI z-scores at birth were smaller in the children of mothers who smoked during pregnancy compared with children of nonsmoking mothers, but BMI z-scores were significantly associated with maternal smoking beginning at the age of 4–5 years, and differences increased over time. For example, the difference in the median BMI z-score between the daughters of smokers versus nonsmokers was 0.12 (95% CI: 0.01, 0.21) at 5 years, and 0.30 (95% CI: 0.08, 0.39) at 14 years of age. For lower BMI z-score quantiles, the association with smoking was more pronounced in girls, whereas in boys the association was more pronounced for higher BMI z-score quantiles.Conclusions: A clear difference in BMI z-score (mean and median) between children of smoking and nonsmoking mothers emerged at 4–5 years of age. The shape and size of age-specific effect estimates for maternal smoking during pregnancy varied by age and sex across the BMI z-score distribution.Citation: Riedel C, Fenske N, Müller MJ, Plachta-Danielzik S, Keil T, Grabenhenrich L, von Kries R. 2014. Differences in BMI z-scores between offspring of smoking and nonsmoking mothers: a longitudinal study of German children from birth through 14 years of age. Environ Health Perspect 122:761–767; http://dx.doi.org/10.1289/ehp.1307139

Negative Effects of Maternal Smoking on Pregnancy and the Fetus in Relation to Elevated Levels of Erythropoetin in Umbilical Cord Plasma

Introduction: Based on many scientific research studies, there has been demonstrated a relation between smoking of pregnant women and its negative effects on pregnancy, intrauterine fetal growth, postnatal newborn condition, and development. The aim of our study is to highlight the adverse effects of cigarette use during pregnancy and to evaluate the effect of maternal smoking on the levels of erythropoietin (EPO) in umbilical cord plasma. Our aim was to show an effect of maternal smoking by determining carboxyhemoglobin (COHb) levels in maternal blood, too. Design: Prospective analysis. Setting: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. Methods: Our study included 174 newborns. Mothers were divided into group of smokers (n = 67) and non-smokers (n = 107). This prospective study was realized from February 2012 to November 2013 at the Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Slovak Republic. Patients signed a written informed consent and completed a questionnaire that involved medical history, and data of their smoking habits. EPO levels were measured in 174 samples of umbilical cord plasma. Infants were born spontaneously at term. Results: We observed significantly higher EPO levels in umbilical cord plasma in children born to smokers in contrast to non-smokers’ (children of non-smoking mothers: 19 ± 8 mIU/mL; children of smokers: 61 ± 33 mIU/mL, p

Crispy Cravings May Affect Baby’s Health: Prenatal Acrylamide Exposure Is Associated with Reduced Birth Weight

Vol. 120, No. 12 News | Science SelectionsOpen AccessCrispy Cravings May Affect Baby’s Health: Prenatal Acrylamide Exposure Is Associated with Reduced Birth Weight Julia R. Barrett Julia R. Barrett Search for more papers by this author Published:1 December 2012https://doi.org/10.1289/ehp.120-a475bCited by:1View Article in:中文版AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Many commonly eaten foods contain acrylamide, a known neurotoxicant and suspected human carcinogen. Previous animal studies have suggested acrylamide may also cause reduced birth weight in prenatally exposed offspring. Investigators now report an association between higher concentrations of acrylamide and glycidamide hemoglobin adducts in umbilical cord blood and reduced birth weight in children of women who ate diets rich in acrylamide [EHP 120(12):1739–1745; Pedersen et al.].Acrylamide forms during frying or high-temperature baking of carbohydrate-rich foods such as fried potatoes, potato chips, cookies, and breakfast cereals. Within the body, acrylamide and its metabolite glycidamide form adducts, or chemically joined products, with proteins and DNA. These adducts can potentially disrupt genetic and biological functions.Pregnant women at 11 locations in Denmark, Greece, Norway, Spain, and England participated in the study during 2006–2011, and the investigators used information on 1,101 mother–child pairs. Demographic and detailed dietary information was collected from all the women, umbilical cord blood samples were obtained at birth, and birth information was extracted from medical records.Acrylamide and glycidamide hemoglobin adducts were found in all cord blood samples, and levels tended to be higher if the mother smoked. Subsequent analyses accounted for maternal smoking as well as other potentially confounding factors, such as length of pregnancy, child’s sex and country of birth, and mother’s age, prepregnancy weight, and ethnicity.New findings suggest that eating a diet rich in acrylamide during pregnancy could increase the risk of low birth weight.© 2012 Rob Mattingley/iStockphoto.comThe investigators found an association between decreasing birth weight and increasing levels of adducts. In a comparison of the highest and lowest quartiles of exposure among children of nonsmoking mothers, acrylamide and glycidamide were associated with average birth weight decreases of 107 and 103 g (3.8 and 3.6 oz), respectively. These decreases are comparable with those attributed to moderate smoking during pregnancy. Reduced birth weight is linked with adverse health effects such as impaired growth and development early in life and increased incidence of cardiovascular disease, diabetes, and osteoporosis in adulthood.The availability of adduct measurements and the large, well-characterized study population are key strengths of the study. However, there remained the potential for unmeasured or uncontrolled factors to influence the results. Furthermore, it was not possible to precisely characterize dietary acrylamide intake, because even in the same types of foods, levels can vary depending on manufacturing and preparation methods. If confirmed by further research, the results of this study suggest that pregnant women may benefit from reduced consumption of acrylamide-containing foods.FiguresReferencesRelatedDetailsCited by Krishna G, Divyashri G, Prapulla S and Muralidhara (2015) A Combination Supplement of Fructo- and Xylo-Oligosaccharides Significantly Abrogates Oxidative Impairments and Neurotoxicity in Maternal/Fetal Milieu Following Gestational Exposure to Acrylamide in Rat, Neurochemical Research, 10.1007/s11064-015-1687-x, 40:9, (1904-1918), Online publication date: 1-Sep-2015. Vol. 120, No. 12 December 2012Metrics About Article Metrics Publication History Originally published3 December 2012Published in print1 December 2012 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Folate status in Spanish schoolchildren and its association with parental smoking habits

To study the folate status in a group of Spanish schoolchildren and its association with parental smoking habits. A group of 511 schoolchildren between 9 and 12 years old from Madrid (Spain) were studied. Parental smoking habits were self-reported by a questionnaire. Energy and nutrients intake (especially folates) were calculated with a "3-day diet record" and during two days (Monday and Tuesday) the food consumption was controlled in the school canteen using the "precise weighing method" (recording the weights of food served and leftovers on the plate). Folate intake of the sample was compared with the recommended intakes (RI) for this vitamin. Folate, vitamin B₁₂ and homocysteine were determined. Student's t-test, Mann Whitney Test, Pearson and Spearman correlation, ANCOVA, MANCOVA and multiple linear regression were applied for statistical analysis. Significance was set at P < 0.05. Vegetable and fruit consumption, folate intake and its coverage to recommended folate intake (I/RI%) and serum folate levels were higher in children of nonsmoking mothers than in children of smoking mothers. Serum folate level in 13.3% of the children studied was below 6 ng/mL (moderate deficit), and in 0.26% was below 3 ng/mL (severe deficit). Taking into account others confounding factors a negative and significant correlation was observed between serum folate levels of children and smoking habits in mothers (r = -0.257, p = 0.01). The maternal smoking habits might determine folate intake and serum folate levels on their offspring.

Fetal Exposure to Maternal and Paternal Smoking and the Risks of Wheezing in Preschool Children

Previous studies have suggested that fetal smoke exposure is associated with increased risks of wheezing during childhood. The underlying pathways are unknown. We examined the associations of parental smoking during pregnancy with wheezing in preschool children and whether these associations are explained by postnatal smoke exposure or small for gestational age at birth. This study was embedded in a population-based prospective cohort study. Parental smoking was prospectively assessed by questionnaires. Wheezing was reported at 1 to 4 years. Small for gestational age at birth was available from registries. The analyses were based on 4,574 subjects. Maternal smoking during the first trimester only was not associated with wheezing. Continued maternal smoking in pregnancy was associated with the risk of wheezing at 1 to 4 years (P for trends < .05). The strongest effect estimates were observed for frequent wheezing (four or more episodes of wheezing per year) until age 3 years (OR [95% CI]: age 1,1.64 [1.12-2.40]; age 2, 1.64 [1.01-2.64]; age 3, 2.19 [1.24-3.86]). Among children of nonsmoking mothers, fetal exposure to paternal smoking was not consistently associated with the risks of wheezing. The associations of continued maternal smoking during pregnancy with wheezing symptoms were independent of postnatal smoke exposure or small for gestational age at birth. Fetal exposure to continued maternal smoking is associated with increased risks of wheezing in preschool children. Further research is needed to explore the effects of paternal smoking. Diminishing maternal smoking before conception or in early pregnancy is likely to have the greatest impact on reducing childhood wheezing.

THE EFFECT OF PRENATAL AND POST NATAL EXPOSURE TO SECOND HAND SMOKE ON THE DEVELOPMENT OF WHEEZING BEFORE THE AGE OF 2: A EUROPEAN STUDY

Background-Aim. It has been estimated that at least 700 million children worldwide breathe air polluted by second hand smoke (SHS) at home. We assessed the independent and combined role of prenatal and postnatal exposure to SHS on the development of wheeze in infants before age 2. Methods. We examined pooled data for 49415 mother-child pairs from 19 birth cohorts in 9 countries participating in the EU funded ENRIECO project (ALSPAC, AMICS-Barcelona, AMICS-Menorca, BAMSE, CONER, DARC, EDEN, Generation R, GINI, INMA Guipuzkoa, INMA Sabadell, INMA Valencia, KOALA, Leicester, LISA, MAS, NINFEA, PIAMA-NHS, and RHEA). Information on prenatal exposure to maternal active smoking, prenatal exposure to SHS (paternal or others smoking in the mother’s environment) and postnatal SHS exposure (parents or others smoking in the child’s environment) was collected. We used multilevel mixed-effects logistic regression. Complete information on wheeze, active and passive smoking and covariates used in adjusted models was available for 25727 children. Results. Among non-smoking mothers an increased risk towards the development of wheeze during the first 2 years of life was associated with any exposure to SHS as a fetus and/or during infancy in both the pooled (OR=1.18, 95%CI 1.10-1.27) and in the meta-analysis (OR = 1.16, 1.06-1.26). Increased risks were observed for fetal exposure to SHS only during pregnancy (OR= 1.14, 1.05-1.24) and to children exposed to SHS during both pregnancy and infancy (OR=1.29, 1.18-1.42). Combined active maternal smoking during pregnancy and SHS exposure during infancy led to the highest risks observed (OR=1.76, 1.60-1.93). Approximately 8% of wheeze during the first 2 years in children of non-smoking mothers could be attributed to SHS. Conclusions. SHS exposure during pregnancy and infancy was associated both mutually and independently with the development of wheeze before the age of 2 indicating the importance of adopting smoke free homes and environments.

Passive smoking and behavioural problems in children: Results from the LISAplus prospective birth cohort study

ObjectiveTo analyse the association between pre- and postnatal exposure to tobacco smoke and child behavioural problems and to further investigate the influence of trimester-specific exposure to maternal smoking and the impact of paternal smoking at home on the same outcome. MethodsData of 3097 German children recruited at birth for a population-based, prospective study were used. Detailed information on children's tobacco smoke exposure was collected by self-administered questionnaires at each follow-up. Behavioural outcomes were measured by the Strengths and Difficulties Questionnaire applied at 10-year follow-up. ResultsChildren exposed to environmental tobacco smoke at home showed increased risks of hyperactivity/inattention problems. Only smoking during the entire pregnancy increased the risk for conduct and hyperactivity/inattention problems (proportional odds ratio (pOR)=1.58, 95% confidence interval (CI)=1.06–2.37 and pOR=1.67, CI=1.03–2.72). Pre- and postnatal exposure to paternal smoking was associated with hyperactivity/inattention problems in children of non-smoking mothers (pOR=1.97, CI=1.06–3.65). Effect estimates were adjusted for study centre, sex, parental educational level, mother's age at birth, having a single parent and time spent in front of a screen. ConclusionsNot only maternal smoking during pregnancy but also paternal smoking at home should be considered as a risk for hyperactivity/inattention problems in children.

Birth weight in a large series of triplets.

BackgroundTriplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on important background variables such as zygosity. The objective of this study is to examine factors associated with birth weight in a large, population-based sample of triplets registered with the Netherlands Twin Register (NTR).MethodsIn a sample of 1230 triplets from 410 families, the effects of assisted reproductive techniques, zygosity, birth order, gestational age, sex, maternal smoking and alcohol consumption during pregnancy on birth weight were assessed. The resemblance among triplets for birth weight was estimated as a function of zygosity. Birth weight discordance within families was studied by the pair-wise difference between triplets, expressed as a percentage of the birth weight of the heaviest child. We compare data from triplets registered with the NTR with data from population records, which include live births, stillbirths and children that have deceased within days after birth.ResultsThere was no effect of assisted reproductive techniques on triplet birth weight. At gestational age 24 to 40 weeks triplets gained on average 130 grams per week; boys weighed 110 grams more than girls and triplets of smoking mothers weighted 104 grams less than children of non-smoking mothers. Monozygotic triplets had lower birth weights than di- and trizygotic triplets and birth weight discordance was smaller in monozygotic triplets than in di- and trizygotic triplets. The correlation in birth weight among monozygotic and dizygotic triplets was 0.42 and 0.32, respectively. In nearly two-thirds of the families, the heaviest and the lightest triplet had a birth weight discordance over 15%. The NTR sample is representative for the Dutch triplet population that is still alive 28 days after birth.ConclusionBirth weight is an important determinant of childhood development. Triplet status, gestational age, sex, zygosity and maternal smoking affect birth weight. The combined effects amount to a difference of 364 grams between monozygotic girl triplets of smoking mothers compared to dizygotic boy triplets of non-smoking mothers of the same gestational age. Birth weight in triplets is also influenced by genetic factors, as indicated by a larger correlation in monozygotic than in di- and trizygotic triplets.

Maternal consumption of coffee and tea during pregnancy and risk of childhood ALL: results from an Australian case–control study

To investigate whether maternal coffee and/or tea consumption during the last 6 months of pregnancy was associated with risk of childhood ALL. Data on coffee and tea drinking during pregnancy from 337 case mothers and 697 control mothers were analyzed using unconditional multivariable logistic regression. A meta-analysis of our findings with those of previous studies was also conducted. There was little evidence of an overall association between maternal coffee consumption and risk of ALL: OR 0.89 (95% CI 0.61, 1.30), although there was some suggestion that higher levels of intake might increase the risk in children of non-smoking mothers: OR for 2+ cups/day = 1.44 (95% CI 0.85, 2.42); this was supported by our meta-analysis. Risk was also elevated among cases with chromosomal translocations. The overall OR for maternal tea consumption was 0.82 (95% CI 0.56, 1.18), although the OR for T-cell ALL was 0.21 (95% CI 0.08, 0.51). Among ALL cases with translocations, the ORs for tea consumption tended to be elevated: OR = 1.70 (95% CI 0.79-3.68) for 2+ cups/day. The observed increased risk associated with coffee and tea consumption may be confined to ALL with translocations. These associations should be explored further in large international consortia.

Growth in utero and body mass index at age 5 years in children of smoking and non-smoking mothers

Background High birth weight is associated with overweight later in life, while tobacco exposure in utero is associated with low birth weight, but with later risk of overweight. Aims To examine whether body mass index (BMI) z-scores of children at age 5 are associated with measurements of mid-abdominal diameter (MAD) in utero comparing smoking and non-smoking mothers. Study Design Growth in utero was recorded as MAD in mm per days of gestational age (MAD for gestational age) at 17, 25, 33 and 37 weeks of gestation in 561 infants whose mothers participated in a population-based study in Scandinavia (1986–1988). Outcome Measures The offspring's BMI z-score at 5 years was used as a dependent variable, and MAD for gestational age as well as birth weight divided by gestational age in days were included as explanatory variables in separate linear regression models. Maternal BMI was considered as a potential confounder. Results At 17 and 25 weeks gestation there were no relevant differences in MAD for gestational age between smokers and non-smokers. At 33 and 37 weeks gestation, children of smoking mothers had less increase in MAD than children of non-smoking mothers. In adjusted models, MAD for gestational age in week 33 and 37 was positively associated with BMI z-score at 5 years of age among children of both smoking and non-smoking mothers. Conclusions In this study overweight in children exposed to tobacco smoking in utero was apparently not mediated through foetal growth retardation, followed by enhanced fat accretion after birth.