Smoking Mothers Research Articles

Determinants of wasting among South Sudanese 6- to 59-month-old children in Okugo refugee camp, Gambella Region, South-Western Ethiopia: Unmatched case-control study.

Introduction:Wasting among refugee children continues to be a serious public health problem particularly in conflict and in situations when people are displaced. Evidence of risk factors in the refugee context is crucial to successfully prevent malnutrition and its consequences. However, little information is known about the determinants of wasting in a refugee setting. Hence, this study was aimed to identify determinants of wasting among South Sudanese 6- to 59-month-old children in Okugo refugee camp, South-Western Ethiopia.Methods:Institutional-based unmatched case–control study was conducted on 99 acute malnutrition children (cases) and 297 children who are not malnourished (control) from 6 April to 2 May 2019. The study participant was selected by systematic random sampling and data on exposure variables were collected by face-to-face interview using a structured questionnaire. Data were entered into Epi data version 3.1 and was exported to SPSS version 25 for further analysis. Descriptive, bivariable, and multivariable analyses were done to compute summary statistics and to identify determinants of wasting.Result:The mean age of the cases and controls with standard deviation (SD) was 13.8 (±6.9) and 19.2 (±8.7) months, respectively. Multi-variable analysis revealed that mothers who were unable to read and write (adjusted odds ratio = 3.26, 95% confidence interval (1.07–7.93)), fathers only decision-maker to use donations items in the household (adjusted odds ratio = 3.75, 95% confidence interval (1.28–10.85)), not used all donated refugee food and non-food items (adjusted odds ratio = 2.57; 95% confidence interval (1.17–5.66)), the incidence of diarrhea 2 weeks preceding the survey (adjusted odds ratio = 5.28, 95% confidence interval (2.31–12.04)), and mother’s smoking habit (adjusted odds ratio = 2.98, 95% confidence interval (1.19–7.44)) were significant determinants of wasting.Conclusion:The finding shows that mothers who are unable to read and write, father only decision-maker, parents’ smoking habit, not using all donated refugee food items, and diarrheal disease were found to be independent determinants of wasting. Hence, interventions on acute malnutrition which are focused on empowering women through training and strengthening their control over the household assets, proper utilization of donated food, and non-food items will play a paramount role.

Maternal factors associated with smoking during gestation and consequences in newborns: results of an 18-year study

Tobacco use is one of the most important causes of obstetric and perinatal pathologies. Its frequency during pregnancy is high and could be related to various socioeconomic and cultural characteristics of the mothers. The aim of this study is to determine the trend and prevalence of smoking in pregnant mothers in our area over the years and the socio-cultural or obstetric factors associated with smoking as well as the repercussions on the newborns related to its consumption. Retrospective study of 18,959 mothers of healthy newborns in the maternity ward of the regional hospital during the years 2002-2019. The variable under study was maternal smoking during pregnancy compared with various maternal, obstetric, and perinatal factors. A mean percentage of 20.4% of the mothers smoked, with significantly decreasing percentages over the years. There was a significant association between smoking and mothers' age, origin, level of education, the occurrence of previous abortions, parity, type of breastfeeding at discharge, type of delivery, low birth weight, and need for neonatal resuscitation. This defines a profile of pregnant smokers on whom it is important to act: young, Spanish, with a low level of education, multiparous, and with previous miscarriages. Its repercussions are also evident with a lower birth weight in newborns. Knowledge of these factors will make it possible to design more effective intervention strategies to reduce smoking during pregnancy. Any effort that reduces smoking habits can improve the health status of mothers and newborns and the first step is to know who are risk pregnants.

Body Composition Trajectories and Their Determinants Among Infants of Smoking and Ex-Smoking Mothers: Preliminary Result from a Pilot Study

Body Composition Trajectories and Their Determinants Among Infants of Smoking and Ex-Smoking Mothers: Preliminary Result from a Pilot Study

Hair and nail nicotine levels of mothers and their infants as valid biomarkers of exposure to intrauterine tobacco smoke

INTRODUCTIONTobacco use remains the single most modifiable cause of adverse pregnancy outcomes. It is crucial to be able to accurately quantify the burden of tobacco exposure on both the mother and fetus to have better measures of efficacy with interventions being studied.METHODSThis is a descriptive and exploratory study conducted within a randomized controlled trial. Pregnant smoking and non-smoking women were followed from ≤22 weeks’ gestation through delivery with monthly maternal smoking questionnaires, urine cotinine levels, and collection of maternal and infant hair and nail samples, at delivery. Nicotine was extracted and measured (ng/mg) using high-performance liquid chromatography with electrochemical detection.RESULTSForty-six mother–infant dyads (34 pregnant smokers and 12 pregnant non-smokers) had successful completion of maternal and infant hair and nails samples. The median hair nicotine levels of the smoking mothers and their infants was significantly higher than those of the non-smokers (1.015 vs 0.037 ng/ mg, p<0.05 for the mothers; 0.445 vs 0.080 ng/mg, p<0.01 for the infants). Similarly, the median nail nicotine levels for smoking mothers and their infants were significantly higher than the non-smokers (2.130 vs 0.056 ng/mg, p<0.01 for the mothers; 0.594 vs 0.132 ng/mg, p<0.05 for the infants). We found a moderate but significant correlation between maternal hair and nail nicotine (r=0.64, p<0.001), infant hair and nail nicotine (r=0.64; p<0.001), maternal and infant hair nicotine (r=0.61, p<0.001), and maternal and infant nail nicotine levels (r=0.58, p<0.001).CONCLUSIONSOur study shows that both infant hair and nail nicotine levels are valid biomarkers of intrauterine tobacco smoke exposure, and can be used to identify prenatal smoke exposure, correlating well with the level of maternal nicotine exposure.

Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country.

Background:Smoking is one of the modifiable risk factors for adverse maternal and neonatal outcomes and is associated with low birth weight, preterm birth, respiratory, antepartum and intrapartum stillbirth, and perinatal death as well as long-term morbidity in offspring and sudden unexpected infant death. The rate of smoking in low- and middle-income countries is still relevantly high, and Jordan is no exception.Objective:To investigate the effect of active and passive smoking during pregnancy on adverse pregnancy outcomes.Methods:The case-control study was conducted in Jordan in June 2020. Healthy women with full-term singleton pregnancy (n = 180) were interviewed and stratified into three groups: Group I, active smokers; Group II, passive smokers; and Group III, nonsmokers. The study variables included demographic data, current pregnancy history, cotinine level of mothers and newborns, and perinatal outcomes. Statistical analysis was performed using the application package IBM SPSS 25. Various algorithms of statistical analysis were used depending on the type of distribution of feature and data quality. The threshold for statistical significance was set at p < 0.05.Results:Active smokers had significantly lower gestational age at delivery compared to passive and nonsmoking women (p = 0.038 and p = 0.003, respectively). Neonates from active smoking mothers had significantly lower birth weight compared to neonates from passive and nonsmoking women (p = 0.016 and p = 0.019, respectively), significantly lower head and chest circumferences compared to babies from passive smokers (p < 0.001 and p = 0.036, respectively), and significantly lower first-minute Apgar score compared to those from nonsmoking women (p = 0.023). The urine cotinine level was significantly higher in both active and passive smoking women (both p < 0.01), and it was significantly higher in newborns who had been exposed to smoking in utero despite maternal active or passive smoking status (both p < 0.001). There was a weak negative correlation between urine cotinine level and birth weight: r = –0.14 for maternal cotinine level and r = –0.15 for neonate cotinine level.Conclusions:The current study illustrated that smoking during pregnancy leads to offspring with reduced birth weight, birth length, and head and chest circumference; reduces delivery gestational age; and lowers the first-minute Apgar score. Our study findings highlight the need for further research issued to smoking effects on perinatal outcomes, the implementation of actions to develop cessation interventions in the preconception period, and an evaluation of useful interventions to enhance a smoking-free environment during pregnancy.

Influence of Oxidative Stress Generated by Smoking during Pregnancy on Glutathione Status in Mother-Newborn Pairs.

Glutathione plays a key role in maintaining a physiological balance between prooxidants and antioxidants in the human body. Therefore, we examined the influence of maternal smoking as a source of oxidative stress measured by total oxidant capacity (TOC) on reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx-3), and reductase (GR) amount in maternal and umbilical cord blood in 110 (45 smoking and 65 non-smoking) mother-newborn pairs. Concentrations of glutathione status markers and TOC were evaluated by competitive inhibition enzyme immunoassay technique. Plasma TOC levels were significantly higher and the GSH/GSSG ratio, which is considered an index of the cell’s redox status, were significantly lower in smoking women and their offspring than in non-smoking pairs. Decreased GR levels were found in smoking mothers and their newborns compared with similar non-smoking groups. Although plasma GPx-3 concentrations were similar in both maternal groups, in the cord blood of newborns exposed to tobacco smoke in utero they were reduced compared with the levels observed in children of tobacco abstinent mothers. Oxidative stress generated by tobacco smoke impairs glutathione homeostasis in both the mother and the newborn. The severity of oxidative processes in the mother co-existing with the reduced potential of antioxidant systems may have a negative effect on the oxidative-antioxidant balance in the newborn.

Maternal smoking behaviour across the first two pregnancies and small for gestational age birth: Analysis of the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the South of England.

Maternal smoking is established to cause adverse birth outcomes, but evidence considering maternal smoking change across successive pregnancies is sparse. We examined the association between self-reported maternal smoking during and between the first two pregnancies with the odds of small for gestational age (SGA) birth (<10th percentile) in the second infant. Records for the first two pregnancies for 16791 women within the SLOPE (Studying Lifecourse Obesity PrEdictors) study were analysed. This is a population-based cohort of prospectively collected anonymised antenatal and birth healthcare data (2003-2018) in Hampshire, UK. Logistic regression was used to relate maternal smoking change to the odds of SGA birth in the second infant. In the full sample, compared to never smokers, mothers smoking at the start of the first pregnancy had higher odds of SGA birth in the second pregnancy even where they stopped smoking before the first antenatal appointment for the second pregnancy (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.10, 2.03]). If a mother was not a smoker at the first antenatal appointment for either her first or her second pregnancy, but smoked later in her first pregnancy or between pregnancies, there was no evidence of increased risk of SGA birth in the second pregnancy compared to never smokers. A mother who smoked ten or more cigarettes a day at the start of both of her first two pregnancies had the highest odds of SGA birth (3.54 [2.55, 4.92]). Women who were not smoking at the start of the first pregnancy but who subsequently resumed/began smoking and smoked at the start of their second pregnancy, also had higher odds (2.11 [1.51, 2.95]) than never smokers. Smoking in the first pregnancy was associated with SGA birth in the second pregnancy, even if the mother quit by the confirmation of her second pregnancy.

Maternal smoking during pregnancy and long-term ophthalmic morbidity of the offspring

ObjectiveTo examine whether smoking during pregnancy is correlated with long-term ophthalmic complications of the offspring. Study designA population-based cohort analysis was performed comparing all deliveries of mothers who reported smoking during pregnancy and non-smoking mothers between 1991 and 2014 at a single tertiary medical center. Hospitalizations of the offspring up to the age of 18 years involving ophthalmic morbidities were evaluated according to a predefined set of ICD-9 codes. A Kaplan-Meier curve was used to compare cumulative hospitalization rate in exposed and unexposed offspring and a Cox proportional hazards model was used to control for confounders. ResultsDuring the study period, 243,680 deliveries met the inclusion criteria. Of them, 2965 (1.2%) were children of smoking mothers. Ophthalmic-related hospitalizations were significantly higher in children born to smoking mothers, as compared with the non-smoking group (1.4% vs. 0.1%, p < 0.01). Specifically, these hospitalizations were due to higher rates of visual disturbance rate and ophthalmic infections. The Kaplan-Meier curve demonstrated a significant higher cumulative incidence of ophthalmic-related hospitalizations in the smoking group (log rank p < 0.001). Using a Cox proportional hazards model, controlling for potential confounders, maternal tobacco use was found to be independently associated with long-term ophthalmic morbidity of the offspring (adjusted HR = 1.51, CI 1.11–2.04). ConclusionMaternal smoking during pregnancy is an independent risk factor for long-term ophthalmic morbidity of the offspring. These results are in line with many recent studies that strongly support maternal smoking cessation during pregnancy due to high offspring morbidity risk.

How Gut Microbiota Supports Immunity, Growth and Development of Preterm Infants: A Narrative Review

ABSTRACTBackground: Gut microbiota, a complex ecosystem consisting of abundant microorganisms, plays a role in preterm infants’ immunity, growth, and development. Dysbiosis or disruption of the gut microbiota can precipitate various diseases, such as allergy or autoimmune disorders in premature infants. Purpose: This study aimed to review gut microbiota in preterm infants and its role in supporting the infants’ immunity, growth, and development. Discussion: Bifidobactericeae is the predominant microbiota in GI tract of preterm infants. However, various factors can influence this gut microbiota e.g., genetics, lifestyle of the mothers (smoking, diet, use of antibiotic, obesity), birth mode, type of feeding, and environmental factors. Gut dysbiosis can result in impaired immune system which predisposes the preterm infants to infections, even fatal adverse event. Furthermore, the growth and development might be affected as well as lead to various neurodevelopmental and psychiatric disorders. Human milk is a prebiotic source which can stimulate the growth of Baifidobactericeae and Bacteroidetes. If the human milk is inadequate or unavailable, the recommended interventions for gut dysbiosis in premature infants are probiotics, prebiotics, or both supplementations (synbiotics). The administration of prebiotics and probiotics associates with lower morbidity and death rates in preterm infants, as well as shorter duration of hospital stay and duration to achieve full enteral feeding. Conclusions: Immunity as well as growth and development of preterm infants are affected greatly by gut microbiota The less diverse microbiota in preterm infants’ gut predispose them to various health problems. Hence, this problem should be managed properly, one of which is prebiotic and probiotic supplementation Keywords: Gastrointestinal Microbiome, Premature, Immunity, Growth, Development

Прогнозирование риска развития продолжительного течения острого простого бронхита у детей

Актуальность. Факторы и механизмы формирования длительного течения острого простого бронхита у детей на сегодняшний день до конца неизвестны. Описано участие ряда факторов, в том числе клинических, лабораторных и иммунологических. Цель исследования — выявление информативно значимых клинико-анамнестических, лабораторных и иммунологических факторов риска длительного течения бронхита у детей раннего возраста, а также создание математической модели для прогнозирования вероятности развития этой ситуации. Материалы и методы. Под наблюдением находились 122 ребенка в возрасте от 1 до 6 лет с острым простым бронхитом, которые были на обследовании и лечении в инфекционном отделении КУ «Днепровская ГКБ № 1 ДОС». Результаты. Определены факторы риска и создана математическая модель прогноза развития длительного течения острого простого бронхита у детей. Прогностическую значимость имели: масса тела ребенка при рождении более 3,7 кг, курение матери, наличие фоновых состояний, таких как перинатальное поражение центральной нервной системы и хронический тонзиллит, субфебрильная температура тела, продолжительность лихорадки более 4,7 дня, а также уровни g-интерферона и a-дефензинов в ротоглоточной жидкости. Выводы. Полученные результаты показали, что на развитие длительного течения острого простого бронхита у детей влияют клинико-анамнестические, лабораторные и иммунологические факторы. Приведенная математическая модель прогнозирования может использоваться в практической деятельности семейных врачей и педиатров.

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.

Maternal smoking during pregnancy and asthma during the first year of life: a comparative study between smokers and nonsmoker mothers.

We investigated the relationship between maternal smoking in pregnancy and health care problems in the offspring during the first year of life, particularly asthma. A cohort of 648 consecutive infants born at term and alive at Hospital de Sagunto (Valencia, Spain) over one year period was followed for 12 months. Clinical data of the infants were prospectively collected from the database of ambulatory medical records (ABUCASIS) of the Valencia health system. Smoking during pregnancy was recorded in 164 (25.3%) mothers. During the first year of life, asthma was diagnosed in 101 infants, with an incidence of 15.7%. The diagnoses of asthma (25.6% vs. 12.3%; P < 0.0001) and bronchiolitis (44.5% vs. 28.6%; P = 0.0002) during the first year of life were more common among infants in the smoking group. The probability of developing asthma during the first year of life was two-fold higher for the male gender and 2.5 times higher when mothers smoked while pregnant. Up to 52% of asthma cases could have been avoided in infants born to smoking mothers if they did not smoke during pregnancy. Infants in the smoking group showed a lower weight and length at birth than infants in the nonsmoking group differences almost disappeared at 6 months and 12 months. Asthma during the first year of life showed a clear relationship with maternal smoking in pregnancy. Pregnant women should be advised of the significant perinatal risk for respiratory diseases associated with tobacco use.

The effects of tubal sterilization on menopausal age in a cohort of postmenopausal women

To evaluate whether tubal sterilization (TS) has an adverse effect on menopausal age in a cohort of postmenopausal women. The medical records on TS were gathered from 1,228 postmenopausal women in menopause clinic at a tertiary hospital. The age at menarche, the parity, smoking and secondhand smoking status and mother’s age at menopause did not show any significant difference between the groups. Likewise, marital status, educational and yearly income levels were comparable (P &gt; 0.01). Although the mean BMI (P = 0.06) and the rate of oral contraceptive use (P = 0.09) were tended to be higher in non-TS women than in TS group, the difference did not reach statistical significance. The ever use of intrauterine device rate was significantly lower in TS group than in non-TS group (P &lt;0.001). The TS women, in comparison with the non-TS women had undergone earlier natural menopause (P &lt;0.001). The age at menopause had an inverse correlation with TS, and positive correlation with mother’s age at menopause in univariate analyses. However, there was marginally significant correlation between secondhand smoking and age at menopause. Linear stepwise regression analyses revealed that TS and mother’s age at menopause were independent predictors of age at menopause (P &lt; 0.05). We found an earlier age at menopause in women with TS in this study. In this regard, this is the first report about the age at menopause in women with TS, as far as we know.

Within- and between-family transactions of maternal depression and child engagement in the first 2 years of life: Role of prenatal maternal risk and tobacco use.

This study examined transactional associations among maternal depression, maternal sensitivity, and child engagement in the context of a low-income, diverse sample with maternal cigarette smoking during pregnancy (MSDP) as a moderator of these transactions. A random-intercept cross-lagged panel model was used to investigate within- and between-family variability from infancy to toddlerhood. The sample included 247 mother-child dyads (47% girls; 51% African-American; 178 MSDP, 69 non-MSDP). Assessments were conducted once during each trimester of pregnancy and at 2, 9, 16, and 24 months of child ages. Between-family associations revealed that children exposed to higher levels of sensitive parenting across time had higher behavioral engagement from infancy to toddlerhood. At the within-family level, increased sensitive parenting at 9 months was predictive of increased child engagement at 16 months which in turn predicted increases in sensitive parenting at 24 months. Increased maternal depression was concurrently associated with lower maternal sensitivity at 2 months and lower child engagement at 16 months. Contrary to hypotheses, changes in maternal depression were not associated to changes in parenting or child engagement. These associations did not vary between prenatally smoking and nonsmoking mothers. However, there was significantly higher stability in maternal depression across time among nonsmoking mothers compared to those in the MSDP group. Additionally, increased maternal depression was related to lower-than-expected child engagement at 9 months only for the nonsmoking group. Results highlight transactional processes at the within-family level and the importance of timing for parent and child effects on transactional processes.

Prenatal tobacco exposure and the risk of conduct disorder symptoms in offspring at the age of 14 years: Findings from the Raine Study

BackgroundEmerging epidemiological evidence suggests that offspring born to mothers who smoked tobacco during pregnancy may have elevated risk of developing conduct disorder (CD) symptoms. We examined associations between maternal and paternal tobacco smoking during pregnancy and CD symptoms in offspring at the age of 14 years. MethodsWe obtained data from the Raine Study, a multi-generational cohort study based in Western Australia. DSM-oriented scale of the Child Behavior Checklist (CBCL) was used to measure CD symptoms in offspring. Negative binomial regression was used to estimate the rate ratio (risks) (RR) of CD symptoms in offspring. We also produced the E-values to investigate the extent of unmeasured confounding. Paternal smoking during pregnancy was used as a proxy for environmental tobacco smoke exposure. ResultsComplete data were available for 1747 mother-offspring and 1711 father-offspring pairs. After adjusting for potential confounders, we found elevated risks (rates) of CD symptoms in offspring born to mothers smoking tobacco during the first trimester [RR 1.52 (95 % CI: 1.24–1.87)], third trimester [RR 1.36 (95 % CI: 1.09–1.69)] and during both trimesters of pregnancy [RR 1.50 (95 % CI: 1.19–1.90)]. The rates of CD symptoms in offspring increased with the level of exposure to maternal smoking during pregnancy. However, we noted insufficient statistical evidence for an association between paternal smoking during pregnancy and CD symptoms in offspring. ConclusionThe associations we found for maternal but not paternal smoking may suggest a biological mechanism for intrauterine tobacco exposure on the risk of CD symptoms in offspring. Early interventions assisting pregnant mothers to quit tobacco smoking, or avoid smoking initiation, have potential to contribute health benefits to both mothers and their offspring.

Serum levels of TGF-β1, cytokines, angiogenic, and anti-angiogenic factors in pregnant women who smoke

IntroductionWomen who smoke during pregnancy have a reduced risk of preeclampsia. The mechanism of this association is poorly understood. Preeclampsia is an anti-angiogenic and inflammatory state. Transforming growth factor beta 1 (TGF-β1) is a multi-functional anti-inflammatory cytokine that activates membrane bound endoglin on endothelial cells causing a myriad of vascular actions including vasorelaxation. The objective of the study was to determine serum levels of cytokines, angiogenic factors, placental growth factor (PlGF), TGF-β-1 and anti-angiogenic factors, soluble endoglin (sEng) and soluble vascular endothelial growth factor 1 (sVEGFR1) in smoking and non-smoking pregnant women. MethodsUsing enzyme-linked immunosorbent and multiplex assays we prospectively analyzed serum levels of PIGF, TGF-β1, sEng, sVEGFR1 and cytokines in normotensive pregnant smokers and non-smokers. Exclusion criteria included maternal hypertension, autoimmune disorders, rupture of membranes, evidence of labor and drug use. ResultsThere were 59 women in the smoking and 66 in the non-smoking group. Compared to non-smoking mothers. maternal age was lower in smoking mothers with no significant difference in other demographic variables. There was no difference in levels of cytokines, anti-angiogenic factors and PlGF between the two groups. Median TGF-β1 levels were significantly higher in the smoking group (8120 pg/mL vs 6040 pg/mL, p < 0.001) and remained significant after controlling for confounders. TGF-β1 levels correlated positively with cotinine levels in the smoking group. ConclusionsWe speculate that higher TGF-β1 levels may explain the reduced incidence of preeclampsia in mothers who smoke by being available for action on maternal endothelium even after inactivation by circulating maternal sEng.

Advanced maternal age and nicotine consumption during pregnancy

Background&#x0D; Nicotine consumption during pregnancy and advanced maternal age are well known independent risk factors for poor pregnancy outcome and therefore serious public health problems.&#x0D; Objectives&#x0D; Considering the ongoing trend of delaying childbirth in our society, this study investigates potential additive effects of nicotine consumption during pregnancy and advanced maternal age on foetal growth.&#x0D; Sample and Methods&#x0D; In a medical record-based study, we analysed the impact of maternal age and smoking behaviour before and during pregnancy on newborn size among 4142 singleton births that took place in Vienna, Austria between 1990 and 1995.&#x0D; Results&#x0D; Birth weight (H=82.176, p&lt;0.001), birth length (H=91.525, p&lt;0.001) and head circumference (H=42.097, p&lt;0.001) differed significantly according to maternal smoking behaviour. For birth weight, the adjusted mean differences between smokers and non-smokers increased from 101.8g for the &lt; 18-year-old mothers to 254.8g for &gt;35 year olds, with the respective values for birth length being 0.6 cm to 0.7cm, for head circumference from 0.3 cm to 0.6 cm.&#x0D; Conclusion&#x0D; Increasing maternal age amplified the negative effects of smoking during pregnancy on newborn parameters. Our findings identify older smoking mothers as a high-risk group which should be of special interest for public health systems.

Lower educational status interferes with maternal iodine intake during both pregnancy and lactation.

ObjectiveTo investigate factors affecting conscious iodine intake among pregnant and lactating women in a rural area in Hungary.MethodsPregnant women were studied and followed during lactation. Urinary and breast milk iodine concentration (UIC and MIC) were measured by inductively coupled plasma mass spectrometry. Potential interfering factors, including age, educational status and smoking were assessed.ResultsDuring pregnancy and lactation, mild iodine deficiency was observed; median UIC were 66 and 49 µg/L, respectively. Educational status was found to be a strong determinant of both iodine nutrition and smoking status during pregnancy (P < 0.01 and P < 0.001) and lactation (P < 0.001 and P < 0.01). While smoking and non-smoking lactating mothers had similar concentrations of urinary iodine (median UIC: 47 and 51 µg/L, P = 0.95), the breast milk of smoking mothers contained less iodine (median MIC: 150 and 203 µg/L, P = 0.03).ConclusionsBoth low iodine intake and smoking contribute to the higher risk of iodine deficiency in women with lower educational status. In smokers, MIC is often low in spite of normal UIC, presumably due to the iodine transport blocking effect of the cigarette smoke towards breast milk; normal UIC may be misinterpreted as sufficient iodine supply towards the child. Antenatal health promotion strategies should focus on young women with lower educational status, even in regions where sufficient iodine intake has been achieved in non-pregnant adults.

Maternal prenatal smoking and long-term gastrointestinal morbidity of the offspring: A population-based cohort analysis

Tobacco consumption in the form of cigarette smoking is one of the most prevalent controllable risk factors for adverse health outcomes and is a known reproductive toxin. We aimed to study the effect of maternal cigarette smoking during pregnancy on the risk of long-term gastrointestinal (GI) morbidity of their offspring. A population-based cohort analysis was performed comparing long-term GI-related hospitalizations among offspring of smoking mothers compared with offspring of non-smoking mothers up to the age of 18. The analysis included all singletons born between the years 1999–2014 at a single tertiary medical center. A Kaplan-Meier survival curve was used to compare the cumulative GI morbidity, and a Cox proportional hazards model was constructed to adjust for confounders. The study population included 242,342 children who met the inclusion criteria, 2861(1.2 %) of them were born to smokers. Offspring of smoking mothers were found to have higher rates of GI-related hospitalizations (7.2 % vs. 5.4 %, p < 0.01). Furthermore, the cumulative incidence of long-term GI morbidity was higher compared with those born to non-smoking mothers (log-rank p < 0.01). Specifically, an increased risk for inflammatory bowel disease was noted (OR = 1.48, 95 % CI 1.2–1.8, P < 0.01). Using a Cox proportional hazards model, controlling for confounders including maternal age, ethnicity, maternal diabetes mellitus and hypertensive disorders of pregnancy, birth weight, prematurity and mode of delivery, the association between maternal smoking during pregnancy and long-term GI morbidity of the offspring remained significant (adjusted HR = 1.54, 95 % CI 1.3–1.8, P < 0.01). In-utero exposure to maternal smoking is associated with an increased risk for long-term GI morbidity of the offspring.

Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships.

Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother–child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.