Early Intrauterine Exposure to Tobacco-inhaled Products and Obesity

Division of Pediatric Epidemiology, Institute for Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians University of Munich, Munich, Germany.
American Journal of Epidemiology (Impact Factor: 5.23). 01/2004; 158(11):1068-74. DOI: 10.1093/aje/kwg258
Source: PubMed


An association between maternal smoking during pregnancy and offspring obesity has been reported. This study assessed the impact of maternal smoking during the first trimester. Data on 4,974 German children aged 5-6 years were obtained at school entry health examinations in 2001-2002 in Bavaria. Obesity was defined by body mass index using International Obesity Task Force cutpoints. Prevalence of obesity was 1.9% (95% confidence interval (CI): 1.5, 2.4) in offspring of never smokers, 4.5% (95% CI: 2.9, 6.7) for maternal smoking during the first trimester only, and 5.9% (95% CI: 3.8, 8.7) for maternal smoking throughout pregnancy. Unadjusted odds ratios were higher for maternal smoking throughout pregnancy (odds ratio = 3.23, 95% CI: 2.00, 5.21) compared with the first trimester only (odds ratio = 2.41, 95% CI: 1.49, 3.91). Adjusted odds ratios were similar: 1.70 (95% CI: 1.02, 2.87) for maternal smoking throughout pregnancy and 2.22 (95% CI: 1.33, 3.69) for maternal smoking in the first trimester only. When modeled together, no statistically significant difference in obesity risk was found between maternal smoking in the first trimester compared with throughout pregnancy. The effect of intrauterine tobacco exposure on childhood obesity may depend largely on cigarette smoking during the first trimester, whereas the additional impact of smoking throughout pregnancy might be due to confounding by sociodemographics. Women should be encouraged to quit smoking prior to conception.

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    • "There is speculation that the effect of intrauterine tobacco exposure on childhood obesity may depend largely on cigarette smoking during the first trimester, whereas the additional impact of smoking throughout pregnancy might be due to confounding by sociodemographics [8] or residual confounding by genetic and family environmental factors [7, 10]. However, a systematic review of studies reporting on the association between maternal prenatal cigarette smoking and elevated risk for childhood overweight suggested that sociodemographic and behavioral differences between smokers and nonsmokers did not explain the observed association [26]. "
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    ABSTRACT: Aim: To investigate the association between maternal smoking during pregnancy, second-hand tobacco smoke (STS) exposure, education level, and preschool children's wheezing and overweight. Methods: This cohort study used data of the KANC cohort--1,489 4-6-year-old children from Kaunas city, Lithuania. Multivariate logistic regression was employed to study the influence of prenatal and postnatal STS exposure on the prevalence of wheezing and overweight, controlling for potential confounders. Results: Children exposed to maternal smoking during pregnancy had a slightly increased prevalence of wheezing and overweight. Postnatal exposure to STS was associated with a statistically significantly increased risk of wheezing and overweight in children born to mothers with lower education levels (OR 2.12; 95% CI 1.04-4.35 and 3.57; 95% CI 1.76-7.21, accordingly). Conclusions: The present study findings suggest that both maternal smoking during pregnancy and STS increase the risk of childhood wheezing and overweight, whereas lower maternal education might have a synergetic effect. Targeted interventions must to take this into account and address household smoking.
    BioMed Research International 07/2014; 2014:240757. DOI:10.1155/2014/240757 · 1.58 Impact Factor
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    • "Nicotine, in fact, causes higher placental vascular resistance, decreases blood flow in the uterus, and increases the concentration of carboxyhaemoglobin, all factors responsible for chronic hypoxia and reduced fetal development [80]. In addition, children of smoking mothers have a higher risk (RR = 1.5) of being overweight or obese [81,82] because nicotine withdrawal promotes overeating and weight gain, and on the other, children born from smoking mother tend to get less exercise and have a lower quality diet [74]. "
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    ABSTRACT: According to the Barker hypothesis, the period of pregnancy and the intrauterine environment are crucial to the tendency to develop diseases like hypertension, diabetes, coronary heart disease, metabolic disorders, pulmonary, renal and mental illnesses. The external environment affects the development of a particular phenotype suitable for an environment with characteristics that closely resemble intrauterine conditions. If the extra-uterine environment differs greatly from the intra-uterine one, the fetus is more prone to develop disease. Subsequent studies have shown that maternal diseases like depression and anxiety, epilepsy, asthma, anemia and metabolic disorders, like diabetes, are able to determine alterations in growth and fetal development. Similarly, the maternal lifestyle, particularly diet, exercise and smoking during pregnancy, have an important role in determining the risk to develop diseases that manifest themselves both during childhood and particularly in adulthood. Finally, there are abundant potential sources of pollutants, both indoor and outdoor, in the environment in which the child lives, which can contribute to an increased probability to the development of several diseases and that in some cases could be easily avoided.
    Italian Journal of Pediatrics 01/2013; 39(1):7. DOI:10.1186/1824-7288-39-7 · 1.52 Impact Factor
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    • "Thus it is important to investigate perinatal factors and their predictive role in obesity progression. Pre-pregnancy weight [7] [8], weight increase during gestation [7] [9], gestational age [10] [11], smoking habits before and during pregnancy [12] [13] [14] [15] [16] [17], alcohol [10] [11] and coffee [18] consumption during the same period, birth weight [9] [19] [20] and breastfeeding duration and lifestyle of the mother during lactation [21] [22] have been found to be strongly related to an elevated risk of overweight and obesity, either directly or through mediating factors, such as fetal growth restriction [18] and rapid weight gain [22] "
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    ABSTRACT: Objective: To explore associations of perinatal and family factors with preadolescence overweight and obesity in a sample of Greek schoolchildren. Methods: A nationwide cross-sectional study among 2093 students (10.9 ± 0.72 years, 44.9% boys) and their parents were conducted. Anthropometric (e.g., height, weight, motherÕs body mass index (BMI) at the time of the study and at conception), socio-demographic (e.g., age, education, socio-economic sta-tus), diet and other major lifestyle characteristics (e.g., smoking, alcohol intake, physical activity and inactivity) and perinatal factors (e.g., breast-and formula-feeding) were collected with validated questionnaires. Height and weight of students were measured. Overweight/obesity was classified using IOTF cut-offs. Multivariable logistic and linear regression analyses were used to identify major independent factors of overweight/obesity among preadolescents and factors related with the percentage change of motherÕs BMI, respectively. Results: Increased age at pregnancy [odds ratios (OR) = 0.95, 95% Confidence Interval (CI): 0.93–0.97], higher BMI at conception (OR = 1.17, 95% CI: 1.12–1.22) and heavy smoking (OR = 2.02, 95% CI: 1.23–3.33) were positively associated with childÕs overweight/obesity status. Moreover, motherÕs age and TV viewing, indicat-ing inactivity, were the strongest factors of the percentage increase in motherÕs BMI (b ± se = 0.23 ± 0.07, p = 0.002; b ± se = 0.32 ± 0.10, p = 0.002, respectively).
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