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Wu J, Liu X, Qin C, Zhang J, Liu X, Hu J, Wu F, Chen C, Lin Y. Effect of maternal serum albumin level on birthweight and gestational age: an analysis of 39200 singleton newborns. Front Endocrinol (Lausanne) 2024; 15:1266669. [PMID: 38505758 PMCID: PMC10948486 DOI: 10.3389/fendo.2024.1266669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Background Serum albumin plays a pivotal role in regulating plasma oncotic pressure and modulating fluid distribution among various body compartments. Previous research examining the association between maternal serum albumin levels and fetal growth yielded limited and inconclusive findings. Therefore, the specific influence of serum albumin on fetal growth remains poorly understood and warrants further investigation. Methods A retrospective study involved 39200 women who had a singleton live birth at a tertiary-care academic medical center during the period from January 2017 to December 2020. Women were categorized into four groups according to the quartile of albumin concentration during early pregnancy: Q1 group, ≤41.0 g/L; Q2 group, 41.1-42.6 g/L; Q3 group, 42.7-44.3 g/L and Q4 group, >44.3 g/L. The main outcome measures were mid-term estimated fetal weight, birthweight and gestational age. Multivariate linear and logistic regression analysis were performed to detect the independent effect of maternal serum albumin level on fetal growth after adjusting for important confounding variables. Results In the crude analysis, a significant inverse correlation was found between early pregnancy maternal serum albumin levels and fetal growth status, including mid-term ultrasound measurements, mid-term estimated fetal weight, birthweight, and gestational age. After adjustment for a number of confounding factors, mid-term estimated fetal weight, birthweight, and birth height decreased significantly with increasing albumin levels. Compared to the Q2 group, the Q4 group had higher rates of preterm birth (aOR, 1.16; 95% CI, 1.01-1.34), small-for-gestational-age (aOR, 1.27; 95% CI, 1.11-1.45) and low birthweight (aOR, 1.41; 95% CI, 1.18-1.69), and lower rate of large-for-gestational-age (aOR, 0.85; 95% CI, 0.78-0.94). Moreover, to achieve the optimal neonatal outcome, women with higher early pregnancy albumin levels required a greater reduction in albumin levels in later pregnancy stages. Conclusions A higher maternal serum albumin level during early pregnancy was associated with poor fetal growth, with the detrimental effects becoming apparent as early as the mid-gestation period. These findings provided vital information for clinicians to predict fetal growth status and identify cases with a high risk of adverse neonatal outcomes early on.
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Affiliation(s)
- Jiayi Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaorui Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chuanmei Qin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinwen Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xueqing Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianing Hu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cailian Chen
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
- Key Laboratory of System Control and Information Processing, Ministry of Education of China, Shanghai, China
| | - Yi Lin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Leung M, Laden F, Coull BA, Modest AM, Hacker MR, Wylie BJ, Iyer HS, Hart JE, Wei Y, Schwartz J, Weisskopf MG, Papatheodorou S. Ambient temperature during pregnancy and fetal growth in Eastern Massachusetts, USA. Int J Epidemiol 2023; 52:749-760. [PMID: 36495569 PMCID: PMC10244050 DOI: 10.1093/ije/dyac228] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Left unabated, rising temperatures pose an escalating threat to human health. The potential effects of hot temperatures on fetal health have been under-explored. Here, we examined the association between prenatal ambient temperature exposure and fetal growth measures in a Massachusetts-based pregnancy cohort. METHODS We used ultrasound measurements of biparietal diameter (BPD), head circumference (HC), femur length and abdominal circumference (AC), in addition to birthweight (BW), from 9446 births at Beth Israel Deaconess Medical Center from 2011 to 2016. Ultrasound scans were classified into three distinct gestational periods: 16-23 weeks, 24-31 weeks, 32+ weeks; and z-scores were created for each fetal growth measure using the INTERGROWTH-21st standards. We fitted distributed lag models to estimate the time-varying association between weekly temperature and fetal growth, adjusting for sociodemographic characteristics, seasonal and long-term trends, humidity and particulate matter (PM2.5). RESULTS Higher ambient temperature was associated with smaller fetal growth measures. The critical window of exposure appeared to be Weeks 1-20 for ultrasound parameters, and high temperatures throughout pregnancy were important for BW. Associations were strongest for head parameters (BPD and HC) in early to mid-pregnancy, AC late in pregnancy and BW. For example, a 5ºC higher cumulative temperature exposure was associated with a lower mean AC z-score of -0.26 (95% CI: -0.48, -0.04) among 24-31-Week scans, and a lower mean BW z-score of -0.32 (95% CI: -0.51, -0.12). CONCLUSION Higher temperatures were associated with impaired fetal growth. This has major health implications given that extreme temperatures are more common and escalating.
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Affiliation(s)
- Michael Leung
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anna M Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Michele R Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Blair J Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc G Weisskopf
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Peterson AK, Habre R, Niu Z, Amin M, Yang T, Eckel SP, Farzan SF, Lurmann F, Pavlovic N, Grubbs BH, Walker D, Al-Marayati LA, Grant E, Lerner D, Bastain TM, Breton CV. Identifying pre-conception and pre-natal periods in which ambient air pollution exposure affects fetal growth in the predominately Hispanic MADRES cohort. Environ Health 2022; 21:115. [PMID: 36434705 PMCID: PMC9701016 DOI: 10.1186/s12940-022-00925-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/24/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND It is well documented that persons of color experience disproportionate exposure to environmental contaminants, including air pollution, and have poorer pregnancy outcomes. This study assessed the critical windows of exposure to ambient air pollution on in utero fetal growth among structurally marginalized populations in urban Los Angeles. METHODS Participants (N = 281) from the larger ongoing MADRES pregnancy cohort study were included in this analysis. Fetal growth outcomes were measured on average at 32 [Formula: see text] 2 weeks of gestation by a certified sonographer and included estimated fetal weight, abdominal circumference, head circumference, biparietal diameter and femur length. Daily ambient air pollutant concentrations were estimated for four pollutants (particulate matter less than 2.5 µm (PM2.5) and less than 10 µm (PM10) in aerodynamic diameter, nitrogen dioxide (NO2), and 8-h maximum ozone (O3)) at participant residences using inverse-distance squared spatial interpolation from ambient monitoring data. Weekly gestational averages were calculated from 12 weeks prior to conception to 32 weeks of gestation (44 total weeks), and their associations with growth outcomes were modeled using adjusted distributed lag models (DLMs). RESULTS Participants were on average 29 years [Formula: see text] 6 old and predominately Hispanic (82%). We identified a significant sensitive window of PM2.5 exposure (per IQR increase of 6 [Formula: see text]3) between gestational weeks 4-16 for lower estimated fetal weight [Formula: see text] averaged4-16 = -8.7 g; 95% CI -16.7, -0.8). Exposure to PM2.5 during gestational weeks 1-23 was also significantly associated with smaller fetal abdominal circumference ([Formula: see text] averaged1-23 = -0.6 mm; 95% CI -1.1, -0.2). Additionally, prenatal exposure to PM10 (per IQR increase of 13 [Formula: see text]3) between weeks 6-15 of pregnancy was significantly associated with smaller fetal abdominal circumference ([Formula: see text] averaged6-15 = -0.4 mm; 95% CI -0.8, -0.1). DISCUSSION These results suggest that exposure to particulate matter in early to mid-pregnancy, but not preconception or late pregnancy, may have critical implications on fetal growth.
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Affiliation(s)
- Alicia K Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Monica Amin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Fred Lurmann
- Sonoma Technology Inc., Petaluma, CA, 94954, USA
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Daphne Walker
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Laila A Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Edward Grant
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Deborah Lerner
- Eisner Health Medical Center, Los Angeles, CA, 90015, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA.
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Peterson AK, Eckel SP, Habre R, Yang T, Faham D, Amin M, Grubbs BH, Farzan SF, Kannan K, Robinson M, Lerner D, Al-Marayati LA, Walker DK, Grant EG, Breton CV, Bastain TM. Detected prenatal perfluorooctanoic acid (PFOA) exposure is associated with decreased fetal head biometric parameters in participants experiencing higher perceived stress during pregnancy in the MADRES cohort. ENVIRONMENTAL ADVANCES 2022; 9:100286. [PMID: 36507367 PMCID: PMC9731234 DOI: 10.1016/j.envadv.2022.100286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background Perfluoroalkyl substances (PFAS) are ubiquitous synthetic chemicals with long half-lives and are known to cross the placenta during pregnancy. We examined the influence of maternal PFAS levels on in utero fetal growth trajectories and assessed whether maternal stress modified these associations. Methods Blood serum concentrations of five PFAS (PFOS, PFHxS, PFNA, PFOA, PFDA) were measured in 335 prenatal specimens (mean gestational age (GA): 21±9 weeks) in the MADRES cohort. Fetal growth outcomes (head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW)) were abstracted from ultrasound medical records and measured at the 3rd trimester study visit (N = 833 scans, GA range 10-42 weeks, mean 2.4 scans/participant). Adjusted linear mixed models with a GA quadratic growth curve were used for each PFAS exposure and growth outcome. PFOS and PFHxS were modeled continuously (100% sample detection), while PFOA, PFNA, and PFDA were modeled categorically (57-70% sample detection). Scores on the Perceived Stress Scale (PSS) measured in pregnancy were dichotomized at the median (<13 vs. ≥ 13) in stratified models. Results Participants were on average 29±6 years old and predominately Hispanic (76%). Median serum concentrations of PFOS, PFHxS, PFNA, PFOA and PFDA were 1.34, 1.10, 0.07, 0.12, and 0.04 ng/mL, respectively. Participants with detected PFOA concentrations had fetuses with -2.5 mm (95% CI -4.2, -0.8) smaller HC and-0.7 mm (95% CI -1.3, -0.2) smaller BPD on average for a fixed GA than those without detected PFOA concentrations. In models stratified by PSS level, the effects of PFOA on fetal growth parameters were stronger and only significant in participants with higher stress levels (HC: β= -3.5, 95% CI -5.8, -1.4; BPD: β = -0.8, 95% CI -1.6, -1.1). Conclusions Prenatal PFOA exposure adversely impacted fetal head biometric parameters in participants experiencing higher stress during pregnancy.
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Affiliation(s)
- Alicia K. Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Dema Faham
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Monica Amin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2020 Zonal Ave, Los Angeles, CA 90033, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY 10016, USA
| | - Morgan Robinson
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY 10016, USA
| | - Deborah Lerner
- Eisner Health, 1530 S Olive St, Los Angeles, CA 90015, USA
| | - Laila A. Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2020 Zonal Ave, Los Angeles, CA 90033, USA
| | - Daphne K. Walker
- Department of Radiology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave # 2315, Los Angeles, CA 90089, USA
| | - Edward G. Grant
- Department of Radiology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave # 2315, Los Angeles, CA 90089, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 North Soto Street Suite 102, Los Angeles, CA 90032, USA
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Leung M, Weisskopf MG, Laden F, Coull BA, Modest AM, Hacker MR, Wylie BJ, Wei Y, Schwartz J, Papatheodorou S. Exposure to PM2.5 during Pregnancy and Fetal Growth in Eastern Massachusetts, USA. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:17004. [PMID: 34989624 PMCID: PMC8734565 DOI: 10.1289/ehp9824] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Prior studies have examined the association between fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] and fetal growth with either limited spatial or temporal resolution. OBJECTIVES In this study, we examined the association between PM2.5 exposure during pregnancy and fetal growth measures (ultrasound parameters and birth weight) in a pregnancy cohort using spatiotemporally resolved PM2.5 in Eastern Massachusetts, USA. METHODS We used ultrasound measures of biparietal diameter (BPD), head circumference, femur length, and abdominal circumference (AC), in addition to birth weight, from 9,446 pregnancies that were delivered at the Beth Israel Deaconess Medical Center from 2011-2016. We used linear mixed-effects models to examine the associations of PM2.5 in two exposure windows (the first 16 wk of pregnancy and the cumulative exposure up until the assessment of fetal growth) with anatomic scans (ultrasound measures at<24 wk), growth scans (ultrasound measures at≥24wk), and birth weight. All models were adjusted for sociodemographic characteristics, long-term trends, and temperature. RESULTS Higher PM2.5 exposure in the first 16 wk was associated with smaller fetal growth measures, where associations were particularly strong for BPD, AC, and birth weight. For example, a 5-μg/m3 increase in PM2.5 was associated with a lower mean BPD z-score of -0.19 (95% CI: -0.31, -0.06) before 24 wk, a lower mean AC z-score of -0.15 (95% CI: -0.28, -0.01) after 24 wk, and a lower mean birth weight z-score of -0.11 (95% CI: -0.20, -0.01). Analyses examining the associations with cumulative PM2.5 exposure up until the assessment of fetal growth produced attenuated associations. CONCLUSIONS Higher gestational exposure to PM2.5 was associated with smaller fetal growth measures at levels below the current national standards. https://doi.org/10.1289/EHP9824.
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Affiliation(s)
- Michael Leung
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marc G. Weisskopf
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anna M. Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Michele R. Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Blair J. Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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6
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Wrottesley SV, Prioreschi A, Norris SA. The association between fetal growth and neonatal adiposity in urban South African infants. Pediatr Obes 2021; 16:e12737. [PMID: 32997439 DOI: 10.1111/ijpo.12737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine associations between maternal body mass index (BMI), gestational weight gain (GWG) and fetal growth and neonatal adiposity in urban South Africans. METHODS Maternal BMI was assessed at recruitment and GWG (kg/week) was calculated. Longitudinal fetal growth was measured via ultrasound and modelled using Superimposition by Translation and Rotation (SITAR). Neonatal adiposity was assessed using air displacement plethysmography or dual-energy X-ray absorptiometry. Multiple linear regression models were used to examine associations between maternal BMI, GWG and SITAR fetal growth parameters and neonatal fat mass index (FMI; kg/m3 ) in 304 mother-neonate pairs. RESULTS In pooled analyses, longitudinally modelled abdominal circumference size (β = 0.64 kg/m3 , P < .001) and velocity (β = 8.39 kg/m3 , P < .001) and biparietal diameter velocity (β = 4.55 kg/m3 , P = .020) were positively associated with neonatal FMI. GWG was positively associated with neonatal FMI in preliminary models (β = 1.07 kg/m3 per 1 kg/week; P = .040), with pooled models indicating mediation via fetal growth. CONCLUSION In utero abdominal growth is predictive of neonatal adiposity. Additionally, greater fetal growth - particularly of the abdominal circumference - mediates the effect of GWG on neonatal adiposity. In settings such as South Africa, strategies to ensure healthy pregnancy weight gain can contribute to prevention of intergenerational obesity risk.
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Affiliation(s)
- Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton General Hospital, Southampton, UK
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7
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Warkentin S, Carnell S, Oliveira A. Leptin at birth and at age 7 in relation to appetitive behaviors at age 7 and age 10. Horm Behav 2020; 126:104842. [PMID: 32841621 DOI: 10.1016/j.yhbeh.2020.104842] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/05/2020] [Accepted: 08/14/2020] [Indexed: 12/31/2022]
Abstract
Leptin contributes to the control of food intake and energy balance. However, its association with appetitive behaviors during childhood is not well understood. We aimed to investigate the association between leptin, assessed at birth and at 7 years of age (y), and appetitive behaviors assessed at 7 and 10 y. Children from a Portuguese cohort with assessment of leptin levels at birth from umbilical cord blood (n = 645) and at 7 y from venous blood samples (n = 587), were included. The Children's Eating Behavior Questionnaire assessed appetitive behaviors at 7 and 10 y. Weight and height were measured at 7 and 10 y to derive BMI z-scores (BMIz). A series of Generalized Linear Models tested relationships between leptin and appetitive behaviors, adjusting for potential confounders (maternal age, education, pre-pregnancy BMI, smoking during pregnancy, child physical activity and child BMIz), and interaction terms for child sex and child BMIz. At 7 y, 116 boys and 118 girls were classified as having overweight/obesity, and these children had higher leptin levels. Cross-sectional analyses using the 7 y data produced the strongest results. Higher leptin at 7 y was significantly associated with lower scores on Satiety Responsiveness, Food Fussiness and Slowness in Eating, and higher scores on Food Responsiveness, Enjoyment of Food and Emotional Overeating at 7 y. Only the association with Emotional Overeating remained when adjusting for child BMIz. Significant interaction effects between child sex and leptin were found for appetite at 7 y, such that higher leptin was associated with higher Food Responsiveness (p < 0.001) and lower Slowness in Eating (p < 0.001) to a greater extent among boys. Umbilical cord blood leptin was not associated with appetitive behaviors at 7 or 10 y. Our results show that leptin levels are positively associated with food approach and negatively with food avoidant behaviors. Associations were more consistent in cross-sectional analyses (at 7 y), were largely dependent on child weight, and tended to be stronger among boys. Our findings support a role for leptin in affecting appetite, with potential consequences for current weight status and future weight gain.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal.
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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8
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Wrottesley SV, Prioreschi A, Kehoe SH, Ward KA, Norris SA. A maternal "mixed, high sugar" dietary pattern is associated with fetal growth. MATERNAL AND CHILD NUTRITION 2019; 16:e12912. [PMID: 31777191 PMCID: PMC7083459 DOI: 10.1111/mcn.12912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/10/2019] [Accepted: 10/18/2019] [Indexed: 01/06/2023]
Abstract
This study examined associations between a maternal "mixed, high sugar" dietary pattern during pregnancy and ultrasound-determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2 ), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2 ; p = .011) and femur length (0.01 cm/+1 kg/m2 ; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer-term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.
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Affiliation(s)
- Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah H Kehoe
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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9
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Jacobsen GW. Should pregnant women refrain entirely from using nicotine? TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2016; 136:1320. [PMID: 27637028 DOI: 10.4045/tidsskr.16.0732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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10
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Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age. J Dev Orig Health Dis 2015; 6:485-92. [DOI: 10.1017/s2040174415007151] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women’s and Children’s Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01–0.29) and 0.21 (0.13–0.29), respectively. A significant dose–response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P<0.001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.
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11
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Riedel C, Schönberger K, Yang S, Koshy G, Chen YC, Gopinath B, Ziebarth S, von Kries R. Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking--a meta-analysis. Int J Epidemiol 2014; 43:1593-606. [PMID: 25080528 DOI: 10.1093/ije/dyu150] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Some studies reported similar effect estimates for the impact of maternal smoking in pregnancy and paternal smoking on childhood obesity, whereas others suggested higher effects for maternal smoking. We performed a meta-analysis to compare the effect of in utero exposure to maternal smoking and that of paternal or household smoking exposure in utero or after birth with mutual adjustment. METHODS Meta-analysis of observational studies identified in MEDLINE, EMBASE and Web of Knowledge published in 1900-2013. Study inclusion criterion was assessment of the association of maternal smoking during pregnancy and paternal or household smoking (anyone living in the household who smokes) at any time with childhood overweight and obesity. The analyses were based on all studies with mutually adjusted effect estimates for maternal and paternal/household smoking applying a random-effects model. RESULTS Data for 109,838 mother/child pairs were reported in 12 studies. The pooled odds ratios (ORs) for overweight 1.33 [95% confidence interval (CI) 1.23;1.44] (n=6, I2=0.00%) and obesity 1.60 (95% CI 1.37;1.88) (n=4, I2=32.47%) for maternal smoking during pregnancy were higher than for paternal smoking: 1.07 (95% CI 1.00;1.16) (n=6, I2=41.34%) and 1.23 (95% CI 1.10;1.38) (n=4, I2=14.61%), respectively. Similar estimates with widely overlapping confidence limits were found for maternal smoking during pregnancy and childhood overweight and obesity: 1.35 (95% CI 1.20;1.51) (n=3, I2=0.00%) and 1.28 (95% CI 1.07;1.54) (n=3, I2=0.00%) compared with household smoking 1.22 (95% CI 1.06;1.39) (n=3, I2=72.14%) and 1.31 (95% CI 1.15;1.50)] (n=3, I2=0.00%). CONCLUSIONS Higher effect estimates for maternal smoking in pregnancy compared with paternal smoking in mutually adjusted models may suggest a direct intrauterine effect.
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Affiliation(s)
- Christina Riedel
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Katharina Schönberger
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Seungmi Yang
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Gibby Koshy
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Yang-Ching Chen
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Stephanie Ziebarth
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Rüdiger von Kries
- Ludwig Maximilian University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Munich, Germany, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan and Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
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12
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Florath I, Kohler M, Weck MN, Brandt S, Rothenbacher D, Schöttker B, Moß A, Gottmann P, Wabitsch M, Brenner H. Association of pre- and post-natal parental smoking with offspring body mass index: an 8-year follow-up of a birth cohort. Pediatr Obes 2014; 9:121-34. [PMID: 23420701 DOI: 10.1111/j.2047-6310.2012.00146.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 12/14/2012] [Accepted: 12/17/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although many epidemiological studies have shown an association between maternal smoking during pregnancy and offspring overweight, it is still under debate whether intrauterine tobacco smoke exposure directly affects offspring obesity or if the association is rather due to confounding by lifestyle factors. OBJECTIVES The association of parental smoking habits at pre- and post-natal periods with offspring body mass index (BMI) was investigated, whereas maternal smoking during pregnancy was validated by cord serum cotinine measurements. METHODS Multivariable linear regression analysis, based on the German Ulm Birth Cohort Study of 1045 children born in 2000 with annual/biennial follow-up until the age of 8 years (n = 609), was conducted. RESULTS BMI of offspring from mothers who smoked during pregnancy and non-smoking mothers differed significantly at 8 years. Maternal smoking during pregnancy was associated with an increase in BMI of 0.73 kg m(-2) [95% confidence interval: 0.21-1.25] in 8-year-old children after adjustment for multiple potential confounding variables. Both pre- and post-natal smoking of fathers (0.34 [0.01-0.66]/0.45 [0.08-0.81]) and of both parents (1.03 [0.43-1.63]/0.56 [0.14-0.98]) were likewise significantly associated with offspring BMI. CONCLUSIONS The observed patterns suggest that residual confounding by living conditions in smoking families rather than specific intrauterine exposure to tobacco smoke may account for the increased risk of offspring overweight.
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Affiliation(s)
- I Florath
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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13
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Gravel J, Potter B, Dubois L. Prenatal Exposure to Maternal Cigarette Smoke and Offspring Risk of Excess Weight Is Independent of Both Birth Weight and Catch-Up Growth. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/206120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Prenatal exposure to maternal cigarette smoke (PEMCS) is one of the most common insults to the developing fetus and has consistently emerged as an important risk factor for excess weight in the offspring. However, no consensus exists on the mechanism of action or duration of impact. This study seeks to further examine the role of PEMCS on overweight status of children up to age 10. Mother and child pairs (n=1183) were analysed from the Québec Longitudinal Study of Child Development (QLSCD) (1998–2010). Multivariable logistic regression models were used to control for confounders and assess mediation. PEMCS was associated with overweight status at age 10 (OR: 1.70; 95% CI: 1.20–2.43) after adjustment for early life exposures and childhood behaviours. This relationship remained robust after adjustment for birth weight and catch-up growth. Other significant predictors included APGAR score, mother’s immigrant and weight status, family type and child energy intake. The elevated risk of excess weight among the offspring of smoking mothers was not accounted for by other known determinants, and PEMCS appears to play a role independent of birth weight and catch-up growth. Our research suggests that young mothers may be an important audience for targeting preventive strategies.
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Affiliation(s)
- Jonathan Gravel
- Institute of Population Health, University of Ottawa, Ottawa, ON, Canada K1N 6N5
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8MS
| | - Beth Potter
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8MS
| | - Lise Dubois
- Institute of Population Health, University of Ottawa, Ottawa, ON, Canada K1N 6N5
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8MS
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14
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Investigating the relationship between prenatal growth and postnatal outcomes: a systematic review of the literature. J Dev Orig Health Dis 2013; 4:434-41. [DOI: 10.1017/s2040174413000251] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Theories regarding the relationship between pre- and postnatal growth and programming of health have been based on characteristics at birth, with little or no reference to the patterns of growth occurring in utero. Review of the literature to identify studies using ultrasonographically obtained fetal dimensions to track prenatal growth and relate these patterns of growth to postnatal anthropometry and cardiovascular and metabolic risk factors. Review of Medline, Scopus and Proquest for studies reporting on ultrasonographically derived estimates of fetal growth and their association with postnatal anthropometry, body composition or cardiovascular and metabolic risk factors. Quality of papers were assessed using the method developed by Downs and Black. Twenty-nine studies met the inclusion criteria, with a mean score of high quality. Twenty of the studies had follow-up in infancy, five in childhood, three in adolescence and one in adulthood. The associations observed suggest that centile tracking may occur early in pregnancy though whether this is as early as the first trimester is uncertain. The second trimester may be a critical period for the programming of blood pressure and abdominal circumference may be the most sensitive fetal dimension to indicate any programming.
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15
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Tanvig M, Wehberg S, Vinter CA, Joergensen JS, Ovesen PG, Beck-Nielsen H, Jensen DM, Christesen HT. Pregestational body mass index is related to neonatal abdominal circumference at birth--a Danish population-based study. BJOG 2012; 120:320-30. [PMID: 23146023 DOI: 10.1111/1471-0528.12062] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the impact of maternal pregestational body mass index (BMI) and smoking on neonatal abdominal circumference (AC) and weight at birth. To define reference curves for birth AC and weight in offspring of healthy, nonsmoking, normal weight women. DESIGN Population-based study. SETTING Data from the Danish Medical Birth Registry. POPULATION All live singletons without congenital malformations in Denmark 2004-10. METHODS Data on 366,886 singletons at 35(+0) to 41(+6) weeks(+days) of gestation were extracted and analysed using multivariate linear regressions. MAIN OUTCOME MEASURES Birth AC and weight in relation to pregestational maternal BMI, maternal smoking and medical conditions (any). RESULTS Birth AC and weight increased with increasing pregestational BMI, and decreased with smoking (P < 0.0001). Reference curves were created for offspring of healthy, nonsmoking mothers with normal pregestational BMI. Mean AC ranged from 30.1 cm and 30.2 cm at 35 weeks of gestation to 33.9 cm and 34.1 cm at 41 weeks of gestation, for girls and boys, respectively. Mean birthweight ranged from 2581 and 2666 g at 35 weeks to 3705 and 3852 g at 41 weeks of gestation for girls and boys, respectively. Pregestational BMI correlated more to the Z score of birthweight than to the Z score of AC (P < 0.0001). CONCLUSION Birth AC and weight are affected by maternal smoking status and pregestational BMI. Pregestational BMI correlated more to birthweight than to AC. Using data from healthy, nonsmoking mothers with normal pregestational BMI we have provided new reference curves for birth AC and birthweight.
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Affiliation(s)
- M Tanvig
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.
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16
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Beyerlein A, Rückinger S, Toschke AM, Schaffrath Rosario A, von Kries R. Is low birth weight in the causal pathway of the association between maternal smoking in pregnancy and higher BMI in the offspring? Eur J Epidemiol 2011; 26:413-20. [PMID: 21360298 DOI: 10.1007/s10654-011-9560-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 02/17/2011] [Indexed: 12/01/2022]
Abstract
A number of cross-sectional and prospective studies suggested a priming effect of maternal smoking in pregnancy on offspring's obesity. It has been hypothesized that this association might be explained by low birth weight and subsequent catch-up growth in the causal pathway. We therefore examined the role of birth weight in children exposed versus not exposed to cigarette smoking in utero on later body mass index (BMI). Using data of 12,383 children and adolescents (3-17 years of age) recorded in a German population-based survey (KiGGS), we assessed mean body mass index standard deviation scores (BMI-SDS) in different birth weight SDS categories, stratified for children with smoking and non-smoking mothers. We calculated spline regression models with BMI-SDS as outcome variable, cubic splines of birth weight SDS, and potential confounding factors. Children whose mothers had been smoking during pregnancy had lower birth weight SDS and higher BMI-SDS at interview compared to children of non-smoking mothers. However, we observed a linear association between birth weight SDS and BMI-SDS in crude analyses for both groups. Similarly, almost linear effects were observed in adjusted spline regression analyses, except for children with very low birth weight. The respective 95% confidence bands did not preclude a linear effect for the whole birth weight SDS distribution. Our findings suggest that low birth weight is unlikely to be the main cause for the association between intrauterine nicotine exposure and higher BMI in later life. Alternative mechanisms, such as alterations in the noradrenergic system or increased food efficiency, have to be considered.
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Affiliation(s)
- Andreas Beyerlein
- Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University of Munich, Heiglhofstrasse, Germany.
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