Abstract
Objective
Prenatal smoking exposure is associated with obesity and other cardio-metabolic risk factors in children, but no previous meta-analysis has been conducted in adults.
Methods
We investigated the association of prenatal smoking exposure in the Danish General Suburban Population Study (GESUS) with BMI, waist circumference, total cholesterol, type 2 diabetes, gestational type 2 diabetes, and hypertension in adulthood. We subsequently performed a meta-analysis, adding published studies investigating the association between prenatal smoking and the risk of cardio-metabolic outcomes among individuals at least 18 years of age.
Results
We included 19 eligible observational studies with various cardio-metabolic outcomes (N = 24,201–308,981 adults). In individuals exposed to prenatal smoking, the pooled random effects adjusted odds ratio were 1.35 (95% CI: 1.16–1.56) for being overweight, 1.46 (1.39–1.54) for being obese, 1.07 (0.89–1.29) for type 2 diabetes, 1.17 (0.92–1.48) for hypertension, and 1.38 (1.19–1.61) for gestational diabetes mellitus (GDM), compared with no exposure. The standardized means in waist circumference, total cholesterol, diastolic, and systolic blood pressure were not different in individuals exposed vs. not exposed to prenatal smoking. Heterogeneity was moderate to high (51% < I2 < 99%). However, removal of the high heterogeneity removed the associated uncertainty in the point estimate and revealed that prenatal smoking is associated with increased BMI in adulthood. There was also no evidence of publication bias in the meta-analyses.
Conclusions
The findings from the meta-analyses suggested that prenatal smoking exposure is associated with an increased odds ratio of overweight, obesity, and GDM in adulthood, but not with type 2 diabetes, hypertension, waist circumference, or total cholesterol. These findings highlight the importance of abstaining from smoking by pregnant women.
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References
Gillman MW. Developmental origins of health and disease. N Engl J Med. 2005;353:1848–50.
Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65:663–737.
Horta BL, Victora CG, Menezes AM, Halpern R, Barros FC. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol. 1997;11:140–51.
Oken E, Levitan EB, Gillman MW. Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis. Int J Obes (Lond). 2008;32:201–10.
Jamal AKB, Neff LJ, Whitmill J, Babb SD, Graffunder CM. Current cigarette smoking among adults — United States, 2005–2015. Morb Mortal Wkly Rep. 2016;65:1205–11.
Rayfield S, Plugge E. Systematic review and meta-analysis of the association between maternal smoking in pregnancy and childhood overweight and obesity. J Epidemiol Community Health. 2017;71:162–73.
Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP. Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child. 2012;97:1019–26.
Ino T. Maternal smoking during pregnancy and offspring obesity: meta-analysis. Pediatr Int. 2010;52:94–9.
Riedel C, Schonberger K, Yang S, Koshy G, Chen YC, Gopinath B, et al. 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.
Power C, Jefferis BJ. Fetal environment and subsequent obesity: a study of maternal smoking. Int J Epidemiol. 2002;31:413–9.
Geerts CC, Bots ML, Grobbee DE, Uiterwaal CS. Parental smoking and vascular damage in young adult offspring: is early life exposure critical? The atherosclerosis risk in young adults study. Arterioscler Thromb Vasc Biol. 2008;28:2296–302.
Koupil I, Toivanen P. Social and early-life determinants of overweight and obesity in 18-year-old Swedish men. Int J Obes. 2008;32:73–81.
Iliadou AN, Koupil I, Villamor E, Altman D, Hultman C, Langstrom N, et al. Familial factors confound the association between maternal smoking during pregnancy and young adult offspring overweight. Int J Epidemiol. 2010;39:1193–202.
Power C, Atherton K, Thomas C. Maternal smoking in pregnancy, adult adiposity and other risk factors for cardiovascular disease. Atherosclerosis. 2010;211:643–8.
Horta BL, Gigante DP, Nazmi A, Silveira VM, Oliveira I, Victora CG. Maternal smoking during pregnancy and risk factors for cardiovascular disease in adulthood. Atherosclerosis. 2011;219:815–20.
Ayres C, Silveira PP, Barbieri MA, Portella AK, Bettiol H, Agranonik M, et al. Exposure to maternal smoking during fetal life affects food preferences in adulthood independent of the effects of intrauterine growth restriction. J Dev Orig Health Dis. 2011;2:162–7.
Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J. 2011;15:1166–75.
Cupul-Uicab LA, Skjaerven R, Haug K, Melve KK, Engel SM, Longnecker MP. In utero exposure to maternal tobacco smoke and subsequent obesity, hypertension, and gestational diabetes among women in the MoBa cohort. Environ Health Perspect. 2012;120:355–60.
Cupul-Uicab LA, Skjaerven R, Haug K, Travlos GS, Wilson RE, Eggesbo M, et al. Exposure to tobacco smoke in utero and subsequent plasma lipids, ApoB, and CRP among adult women in the MoBa cohort. Environ Health Perspect. 2012;120:1532–7.
de Jonge LL, Harris HR, Rich-Edwards JW, Willett WC, Forman MR, Jaddoe VW, et al. Parental smoking in pregnancy and the risks of adult-onset hypertension. Hypertension. 2013;61:494–500.
Mamun AA, O’Callaghan MJ, Williams GM, Najman JM. Maternal smoking during pregnancy predicts adult offspring cardiovascular risk factors - evidence from a community-based large birth cohort study. PLoS ONE [Electron Resour]. 2012;7:e41106.
Harris HR, Willett WC, Michels KB. Parental smoking during pregnancy and risk of overweight and obesity in the daughter. Int J Obes. 2013;37:1356–63.
Mattsson K, Kallen K, Longnecker MP, Rignell-Hydbom A, Rylander L. Maternal smoking during pregnancy and daughters’ risk of gestational diabetes and obesity. Diabetologia. 2013;56:1689–95.
Jaddoe VW, de Jonge LL, van Dam RM, Willett WC, Harris H, Stampfer MJ, et al. Fetal exposure to parental smoking and the risk of type 2 diabetes in adult women. Diabetes Care. 2014;37:2966–73.
Bao W, Michels KB, Tobias DK, Li S, Chavarro JE, Gaskins AJ, et al. Parental smoking during pregnancy and the risk of gestational diabetes in the daughter. Int J Epidemiol. 2016;45:160–9.
Hogberg L, Cnattingius S, Lundholm C, D’Onofrio BM, Langstrom N, Iliadou AN. Effects of maternal smoking during pregnancy on offspring blood pressure in late adolescence. J Hypertens. 2012;30:693–9.
La Merrill M, Cirrillo P, Krigbaum N, Cohn B. The impact of prenatal parental tobacco smoking on risk of diabetes mellitus in middle-aged women. Endocr Rev. 2015;36:242–49.
Bergholdt HK, Bathum L, Kvetny J, Rasmussen DB, Moldow B, Hoeg T, et al. Study design, participation and characteristics of the Danish General Suburban Population Study. Dan Med J. 2013;60:A4693.
Bakker H, Jaddoe VW. Cardiovascular and metabolic influences of fetal smoke exposure. Eur J Epidemiol. 2011;26:763–70.
Taylor AE, Howe LD, Heron JE, Ware JJ, Hickman M, Munafo MR. Maternal smoking during pregnancy and offspring smoking initiation: assessing the role of intrauterine exposure. Addiction. 2014;109:1013–21.
Gao YJ, Holloway AC, Zeng ZH, Lim GE, Petrik JJ, Foster WG, et al. Prenatal exposure to nicotine causes postnatal obesity and altered perivascular adipose tissue function. Obes Res. 2005;13:687–92.
Newsome CA, Shiell AW, Fall CH, Phillips DI, Shier R, Law CM. Is birth weight related to later glucose and insulin metabolism?--A systematic review. Diabet Med. 2003;20:339–48.
Brion MJ, Leary SD, Lawlor DA, Smith GD, Ness AR. Modifiable maternal exposures and offspring blood pressure: a review of epidemiological studies of maternal age, diet, and smoking. Pediatr Res. 2008;63:593–8.
Dürmuş B, Kruithof CJ, Gillman MH, Willemsen SP, Hofman A, Raat H, et al. Parental smoking during pregnancy, early growth, and risk of obesity in preschool children: the Generation R Study–. Am J Clin Nutr. 2011;94:164–71.
Bruin JE, Gerstein HC, Holloway AC. Long-term consequences of fetal and neonatal nicotine exposure: a critical review. Toxicol Sci. 2010;116:364–74.
Lambers DS, Clark KE. The maternal and fetal physiologic effects of nicotine. Semin Perinatol. 1996;20:115–26.
McDonald SD, Walker M, Perkins S, Beyene J, Murphy K, Gibb W, et al. The effect of tobacco exposure on the fetal hypothalamic–pituitary–adrenal axis. BJOG: Int J Obstet Gynaecol. 2006;113:1289–95.
Oken E, Gillman MW. Fetal origins of obesity. Obes Res. 2003;11:496–506.
Breton CV, Byun HM, Wenten M, Pan F, Yang A, Gilliland FD. Prenatal tobacco smoke exposure affects global and gene-specific DNA methylation. Am J Respir Crit Care Med. 2009;180:462–7.
Joubert BR, Håberg SE, Nilsen RM, Wang X, Vollset SE, Murphy SK, et al. 450K epigenome-wide scan identifies differential DNA methylation in newborns related to maternal smoking during pregnancy. Environ Health Perspect. 2012;120:1425.
Taylor AE, Morris RW, Fluharty ME, Bjorngaard JH, Asvold BO, Gabrielsen ME, et al. Stratification by smoking status reveals an association of CHRNA5-A3-B4 genotype with body mass index in never smokers. PLoS Genet. 2014;10:e1004799.
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We thank librarian Paul Bain at the Countway Library of Medicine at Harvard Medical School for his assistance with crafting and implementing the literature search.
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Kataria, Y., Gaewsky, L. & Ellervik, C. Prenatal smoking exposure and cardio-metabolic risk factors in adulthood: a general population study and a meta-analysis. Int J Obes 43, 763–773 (2019). https://doi.org/10.1038/s41366-018-0206-y
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DOI: https://doi.org/10.1038/s41366-018-0206-y
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