TY - JOUR
T1 - Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America
T2 - An individual participant data meta-analysis of 229,000 singleton births
AU - Philips, Elise M.
AU - Santos, Susana
AU - Trasande, Leonardo
AU - Aurrekoetxea, Juan J.
AU - Barros, Henrique
AU - von Berg, Andrea
AU - Bergström, Anna
AU - Bird, Philippa K.
AU - Brescianini, Sonia
AU - Chaoimh, Carol Ni
AU - Charles, Marie-Aline
AU - Chatzi, Leda
AU - Chevrier, Cécile
AU - Chrousos, George P.
AU - Costet, Nathalie
AU - Criswell, Rachel
AU - Crozier, Sarah
AU - Eggesbo, Merete
AU - Fantini, Maria Pia
AU - Farchi, Sara
AU - Forastiere, Francesco
AU - van Gelder, Marleen M. H. J.
AU - Georgiu, Vagelis
AU - Godfrey, Keith M.
AU - Gori, Davide
AU - Hanke, Wojciech
AU - Heude, Barbara
AU - Hryhorczuk, Daniel
AU - Iñiguez, Carmen
AU - Inskip, Hazel
AU - Karvonen, Anne M.
AU - Kenny, Louise C.
AU - Kull, Inger
AU - Lawlor, Debbie A.
AU - Lehmann, Irina
AU - Magnus, Per
AU - Manios, Yannis
AU - Melén, Erik
AU - Mommers, Monique
AU - Morgen, Camilla S.
AU - Moschonis, George
AU - Murray, Deirdre
AU - Nohr, Ellen A.
AU - Nybo Andersen, Anne-Marie
AU - Oken, Emily
AU - Oostvogels, Adriëtte J. J. M.
AU - Papadopoulou, Eleni
AU - Pekkanen, Juha
AU - Pizzi, Costanza
AU - Polanska, Kinga
AU - Porta, Daniela
AU - Richiardi, Lorenzo
AU - Rifas-Shiman, Sheryl L.
AU - Roeleveld, Nel
AU - Rusconi, Franca
AU - Santos, Ana C.
AU - Sørensen, Thorkild I.A.
AU - Standl, Marie
AU - Stoltenberg, Camilla
AU - Sunyer, Jordi
AU - Thiering, Elisabeth
AU - Thijs, Carel
AU - Torrent, Maties
AU - Vrijkotte, Tanja G. M.
AU - Wright, John
AU - Zvinchuk, Oleksandr
AU - Gaillard, Romy
AU - Jaddoe, Vincent W. V.
PY - 2020
Y1 - 2020
N2 - Author summaryWhy was this study done? Maternal smoking during pregnancy is an important risk factor for various birth complications and childhood overweight. It is not clear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy. The associations of paternal smoking with birth and childhood outcomes also remain unknown. What did the researchers do and find? We conducted an individual participant data meta-analysis using data from 229,158 families from 28 pregnancy and birth cohorts from Europe and North America to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. We observed that smoking in the first trimester only did not increase the risk of preterm birth and small size for gestational age but was associated with a higher risk of childhood overweight, as compared to nonsmoking. Reducing the number of cigarettes during pregnancy, without quitting, was still associated with higher risks of these adverse outcomes. Paternal smoking seems to be associated, independently of maternal smoking, with the risks of childhood overweight. What do these findings mean? Population strategies should focus on parental smoking prevention before or at the start of, rather than during, pregnancy. Future studies are needed to assess the specific associations of smoking in the preconception and childhood periods with offspring outcomes.Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers' median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02-1.35],Pvalue = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02-1.15],Pvalue = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07-2.23],Pvalue <0.001), and childhood overweight (OR 1.42 [95% CI 1.35-1.48],Pvalue <0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52-2.34] instead of OR 2.20 [95% CI 2.02-2.42] when reducing from 5-9 to = 10 to 5-9 and
AB - Author summaryWhy was this study done? Maternal smoking during pregnancy is an important risk factor for various birth complications and childhood overweight. It is not clear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy. The associations of paternal smoking with birth and childhood outcomes also remain unknown. What did the researchers do and find? We conducted an individual participant data meta-analysis using data from 229,158 families from 28 pregnancy and birth cohorts from Europe and North America to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. We observed that smoking in the first trimester only did not increase the risk of preterm birth and small size for gestational age but was associated with a higher risk of childhood overweight, as compared to nonsmoking. Reducing the number of cigarettes during pregnancy, without quitting, was still associated with higher risks of these adverse outcomes. Paternal smoking seems to be associated, independently of maternal smoking, with the risks of childhood overweight. What do these findings mean? Population strategies should focus on parental smoking prevention before or at the start of, rather than during, pregnancy. Future studies are needed to assess the specific associations of smoking in the preconception and childhood periods with offspring outcomes.Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers' median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02-1.35],Pvalue = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02-1.15],Pvalue = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07-2.23],Pvalue <0.001), and childhood overweight (OR 1.42 [95% CI 1.35-1.48],Pvalue <0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52-2.34] instead of OR 2.20 [95% CI 2.02-2.42] when reducing from 5-9 to = 10 to 5-9 and
KW - MATERNAL SMOKING
KW - PRETERM BIRTH
KW - DNA METHYLATION
KW - ASSOCIATION
KW - WEIGHT
KW - GROWTH
KW - EXPOSURE
KW - CHILDREN
KW - CESSATION
KW - OBESITY
U2 - 10.1371/journal.pmed.1003182
DO - 10.1371/journal.pmed.1003182
M3 - Journal article
C2 - 32810184
VL - 17
JO - P L o S Medicine (Online)
JF - P L o S Medicine (Online)
SN - 1549-1277
IS - 8
M1 - e1003182
ER -