Prenatal environmental tobacco smoke exposure and early childhood body mass index

• Type of Material: Article
• Authors: Joe M. Braun, University of North Carolina; Julie L. Daniels, University of North Carolina; Charles Poole, University of North Carolina; Andrew F. Olshan, University of North Carolina; Richard Hornung, Cincinnati Children's Hospital Medical Center; John T. Bernert, Centers for Disease Control and Prevention; Jane Khoury, Cincinnati Children's Hospital Medical Center; Larry L. Needham, Centers for Disease Control and Prevention; Dana Barr, Emory University; Bruce P. Lanphear, Cincinnati Children's Hospital Medical Center
• Language: English
• Date: 2010-11-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 Blackwell Publishing Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1365-3016.2010.01146.x
• Title of Journal or Parent Work: Paediatric and Perinatal Epidemiology
• ISSN: 0269-5022
• Volume: 24
• Issue: 6
• Start Page: 524
• End Page: 534
• Grant/Funding Information: This study was supported by the NICHD Reproductive, Perinatal, and Pediatric Epidemiology Training Grant (T32-HD052468-01), a grant from the National Institute of Environmental Health Sciences (P30ES10126), and from a Children’s Environmental Health Center Grant from the National Institute of Environmental Health Sciences and the US Environmental Protection Agency (PO1 ES11261).
• Keywords: misclassification; maternal prenatal smoking; childhood body mass index; ADULT OBESITY; Pediatrics; maternal prenatal environmental tobacco smoke; ADIPOSITY; serum continine; MATERNAL SMOKING; Science & Technology; SERUM COTININE; OVERWEIGHT; CHILDREN; PREGNANT-WOMEN; Life Sciences & Biomedicine; Obstetrics & Gynecology; BIRTH COHORT; DISEASE; DEVELOPMENTAL ORIGINS; Public, Environmental & Occupational Health
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Maternal smoking during pregnancy is associated with increased risk of childhood overweight body mass index (BMI). Less is known about the association between prenatal secondhand tobacco smoke (SHS) exposure and childhood BMI. We followed 292 mother-child dyads from early pregnancy to 3 years of age. Prenatal tobacco smoke exposure during pregnancy was quantified using self-report and serum cotinine biomarkers. We used linear mixed models to estimate the association between tobacco smoke exposure and BMI at birth, 4 weeks, and 1, 2 and 3 years. During pregnancy, 15% of women reported SHS exposure and 12% reported active smoking, but 51% of women had cotinine levels consistent with SHS exposure and 10% had cotinine concentrations indicative of active smoking. After adjustment for confounders, children born to active smokers (self-report or serum cotinine) had higher BMI at 2 and 3 years of age, compared with unexposed children. Children born to women with prenatal serum cotinine concentrations indicative of SHS exposure had higher BMI at 2 (mean difference [MD] 0.3 [95% confidence interval -0.1, 0.7]) and 3 (MD 0.4 [0, 0.8]) years compared with unexposed children. Using self-reported prenatal exposure resulted in non-differential exposure misclassification of SHS exposures that attenuated the association between SHS exposure and BMI compared with serum cotinine concentrations. These findings suggest active and secondhand prenatal tobacco smoke exposure may be related to an important public health problem in childhood and later life. In addition, accurate quantification of prenatal secondhand tobacco smoke exposures is essential to obtaining valid estimates.