Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births
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 preg...
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| creator | Philips, Elise M Santos, Susana Trasande, Leonardo Aurrekoetxea, Juan J Barros, Henrique von Berg, Andrea Bergström, Anna Bird, Philippa K Brescianini, Sonia Chaoimh, Carol Ní Charles, Marie-Aline Chatzi, Leda Chevrier, Cécile Chrousos, George P Costet, Nathalie Criswell, Rachel Louise Crozier, Sarah Eggesbø, Merete Åse Fantini, Maria Pia Farchi, Sara Forastiere, Francesco van Gelder, Marleen M.H.J Georgiu, Vagelis Godfrey, Keith M Gori, Davide Hanke, Wojciech Heude, Barbara Hryhorczuk, Daniel Iñiguez, Carmen Inskip, Hazel M Karvonen, Anne M Kenny, Louise C Kull, Inger Lawlor, Debbie A Lehmann, Irina Magnus, Per Manios, Yannis Melén, Erik Mommers, Monique Morgen, Camilla Schmidt Moschonis, George Murray, Deirdre Nohr, Ellen A Nybo Andersen, Anne-Marie Oken, Emily Oostvogels, Adriëtte J.J.M Papadopoulou, Eleni Zoumpoulia Pekkanen, Juha Pizzi, Costanza Polanska, Kinga Porta, Daniela Richiardi, Lorenzo Rifas-Shiman, Sheryl L Roeleveld, Nel Rusconi, Franca Santos, Ana C Sørensen, Thorkild I.A Standl, Marie Stoltenberg, Camilla Sunyer, Jordi Thiering, Elisabeth Thijs, Carel Torrent, Maties Vrijkotte, Tanja G.M Wright, John Zvinchuk, Oleksandr Gaillard, Romy Jaddoe, Vincent W.V |
| description | 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], P value = 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], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 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 ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [9 |
| format | Article |
| fullrecord | <record><control><sourceid>cristin_3HK</sourceid><recordid>TN_cdi_cristin_nora_11250_2729274</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>11250_2729274</sourcerecordid><originalsourceid>FETCH-cristin_nora_11250_27292743</originalsourceid><addsrcrecordid>eNqNjjFOA0EMRbehQIE7mJ5ImwEUhS6KElFR0a_MjLNjZdZezXiDckquxGzgAFS_8Pv-77b53kWUngqwwIiZxDBBGfTE0kOY8hxjpl5Q_AVQAmQupwJ6BAxnyoXgk7NF0Mm8DvXRzPjIKUTVAFqZL-I-2rywn7KOdEXedW5tB8rs8RW2Uu-BzxymKlBNjD2PKAYBDWEgwyUKpkvh67hzm8e2baFUwUSm8qtR7pqbI6ZC93-5aB4O-4_d29JXb2PpRDN2q5V7aTu3dhu3fn76D_MDdXRlJQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births</title><source>NORA - Norwegian Open Research Archives</source><creator>Philips, Elise M ; Santos, Susana ; Trasande, Leonardo ; Aurrekoetxea, Juan J ; Barros, Henrique ; von Berg, Andrea ; Bergström, Anna ; Bird, Philippa K ; Brescianini, Sonia ; Chaoimh, Carol Ní ; Charles, Marie-Aline ; Chatzi, Leda ; Chevrier, Cécile ; Chrousos, George P ; Costet, Nathalie ; Criswell, Rachel Louise ; Crozier, Sarah ; Eggesbø, Merete Åse ; Fantini, Maria Pia ; Farchi, Sara ; Forastiere, Francesco ; van Gelder, Marleen M.H.J ; Georgiu, Vagelis ; Godfrey, Keith M ; Gori, Davide ; Hanke, Wojciech ; Heude, Barbara ; Hryhorczuk, Daniel ; Iñiguez, Carmen ; Inskip, Hazel M ; Karvonen, Anne M ; Kenny, Louise C ; Kull, Inger ; Lawlor, Debbie A ; Lehmann, Irina ; Magnus, Per ; Manios, Yannis ; Melén, Erik ; Mommers, Monique ; Morgen, Camilla Schmidt ; Moschonis, George ; Murray, Deirdre ; Nohr, Ellen A ; Nybo Andersen, Anne-Marie ; Oken, Emily ; Oostvogels, Adriëtte J.J.M ; Papadopoulou, Eleni Zoumpoulia ; Pekkanen, Juha ; Pizzi, Costanza ; Polanska, Kinga ; Porta, Daniela ; Richiardi, Lorenzo ; Rifas-Shiman, Sheryl L ; Roeleveld, Nel ; Rusconi, Franca ; Santos, Ana C ; Sørensen, Thorkild I.A ; Standl, Marie ; Stoltenberg, Camilla ; Sunyer, Jordi ; Thiering, Elisabeth ; Thijs, Carel ; Torrent, Maties ; Vrijkotte, Tanja G.M ; Wright, John ; Zvinchuk, Oleksandr ; Gaillard, Romy ; Jaddoe, Vincent W.V</creator><creatorcontrib>Philips, Elise M ; Santos, Susana ; Trasande, Leonardo ; Aurrekoetxea, Juan J ; Barros, Henrique ; von Berg, Andrea ; Bergström, Anna ; Bird, Philippa K ; Brescianini, Sonia ; Chaoimh, Carol Ní ; Charles, Marie-Aline ; Chatzi, Leda ; Chevrier, Cécile ; Chrousos, George P ; Costet, Nathalie ; Criswell, Rachel Louise ; Crozier, Sarah ; Eggesbø, Merete Åse ; Fantini, Maria Pia ; Farchi, Sara ; Forastiere, Francesco ; van Gelder, Marleen M.H.J ; Georgiu, Vagelis ; Godfrey, Keith M ; Gori, Davide ; Hanke, Wojciech ; Heude, Barbara ; Hryhorczuk, Daniel ; Iñiguez, Carmen ; Inskip, Hazel M ; Karvonen, Anne M ; Kenny, Louise C ; Kull, Inger ; Lawlor, Debbie A ; Lehmann, Irina ; Magnus, Per ; Manios, Yannis ; Melén, Erik ; Mommers, Monique ; Morgen, Camilla Schmidt ; Moschonis, George ; Murray, Deirdre ; Nohr, Ellen A ; Nybo Andersen, Anne-Marie ; Oken, Emily ; Oostvogels, Adriëtte J.J.M ; Papadopoulou, Eleni Zoumpoulia ; Pekkanen, Juha ; Pizzi, Costanza ; Polanska, Kinga ; Porta, Daniela ; Richiardi, Lorenzo ; Rifas-Shiman, Sheryl L ; Roeleveld, Nel ; Rusconi, Franca ; Santos, Ana C ; Sørensen, Thorkild I.A ; Standl, Marie ; Stoltenberg, Camilla ; Sunyer, Jordi ; Thiering, Elisabeth ; Thijs, Carel ; Torrent, Maties ; Vrijkotte, Tanja G.M ; Wright, John ; Zvinchuk, Oleksandr ; Gaillard, Romy ; Jaddoe, Vincent W.V</creatorcontrib><description>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], P value = 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], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 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 ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations.
Conclusions
We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy.</description><language>eng</language><publisher>PLOS</publisher><creationdate>2020</creationdate><rights>info:eu-repo/semantics/openAccess</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,776,881,26544</link.rule.ids><linktorsrc>$$Uhttp://hdl.handle.net/11250/2729274$$EView_record_in_NORA$$FView_record_in_$$GNORA$$Hfree_for_read</linktorsrc></links><search><creatorcontrib>Philips, Elise M</creatorcontrib><creatorcontrib>Santos, Susana</creatorcontrib><creatorcontrib>Trasande, Leonardo</creatorcontrib><creatorcontrib>Aurrekoetxea, Juan J</creatorcontrib><creatorcontrib>Barros, Henrique</creatorcontrib><creatorcontrib>von Berg, Andrea</creatorcontrib><creatorcontrib>Bergström, Anna</creatorcontrib><creatorcontrib>Bird, Philippa K</creatorcontrib><creatorcontrib>Brescianini, Sonia</creatorcontrib><creatorcontrib>Chaoimh, Carol Ní</creatorcontrib><creatorcontrib>Charles, Marie-Aline</creatorcontrib><creatorcontrib>Chatzi, Leda</creatorcontrib><creatorcontrib>Chevrier, Cécile</creatorcontrib><creatorcontrib>Chrousos, George P</creatorcontrib><creatorcontrib>Costet, Nathalie</creatorcontrib><creatorcontrib>Criswell, Rachel Louise</creatorcontrib><creatorcontrib>Crozier, Sarah</creatorcontrib><creatorcontrib>Eggesbø, Merete Åse</creatorcontrib><creatorcontrib>Fantini, Maria Pia</creatorcontrib><creatorcontrib>Farchi, Sara</creatorcontrib><creatorcontrib>Forastiere, Francesco</creatorcontrib><creatorcontrib>van Gelder, Marleen M.H.J</creatorcontrib><creatorcontrib>Georgiu, Vagelis</creatorcontrib><creatorcontrib>Godfrey, Keith M</creatorcontrib><creatorcontrib>Gori, Davide</creatorcontrib><creatorcontrib>Hanke, Wojciech</creatorcontrib><creatorcontrib>Heude, Barbara</creatorcontrib><creatorcontrib>Hryhorczuk, Daniel</creatorcontrib><creatorcontrib>Iñiguez, Carmen</creatorcontrib><creatorcontrib>Inskip, Hazel M</creatorcontrib><creatorcontrib>Karvonen, Anne M</creatorcontrib><creatorcontrib>Kenny, Louise C</creatorcontrib><creatorcontrib>Kull, Inger</creatorcontrib><creatorcontrib>Lawlor, Debbie A</creatorcontrib><creatorcontrib>Lehmann, Irina</creatorcontrib><creatorcontrib>Magnus, Per</creatorcontrib><creatorcontrib>Manios, Yannis</creatorcontrib><creatorcontrib>Melén, Erik</creatorcontrib><creatorcontrib>Mommers, Monique</creatorcontrib><creatorcontrib>Morgen, Camilla Schmidt</creatorcontrib><creatorcontrib>Moschonis, George</creatorcontrib><creatorcontrib>Murray, Deirdre</creatorcontrib><creatorcontrib>Nohr, Ellen A</creatorcontrib><creatorcontrib>Nybo Andersen, Anne-Marie</creatorcontrib><creatorcontrib>Oken, Emily</creatorcontrib><creatorcontrib>Oostvogels, Adriëtte J.J.M</creatorcontrib><creatorcontrib>Papadopoulou, Eleni Zoumpoulia</creatorcontrib><creatorcontrib>Pekkanen, Juha</creatorcontrib><creatorcontrib>Pizzi, Costanza</creatorcontrib><creatorcontrib>Polanska, Kinga</creatorcontrib><creatorcontrib>Porta, Daniela</creatorcontrib><creatorcontrib>Richiardi, Lorenzo</creatorcontrib><creatorcontrib>Rifas-Shiman, Sheryl L</creatorcontrib><creatorcontrib>Roeleveld, Nel</creatorcontrib><creatorcontrib>Rusconi, Franca</creatorcontrib><creatorcontrib>Santos, Ana C</creatorcontrib><creatorcontrib>Sørensen, Thorkild I.A</creatorcontrib><creatorcontrib>Standl, Marie</creatorcontrib><creatorcontrib>Stoltenberg, Camilla</creatorcontrib><creatorcontrib>Sunyer, Jordi</creatorcontrib><creatorcontrib>Thiering, Elisabeth</creatorcontrib><creatorcontrib>Thijs, Carel</creatorcontrib><creatorcontrib>Torrent, Maties</creatorcontrib><creatorcontrib>Vrijkotte, Tanja G.M</creatorcontrib><creatorcontrib>Wright, John</creatorcontrib><creatorcontrib>Zvinchuk, Oleksandr</creatorcontrib><creatorcontrib>Gaillard, Romy</creatorcontrib><creatorcontrib>Jaddoe, Vincent W.V</creatorcontrib><title>Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births</title><description>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], P value = 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], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 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 ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations.
Conclusions
We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy.</description><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>3HK</sourceid><recordid>eNqNjjFOA0EMRbehQIE7mJ5ImwEUhS6KElFR0a_MjLNjZdZezXiDckquxGzgAFS_8Pv-77b53kWUngqwwIiZxDBBGfTE0kOY8hxjpl5Q_AVQAmQupwJ6BAxnyoXgk7NF0Mm8DvXRzPjIKUTVAFqZL-I-2rywn7KOdEXedW5tB8rs8RW2Uu-BzxymKlBNjD2PKAYBDWEgwyUKpkvh67hzm8e2baFUwUSm8qtR7pqbI6ZC93-5aB4O-4_d29JXb2PpRDN2q5V7aTu3dhu3fn76D_MDdXRlJQ</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Philips, Elise M</creator><creator>Santos, Susana</creator><creator>Trasande, Leonardo</creator><creator>Aurrekoetxea, Juan J</creator><creator>Barros, Henrique</creator><creator>von Berg, Andrea</creator><creator>Bergström, Anna</creator><creator>Bird, Philippa K</creator><creator>Brescianini, Sonia</creator><creator>Chaoimh, Carol Ní</creator><creator>Charles, Marie-Aline</creator><creator>Chatzi, Leda</creator><creator>Chevrier, Cécile</creator><creator>Chrousos, George P</creator><creator>Costet, Nathalie</creator><creator>Criswell, Rachel Louise</creator><creator>Crozier, Sarah</creator><creator>Eggesbø, Merete Åse</creator><creator>Fantini, Maria Pia</creator><creator>Farchi, Sara</creator><creator>Forastiere, Francesco</creator><creator>van Gelder, Marleen M.H.J</creator><creator>Georgiu, Vagelis</creator><creator>Godfrey, Keith M</creator><creator>Gori, Davide</creator><creator>Hanke, Wojciech</creator><creator>Heude, Barbara</creator><creator>Hryhorczuk, Daniel</creator><creator>Iñiguez, Carmen</creator><creator>Inskip, Hazel M</creator><creator>Karvonen, Anne M</creator><creator>Kenny, Louise C</creator><creator>Kull, Inger</creator><creator>Lawlor, Debbie A</creator><creator>Lehmann, Irina</creator><creator>Magnus, Per</creator><creator>Manios, Yannis</creator><creator>Melén, Erik</creator><creator>Mommers, Monique</creator><creator>Morgen, Camilla Schmidt</creator><creator>Moschonis, George</creator><creator>Murray, Deirdre</creator><creator>Nohr, Ellen A</creator><creator>Nybo Andersen, Anne-Marie</creator><creator>Oken, Emily</creator><creator>Oostvogels, Adriëtte J.J.M</creator><creator>Papadopoulou, Eleni Zoumpoulia</creator><creator>Pekkanen, Juha</creator><creator>Pizzi, Costanza</creator><creator>Polanska, Kinga</creator><creator>Porta, Daniela</creator><creator>Richiardi, Lorenzo</creator><creator>Rifas-Shiman, Sheryl L</creator><creator>Roeleveld, Nel</creator><creator>Rusconi, Franca</creator><creator>Santos, Ana C</creator><creator>Sørensen, Thorkild I.A</creator><creator>Standl, Marie</creator><creator>Stoltenberg, Camilla</creator><creator>Sunyer, Jordi</creator><creator>Thiering, Elisabeth</creator><creator>Thijs, Carel</creator><creator>Torrent, Maties</creator><creator>Vrijkotte, Tanja G.M</creator><creator>Wright, John</creator><creator>Zvinchuk, Oleksandr</creator><creator>Gaillard, Romy</creator><creator>Jaddoe, Vincent W.V</creator><general>PLOS</general><scope>3HK</scope></search><sort><creationdate>2020</creationdate><title>Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births</title><author>Philips, Elise M ; Santos, Susana ; Trasande, Leonardo ; Aurrekoetxea, Juan J ; Barros, Henrique ; von Berg, Andrea ; Bergström, Anna ; Bird, Philippa K ; Brescianini, Sonia ; Chaoimh, Carol Ní ; Charles, Marie-Aline ; Chatzi, Leda ; Chevrier, Cécile ; Chrousos, George P ; Costet, Nathalie ; Criswell, Rachel Louise ; Crozier, Sarah ; Eggesbø, Merete Åse ; Fantini, Maria Pia ; Farchi, Sara ; Forastiere, Francesco ; van Gelder, Marleen M.H.J ; Georgiu, Vagelis ; Godfrey, Keith M ; Gori, Davide ; Hanke, Wojciech ; Heude, Barbara ; Hryhorczuk, Daniel ; Iñiguez, Carmen ; Inskip, Hazel M ; Karvonen, Anne M ; Kenny, Louise C ; Kull, Inger ; Lawlor, Debbie A ; Lehmann, Irina ; Magnus, Per ; Manios, Yannis ; Melén, Erik ; Mommers, Monique ; Morgen, Camilla Schmidt ; Moschonis, George ; Murray, Deirdre ; Nohr, Ellen A ; Nybo Andersen, Anne-Marie ; Oken, Emily ; Oostvogels, Adriëtte J.J.M ; Papadopoulou, Eleni Zoumpoulia ; Pekkanen, Juha ; Pizzi, Costanza ; Polanska, Kinga ; Porta, Daniela ; Richiardi, Lorenzo ; Rifas-Shiman, Sheryl L ; Roeleveld, Nel ; Rusconi, Franca ; Santos, Ana C ; Sørensen, Thorkild I.A ; Standl, Marie ; Stoltenberg, Camilla ; Sunyer, Jordi ; Thiering, Elisabeth ; Thijs, Carel ; Torrent, Maties ; Vrijkotte, Tanja G.M ; Wright, John ; Zvinchuk, Oleksandr ; Gaillard, Romy ; Jaddoe, Vincent W.V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-cristin_nora_11250_27292743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Philips, Elise M</creatorcontrib><creatorcontrib>Santos, Susana</creatorcontrib><creatorcontrib>Trasande, Leonardo</creatorcontrib><creatorcontrib>Aurrekoetxea, Juan J</creatorcontrib><creatorcontrib>Barros, Henrique</creatorcontrib><creatorcontrib>von Berg, Andrea</creatorcontrib><creatorcontrib>Bergström, Anna</creatorcontrib><creatorcontrib>Bird, Philippa K</creatorcontrib><creatorcontrib>Brescianini, Sonia</creatorcontrib><creatorcontrib>Chaoimh, Carol Ní</creatorcontrib><creatorcontrib>Charles, Marie-Aline</creatorcontrib><creatorcontrib>Chatzi, Leda</creatorcontrib><creatorcontrib>Chevrier, Cécile</creatorcontrib><creatorcontrib>Chrousos, George P</creatorcontrib><creatorcontrib>Costet, Nathalie</creatorcontrib><creatorcontrib>Criswell, Rachel Louise</creatorcontrib><creatorcontrib>Crozier, Sarah</creatorcontrib><creatorcontrib>Eggesbø, Merete Åse</creatorcontrib><creatorcontrib>Fantini, Maria Pia</creatorcontrib><creatorcontrib>Farchi, Sara</creatorcontrib><creatorcontrib>Forastiere, Francesco</creatorcontrib><creatorcontrib>van Gelder, Marleen M.H.J</creatorcontrib><creatorcontrib>Georgiu, Vagelis</creatorcontrib><creatorcontrib>Godfrey, Keith M</creatorcontrib><creatorcontrib>Gori, Davide</creatorcontrib><creatorcontrib>Hanke, Wojciech</creatorcontrib><creatorcontrib>Heude, Barbara</creatorcontrib><creatorcontrib>Hryhorczuk, Daniel</creatorcontrib><creatorcontrib>Iñiguez, Carmen</creatorcontrib><creatorcontrib>Inskip, Hazel M</creatorcontrib><creatorcontrib>Karvonen, Anne M</creatorcontrib><creatorcontrib>Kenny, Louise C</creatorcontrib><creatorcontrib>Kull, Inger</creatorcontrib><creatorcontrib>Lawlor, Debbie A</creatorcontrib><creatorcontrib>Lehmann, Irina</creatorcontrib><creatorcontrib>Magnus, Per</creatorcontrib><creatorcontrib>Manios, Yannis</creatorcontrib><creatorcontrib>Melén, Erik</creatorcontrib><creatorcontrib>Mommers, Monique</creatorcontrib><creatorcontrib>Morgen, Camilla Schmidt</creatorcontrib><creatorcontrib>Moschonis, George</creatorcontrib><creatorcontrib>Murray, Deirdre</creatorcontrib><creatorcontrib>Nohr, Ellen A</creatorcontrib><creatorcontrib>Nybo Andersen, Anne-Marie</creatorcontrib><creatorcontrib>Oken, Emily</creatorcontrib><creatorcontrib>Oostvogels, Adriëtte J.J.M</creatorcontrib><creatorcontrib>Papadopoulou, Eleni Zoumpoulia</creatorcontrib><creatorcontrib>Pekkanen, Juha</creatorcontrib><creatorcontrib>Pizzi, Costanza</creatorcontrib><creatorcontrib>Polanska, Kinga</creatorcontrib><creatorcontrib>Porta, Daniela</creatorcontrib><creatorcontrib>Richiardi, Lorenzo</creatorcontrib><creatorcontrib>Rifas-Shiman, Sheryl L</creatorcontrib><creatorcontrib>Roeleveld, Nel</creatorcontrib><creatorcontrib>Rusconi, Franca</creatorcontrib><creatorcontrib>Santos, Ana C</creatorcontrib><creatorcontrib>Sørensen, Thorkild I.A</creatorcontrib><creatorcontrib>Standl, Marie</creatorcontrib><creatorcontrib>Stoltenberg, Camilla</creatorcontrib><creatorcontrib>Sunyer, Jordi</creatorcontrib><creatorcontrib>Thiering, Elisabeth</creatorcontrib><creatorcontrib>Thijs, Carel</creatorcontrib><creatorcontrib>Torrent, Maties</creatorcontrib><creatorcontrib>Vrijkotte, Tanja G.M</creatorcontrib><creatorcontrib>Wright, John</creatorcontrib><creatorcontrib>Zvinchuk, Oleksandr</creatorcontrib><creatorcontrib>Gaillard, Romy</creatorcontrib><creatorcontrib>Jaddoe, Vincent W.V</creatorcontrib><collection>NORA - Norwegian Open Research Archives</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Philips, Elise M</au><au>Santos, Susana</au><au>Trasande, Leonardo</au><au>Aurrekoetxea, Juan J</au><au>Barros, Henrique</au><au>von Berg, Andrea</au><au>Bergström, Anna</au><au>Bird, Philippa K</au><au>Brescianini, Sonia</au><au>Chaoimh, Carol Ní</au><au>Charles, Marie-Aline</au><au>Chatzi, Leda</au><au>Chevrier, Cécile</au><au>Chrousos, George P</au><au>Costet, Nathalie</au><au>Criswell, Rachel Louise</au><au>Crozier, Sarah</au><au>Eggesbø, Merete Åse</au><au>Fantini, Maria Pia</au><au>Farchi, Sara</au><au>Forastiere, Francesco</au><au>van Gelder, Marleen M.H.J</au><au>Georgiu, Vagelis</au><au>Godfrey, Keith M</au><au>Gori, Davide</au><au>Hanke, Wojciech</au><au>Heude, Barbara</au><au>Hryhorczuk, Daniel</au><au>Iñiguez, Carmen</au><au>Inskip, Hazel M</au><au>Karvonen, Anne M</au><au>Kenny, Louise C</au><au>Kull, Inger</au><au>Lawlor, Debbie A</au><au>Lehmann, Irina</au><au>Magnus, Per</au><au>Manios, Yannis</au><au>Melén, Erik</au><au>Mommers, Monique</au><au>Morgen, Camilla Schmidt</au><au>Moschonis, George</au><au>Murray, Deirdre</au><au>Nohr, Ellen A</au><au>Nybo Andersen, Anne-Marie</au><au>Oken, Emily</au><au>Oostvogels, Adriëtte J.J.M</au><au>Papadopoulou, Eleni Zoumpoulia</au><au>Pekkanen, Juha</au><au>Pizzi, Costanza</au><au>Polanska, Kinga</au><au>Porta, Daniela</au><au>Richiardi, Lorenzo</au><au>Rifas-Shiman, Sheryl L</au><au>Roeleveld, Nel</au><au>Rusconi, Franca</au><au>Santos, Ana C</au><au>Sørensen, Thorkild I.A</au><au>Standl, Marie</au><au>Stoltenberg, Camilla</au><au>Sunyer, Jordi</au><au>Thiering, Elisabeth</au><au>Thijs, Carel</au><au>Torrent, Maties</au><au>Vrijkotte, Tanja G.M</au><au>Wright, John</au><au>Zvinchuk, Oleksandr</au><au>Gaillard, Romy</au><au>Jaddoe, Vincent W.V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births</atitle><date>2020</date><risdate>2020</risdate><abstract>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], P value = 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], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 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 ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations.
Conclusions
We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy.</abstract><pub>PLOS</pub><oa>free_for_read</oa></addata></record> |
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| title | Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births |
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