Maternal Smoking and Metabolic Health Biomarkers in Newborns

Abstract

BackgroundMaternal smoking has been associated with elevated risk of type 2 diabetes among the offspring in adulthood. The mechanisms underlying this fetal “programming” effect remain unclear. The present study sought to explore whether maternal smoking affects metabolic health biomarkers in fetuses/newborns.MethodsIn a prospective singleton pregnancy cohort (n = 248), we compared metabolic health biomarkers in the newborns of smoking and non-smoking mothers. Outcomes included cord plasma insulin, proinsulin, insulin-like growth factor I (IGF-I), IGF-II, leptin and adiponectin concentrations, glucose-to-insulin ratio (an indicator of insulin sensitivity) and proinsulin-to-insulin ratio (an indicator of β-cell function).ResultsIndependent of maternal (glucose tolerance, age, ethnicity, parity, education, body mass index, alcohol use) and infant (sex, gestational age, birth weight z score, mode of delivery, cord blood glucose concentration) characteristics, the newborns of smoking mothers had lower IGF-I concentrations (mean: 6.7 vs. 8.4 nmol/L, adjusted p = 0.006), and marginally higher proinsulin-to-insulin ratios (0.94 vs. 0.72, adjusted p = 0.06) than the newborns of non-smoking mothers. Cord plasma insulin, proinsulin, IGF-II, leptin and adiponectin concentrations and glucose-to-insulin ratios were similar in the newborns of smoking and non-smoking mothers.ConclusionsMaternal smoking was associated with decreased fetal IGF-I levels, and borderline lower fetal β-cell function. Larger cohort studies are required to confirm the latter finding. The preliminary findings prompt the hypothesis that these early life metabolic changes may be involved in the impact of maternal smoking on future risk of metabolic syndrome related disorders in the offspring.

Associations of maternal prenatal smoking with umbilical cord blood hormones: the Project Viva cohort

“…One study [10] found an association between prenatal smoking and higher IGF-1, although this was in a very small sample (n=62) without control for potential confounding variables. Also somewhat consistent with our results, in prior studies, prenatal smoking was not associated with IGF-2 [14, 22] and was inversely associated with IGFBP-3 [16, 22]. …”

“…Most have shown an association between prenatal smoking and lower IGF-1 [11, 13, 14, 16, 22], consistent with our findings. One study [10] found an association between prenatal smoking and higher IGF-1, although this was in a very small sample (n=62) without control for potential confounding variables.…”

“…Consistent with this, in in vitro models, low IGF-1 impairs pancreatic beta cell formation, presumably due to structural similarity and cross-talk between IGF-1 and insulin [35]. In one study [14], prenatal smoking was associated with lower IGF-1 and higher proinsulin-to-insulin ratio in the cord blood, raising the possibility that lower intrauterine IGF-1 from smoking may impair beta cell function. To better elucidate these relationships, future studies should consider the full pathway from prenatal smoking, to cord blood hormone profile, to later cardiometabolic health.…”

Smoking-Induced Changes in the Maternal Immune, Endocrine, and Metabolic Pathways and Their Impact on Fetal Growth: A Topical Review

“…Furthermore, maternal serum human placental lactogen, β-human chorionic gonadotropin, and placental growth hormone levels are negatively correlated with the number of cigarettes smoked per day [28] . Cord plasma concentrations of insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 were lower in fetuses of smoking mothers [29] . All these hormones interplay to ensure fetal growth; hence, any factor affecting the balanced cross talk may result in FGR through the increased risk of preterm labor and impaired placental function.…”

Serum adiponectin concentration in healthy, eutrophic full-term neonates born by cesarean section

“…Stężenie adiponektyny w krwi pępowinowej noworodków matek chorych na cukrzycę, podobnie inne patologie ciąży, jak stan przedrzucawkowy, nie wpływają na stęże-nie adiponektyny u noworodka niezależnie od wystąpienia małej urodzeniowej mc [21]. Stosowanie diety śródziemnomorskiej oraz ilość spożywanej energii przez kobietę ciężarną, a także palenie papierosów w ciąży nie zmieniają istotnie stężenia adiponektyny w krwi pępowinowej noworodka [22,23]. Jedynymi dotychczas publikowanymi wynikami badań wpływu porodu zabiegowego (cięcie cesarskie planowe i nagłe) na stężenia adiponektyny u noworodków są badania Logana i wsp.…”