Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome

Lamm, Steven H.; Ferdosi, Hamid; Boroje, Isabella J.; Afari-Dwamena, Nana Ama; Qian, Lu; Dash, Elisabeth Dissen; Ji, Li Li; Chen, Rusan; Feinleib, Manning

doi:10.1016/j.pmedr.2020.101080

Cited by 13 publications

(11 citation statements)

References 23 publications

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“…Our results for birth weight are in line with previously published studies. Many studies, including the meta-analyses by Abraham et al, showed relationships of smoking during pregnancy with lower fetal measurements, including low birth weight (LBW), small-for-gestational age birth weight (SGA), and FGR [5,17,18,30,31]. Xaverius et al showed that the risk of low birth weight for quitting smoking before pregnancy was similar to that of never smokers [30].…”

Section: Discussionmentioning

confidence: 99%

“…Adverse birth outcomes have been associated not only with increased perinatal mortality and offspring neurodevelopmental disorders but also with long-term adverse health effects [1,3]. In particular, abnormal (low and high) birth weight has been associated with a higher risk of "non-communicable diseases" such as obesity/overweight or diabetes mellitus and cardiovascular diseases [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Although many studies have shown that neonates of smoking mothers have a lower birth weight [5,17], not everything has been clarified. Firstly, the effects of smoking cessation on birth weight have not been established [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Lewandowska

Więckowska

Sztorc

et al. 2020

JCM

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Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Lewandowska

Więckowska

Sztorc

et al. 2020

JCM

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“…Children with PTE have an increased risk for poorer physical health at birth, that is, lower birthweight, and small for gestational age (birthweight ≤ 10th percentile for gestational age; Chiolero et al, 2005; Lamm et al, 2020; Mitchell et al, 2007; Tong et al, 2017) and elevated rates of obesity (Chen et al, 2006) and asthma (Gilliland et al, 2001) later in childhood. PTE has also been linked to negative effects on breastfeeding, including high levels of nicotine in breastmilk, decreased breastmilk volume, and shorter duration of breastfeeding (for a review see Napierala et al, 2016).…”

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confidence: 99%

Prenatal tobacco exposure associations with physical health and neurodevelopment in the ABCD cohort.

Gonzalez¹,

Uban²,

Tapert³

2023

Health Psychology

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Objective: To investigate the strength and reproducibility of the teratogenic impact of prenatal tobacco exposure (PTE) on child physical health and neurodevelopmental outcomes, in the context of intersecting sociodemographic and other prenatal correlates, and test if early postnatal health mediates PTE associations with childhood outcomes. Method: Among 9–10-year-olds (N = 8,803) in the Adolescent Brain Cognitive Development Study, linear mixed-effect models tested PTE associations with birth and childhood outcomes of physical health, cognitive performance, and brain structure, controlling for confounding sociodemographic and prenatal health correlates. Mediation analysis tested the extent to which health at birth explained the associations between PTE and childhood outcomes. Results: PTE was reported by 12% of mothers (8% [n = 738] pre-knowledge of pregnancy only, and 4% [n = 361] pre- and post-knowledge of pregnancy). PTE was highest for children with a risk for passive smoke exposure. Overall, children with any PTE had shorter breastfeeding durations than those without PTE, and PTE following knowledge of pregnancy was associated with being small for gestational age having lower birth weight, and obesity and lower cortical volume and surface area in childhood. Among children from high-parent education households, any PTE was related to lower cognitive performance, which was partially mediated by duration of breastfeeding. Conclusions: PTE was linked to poorer health indicators at birth and neurodevelopmental outcomes at age 9–10 years in a large community cohort, independent of sociodemographic factors. Efficacious interventions for smoking-cessation during pregnancy are still needed and should incorporate support for breastfeeding to promote healthier development.

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“…Studies evaluating tobacco exposure based on the reported number of cigarettes smoked per day had shown an association between the time of smoking cessation during pregnancy and the risk of low birth weight or preterm delivery [30][31][32][33] . Compared to these publications, the contribution of our study is to have evaluated the exposure to smoking, active or passive, by the use of a biomarker the exhaled CO with a threshold value of exposure >3 ppm (sensitivity of 0.89) 25 associated with the declared number of cigarettes smoked per day.…”

Section: Effects Of Passive Smokingmentioning

confidence: 99%

Fetal growth restriction, low birth weight, and preterm birth: Effects of active or passive smoking evaluated by maternal expired CO at delivery, impacts of cessation at different trimesters

Delcroix-Gomez¹,

Delcroix²,

Jamee³

et al. 2022

Tob. Induc. Dis.

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INTRODUCTION The objectives of this study were to evaluate the effect of cessation of active smoking during the 1st, 2nd, and 3rd trimesters of pregnancy on the risk of reduced birth weight and prematurity using an exhaled carbon monoxide biomarker with a cut-off value ≥3 ppm as well as the effects of passive smoking. METHODS This was a multicenter prospective cohort study involving pregnant smokers and non-smokers. Pregnant smokers were identified at the first prenatal visit before 15 weeks of amenorrhea by the number of cigarettes smoked per day and by the carbon monoxide breath test. Women were classified into 6 groups: non-smokers, passive smokers, first trimester cessation, second trimester cessation, third trimester cessation, and smoking throughout pregnancy. Smoking cessation was defined if the pregnant woman reported quitting smoking and if she achieved an exhaled CO level of <3 ppm. The association between smoking cessation and fetal growth restriction or prematurity was assessed by multivariate logistic regression. Passive smoking was defined for non-smoking women on declarative smoking status and exhaled CO ≥3 ppm. The association between passive smoking and fetal growth restriction or prematurity was assessed by multivariate logistic regression. RESULTS The number of patients included was 5244. The incidence of fetal growth restriction below the 10th percentile was 10.6%, 12.1%, 8.5%, 9.1%, 21.1%, and 22.9%, respectively, for the non-smoking, passive smoking, first, second, third trimester cessation, and full-pregnancy smoking, groups. The risk of FGR compared to non-smokers was OR=2.3 (95% CI: 1.18–4.30, p=0.014) for patients who quit smoking in the third trimester, OR=2.5 (95% CI: 2.03–3.12, p<0.001) for women who smoked throughout pregnancy. After logistic regression, FGR (AOR=1.9; 95% CI: 0.96–3.82) for women who quit smoking in the 3rd trimester (AOR=1.8; 95% CI: 1.38–2.31, p<0.001). The risk of FGR <5th percentile was AOR=1.96 (95% CI: 1.36–2.48, p<0.001). CONCLUSIONS Active or passive smoking during pregnancy is associated with an increased risk of intrauterine growth restriction and low birth weight. Cessation in the 1st and 2nd trimester reduces the risk of intrauterine growth restriction or low birth weight. Passive smoking has a deleterious impact on fetal development, intermediate to that of active smoking.

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Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome

Cited by 13 publications

References 23 publications

Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Prenatal tobacco exposure associations with physical health and neurodevelopment in the ABCD cohort.

Fetal growth restriction, low birth weight, and preterm birth: Effects of active or passive smoking evaluated by maternal expired CO at delivery, impacts of cessation at different trimesters

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