Smoking during pregnancy and risk of abnormal glucose tolerance: a prospective cohort study

Abstract

BackgroundDisturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT.MethodsWe utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 mg/dL on the routine 1-hour glucose tolerance test (1-hr OGTT). We used multivariable regression to assess the effect of pre, early, and mid-pregnancy smoking on risk of AGT and screening plasma glucose value from the 1-hr OGTT.ResultsIn age-adjusted models, women who smoked > 0-9 cigarettes/day in pre-pregnancy had an increased risk of AGT (OR = 1.90; 95% CI 1.02-3.55) compared to non-smokers; this was attenuated in multivariable models. Smoking in early (OR = 0.48; 95% CI 0.21-1.10) and mid pregnancy (OR = 0.38; 95% CI 0.13-1.11) were not associated with AGT in multivariable models. Smoking during early and mid pregnancy were independently associated with lower glucose screening values, while smoking in pre-pregnancy was not.ConclusionsIn this prospective cohort of Hispanic women, we did not observe an association between smoking prior to or during pregnancy and risk of AGT. Findings from this study, although based on small numbers of cases, extend prior research to the Hispanic population.

Predictors of Gestational Weight Gain among White and Latina Women and Associations with Birth Weight

“…Furthermore, smoking status data was collected in the context of the first prenatal appointment and may be subject to social desirability bias and may only reflect smoking status at the first prenatal visit. However, the prevalence of smoking in our sample (19%) is consistent with smoking rates among White [ 2 , 3 , 32 , 33 ] and Latina pregnant women [ 43 ] in previous studies. Presence of gestational diabetes, shown to be associated with birth weight [ 44 , 45 ], was not controlled for.…”

Cigarette smoking and gestational diabetes mellitus in Hispanic woman

“…However, findings were not stratified by Hispanic ethnicity. In an earlier prospective cohort study at Baystate Medical Center, the Latina GDM Study, Haskins et al found the suggestion of a protective effect for smoking in early (OR=0.48, 95% CI 0.21–1.10) and mid (OR=0.38, 95% CI 0.13–1.11) pregnancy and risk of abnormal glucose tolerance (defined as exceeding 135 mg/dl on the routine 1-hour oral glucose tolerance screening test) which was not statistically significant [28]. To our knowledge this is the first study to evaluate the association between smoking and frank GDM in Hispanic women.…”

“…However, we did not have information on acculturation. While acculturation has been associated with smoking in nonpregnant women [29, 30], prior studies among the Baystate Medical Center Hispanic prenatal care population found no association between smoking and birthplace and language preference in this predominantly Puerto Rican Hispanic prenatal care population [28, 31]. …”

Parental smoking during pregnancy and offspring cardio-metabolic risk factors at ages 17 and 32

“…Prior studies have focused mostly on maternal smoking, rather than paternal smoking, and the associations of maternal smoking with offspring obesity 16,17 and blood pressure 18 . Evidence regarding the associations of parental smoking with other cardio-metabolic risk (CMR) traits is sparse 19–21 .…”