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

Philips, Elise M.; Santos, Susana; Trasande, Leonardo; Aurrekoetxea, Juan José; Barros, Henrique; Berg, Andrea von; Bergström, Anna; Bird, Philippa K; Brescianini, Sonia; Chaoimh, Carol Ní; Munier, Charles; Chatzi, Leda; Chevrier, Cécile; Chrousos, George P.; Costet, Nathalie; Criswell, Rachel; Crozier, Sarah; Eggesbø, Merete; Fantini, Maria Pia; Farchi, Sara; Forastiére, Francesco; Gelder, Marleen M.H.J. van; Georgiu, Vagelis; Godfrey, Keith M.; Gori, Davide; Hanke, Wojciech; Heude, Barbara; Hryhorczuk, Daniel; Íñiguez, Carmen; Inskip, Hazel; Karvonen, Anne M.; Kenny, Louise C.; Kull, Inger; Lawlor, Debbie A.; Lehmann, Irina; Magnus, Per; Μanios, Yannis; Melén, Erik; Mommers, Monique; Morgen, Camilla Schmidt; Moschonis, George; Murray, Deirdre M.; Nøhr, Ellen Aagaard; Andersen, Anne‐Marie Nybo; Oken, Emily; Oostvogels, Adriëtte J. J. M.; Papadopoulou, Eleni; Pekkanen, Juha; Pizzi, Costanza; Polańska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Rifas‐Shiman, Sheryl L.; Roeleveld, Nel; Rusconi, Franca; Santos, Ana Cristina; Sørensen, Thorkild I A; Standl, Marie; Stoltenberg, Camilla; Sunyer, Jordi; Thiering, Elisabeth; Thijs, Carel; Torrent, Maties; Vrijkotte, Tanja G. M.; Wright, John; Звінчук, Олександр; Gaillard, Romy; Jaddoe, Vincent W. V.

doi:10.1371/journal.pmed.1003182

Cited by 65 publications

(55 citation statements)

References 54 publications

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“…Women smoking tobacco during pregnancy are more likely to experience pneumonia, influenza, bronchitis, and myocardial infection than non-smoking pregnant women. They are also more likely to experience pregnancy complications such as ectopic pregnancy, placenta prævia, intrauterine growth restriction, and delivery issues including preterm birth [ 15 , 16 , 17 , 18 , 19 ]. However, maternal tobacco smoking during pregnancy has been consistently associated with lower risks of pre-eclampsia, probably through vascular protective effects of carbon monoxide [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review

Nakamura

Ochsenbein

Lepeule

2021

IJERPH

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In utero exposure to maternal tobacco smoking is the leading cause of birth complications in addition to being associated with later impairment in child’s development. Epigenetic alterations, such as DNA methylation (DNAm), miRNAs expression, and histone modifications, belong to possible underlying mechanisms linking maternal tobacco smoking during pregnancy and adverse birth outcomes and later child’s development. The aims of this review were to provide an update on (1) the main results of epidemiological studies on the impact of in utero exposure to maternal tobacco smoking on epigenetic mechanisms, and (2) the technical issues and methods used in such studies. In contrast with miRNA and histone modifications, DNAm has been the most extensively studied epigenetic mechanism with regard to in utero exposure to maternal tobacco smoking. Most studies relied on cord blood and children’s blood, but placenta is increasingly recognized as a powerful tool, especially for markers of pregnancy exposures. Some recent studies suggest reversibility in DNAm in certain genomic regions as well as memory of smoking exposure in DNAm in other regions, upon smoking cessation before or during pregnancy. Furthermore, reversibility could be more pronounced in miRNA expression compared to DNAm. Increasing evidence based on longitudinal data shows that maternal smoking-associated DNAm changes persist during childhood. In this review, we also discuss some issues related to cell heterogeneity as well as downstream statistical analyses used to relate maternal tobacco smoking during pregnancy and epigenetics. The epigenetic effects of maternal smoking during pregnancy have been among the most widely investigated in the epigenetic epidemiology field. However, there are still huge gaps to fill in, including on the impact on miRNA expression and histone modifications to get a better view of the whole epigenetic machinery. The consistency of maternal tobacco smoking effects across epigenetic marks and across tissues will also provide crucial information for future studies. Advancement in bioinformatic and biostatistics approaches is key to develop a comprehensive analysis of these biological systems.

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Section: Introductionmentioning

confidence: 99%

Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review

Nakamura

Ochsenbein

Lepeule

2021

IJERPH

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“…On the other hand, cigarette smoke contains thousands of known toxic components and although pathways linking prenatal exposure to cigarette smoking and obesity are not well understood (9,10) , even very low doses of cigarette smoke exposure during pregnancy may increase the risk overweight and obesity (11,12) in the offspring.…”

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confidence: 99%

Pregestational BMI and higher offspring’s risk of overweight/obesity in smoker and non-smoker mothers

Martín‐Calvo

Neri

Segura

et al. 2020

Public Health Nutr.

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Objective: To assess the association between pregestational BMI and offspring’s risk of overweight/obesity after accounting for the most important confounders, especially maternal smoking habit. Design: Prospective cohort study. Setting: The Seguimiento Universidad de Navarra (SUN) study is a prospective cohort of Spanish graduates with more than 22 000 participants nationwide. Recruitment started in 1999, and it is permanently open. Data on diet, lifestyle and clinical diagnoses are collected at baseline and every 2 years. Participants: Women from the SUN cohort who reported at least one pregnancy during follow-up (n 3496) were invited to this study. Among them, 1527 agreed to participate and completed an additional more detailed online questionnaire on their pregnancy history and their offspring’s nutritional status. Results: After excluding 165 children, we analysed data of 2791 participants born to 1485 mothers and observed that each 5 kg/m2 increase in pregestational BMI was associated with a 0·22 (95 % CI 0·15, 0·29) higher z-score in offspring’s BMI and higher risk of overweight/obesity (multivariable-adjusted relative risk (RR) 1·57 (95 % CI 1·39, 1·77)) in childhood or adolescence. Furthermore, we observed stronger association in children born to smoker mothers (RR 1·91; 95 % CI 1·48, 2·46) than from non-smoker mothers (RR 1·51; 95 % CI 1·31, 1·73) (Pfor interaction = 0·02). Conclusions: We found a synergistic interaction between pregestational BMI and maternal smoking habit on offspring’s z-score of the BMI and in their risk of overweight/obesity. Although further research is needed to analyse dose–response relationships, these findings reinforce the importance of promoting healthy lifestyles in pregnant women in order to prevent childhood obesity.

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“…In humans, both paternal and maternal smoking during gestation, especifically in the first trimester, have been associated with an increased risk of childhood overweight. Reducing the number of cigarettes, without quitting, did not decrease this risk [ 47 ]. Mother smoking seems to affect DNA methylation; even so, the association between DNA methylation and adipocytes increase have not been elucidated in children yet, but in adults smoking-induced DNA methylation was shown to be present in adipose cells [ 48 , 49 ].…”

Section: Pregnancy and Bat In Newborns: The Role Of Fetal Programmingmentioning

confidence: 99%

Brown Adipose Tissue: New Challenges for Prevention of Childhood Obesity. A Narrative Review

et al. 2021

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Pediatric obesity remains a challenge in modern society. Recently, research has focused on the role of the brown adipose tissue (BAT) as a potential target of intervention. In this review, we revised preclinical and clinical works on factors that may promote BAT or browning of white adipose tissue (WAT) from fetal age to adolescence. Maternal lifestyle, type of breastfeeding and healthy microbiota can affect the thermogenic activity of BAT. Environmental factors such as exposure to cold or physical activity also play a role in promoting and activating BAT. Most of the evidence is preclinical, although in clinic there is some evidence on the role of omega-3 PUFAs (EPA and DHA) supplementation on BAT activation. Clinical studies are needed to dissect the early factors and their modulation to allow proper BAT development and functions and to prevent onset of childhood obesity.

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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

Abstract: Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here:

Cited by 65 publications

References 54 publications

Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review

Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review

Pregestational BMI and higher offspring’s risk of overweight/obesity in smoker and non-smoker mothers

Brown Adipose Tissue: New Challenges for Prevention of Childhood Obesity. A Narrative Review

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