Daughters of Mothers Who Smoke: A Population‐based Cohort Study of Maternal Prenatal Tobacco use and Subsequent Prenatal Smoking in Offspring

Abstract

Background Prenatal exposure to tobacco is associated with adverse health outcomes for the mother and child, and has been associated with an increased risk of tobacco smoking and nicotine dependence in offspring. The objective of this study was to examine the risk of prenatal smoking, among daughters, associated with maternal prenatal smoking. Methods We used a population-based cohort study design, with linked vital records data of mothers and daughters delivering 1984–1996 and 1996–2013, respectively, in Washington State. The exposure of interest was mothers’ prenatal smoking (any versus no smoking at any time during pregnancy), while the outcome was daughters’ prenatal smoking (similarly assessed). We used multivariable log-binomial regression to obtain estimates of the relative risk (RR) and 95% confidence interval (CI). Results Daughters exposed to maternal prenatal smoking were more likely to smoke during their pregnancy, compared to unexposed daughters (RR = 1.78; 95% CI: 1.72, 1.84, adjusted for the year the daughter delivered, her marital status and educational attainment, and the mothers’ race/ethnicity). Conclusions In this relatively young population, we found that daughters exposed to maternal prenatal smoking have an increased risk of smoking later on during their own pregnancy, emphasizing the importance of exposures during the prenatal period. The mechanisms leading to prenatal smoking are multifactorial and likely include behavioral, genetic, epigenetic and environmental factors. An understanding of this risk factor for prenatal smoking may guide healthcare providers to better target smoking cessation interventions to at-risk populations.

Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia

“…In this study, previous smoking history and exposure to maternal prenatal smoking were factors associated with using snus in pregnancy. This corresponds with a study demonstrating an intergenerational association of mothers' and daughters' smoking habits during pregnancy, indicating that daughters exposed in utero were more likely to smoke when pregnant than unexposed daughters [39]. Though the mechanism behind this is multifactorial and likely includes behavioural, (epi)genetic and environmental factors [39], it suggests a nicotine susceptibility affecting the risk of use in pregnancy.…”

The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort

“…Infants born to women who smoked had higher after adjusting for multiple factors. 17 Although smoking is a modifiable risk factor that can usually be identified by history alone and addressed with education and support, pregnancy is a unique period where cessation rates can be high because of the perceived risks to the fetus. A recent New Zealand study 18 showed that while almost 50% of women who smoked stopped during pregnancy, relapse rates were high at 36%, with heavy smokers and those with another smoker in the family less likely to quit.…”

Differences in Prenatal Tobacco Exposure Patterns among 13 Race/Ethnic Groups in California

“…The effects of prenatal exposure may manifest in childhood, with increased risk of impaired lung function, asthma, obesity, cognitive deficits and detrimental cardiovascular consequences [15,16,17,18,19,20,21,22,23]. Epigenetic changes from in-utero exposure to tobacco have been detected in children [24], and prenatal smoking has been shown to influence smoking habits of future generations [25,26].…”