Exposure to second-hand smoke and reproductive outcomes depending on maternal asthma

Abstract

Tobacco consumption and exposure to second-hand smoke (SHS) are associated with reduced birth weight. One issue that has not been clarified previously is that of the potential higher risk of this outcome in mothers with asthma. We assessed the role of prenatal maternal tobacco use and SHS on reproductive outcomes and assessed the interaction with maternal history of asthma.Data was collected from the INMA study, a maternal birth cohort selected from the general population established in Spain in 2002. We measured cotinine at the 32nd week of pregnancy in 2,219 females. Diagnosed maternal asthma was self-reported during pregnancy.35% of mothers reported not being exposed to smoking or SHS during pregnancy. Active smoking (i.e. self-reported or cotinine .50 ng?mL ) was related to a 134 g decrease in birth weight and a relative risk of 1.8 for small for gestational age and fetal growth restriction. These results were not modified by maternal asthma. Maternal asthma had a similar frequency in all exposure groups. Non SHS-exposed females had the lowest prevalence of asthma. SHS (i.e. cotinine 20-50 ng?mL -1 ) decreased birth weight by 32 g among those without maternal asthma, but these differences were not statistically significant (95% CI -88.76-24.76). Maternal asthma did not promote these effects. Maternal history of asthma did not modify the effects of smoking on reproductive outcomes in a cohort sampled from the general population.

Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study

“…Meta-analyses of studies among non-smoking women have shown that SHS exposure during pregnancy was associated with a 1.32 (95% CI 1.07 to 1.63; p = 0.02) times increased risk of low birth weight and a 1.23 (95% CI 1.09 to 1.38; p < 0.001) times increased risk of stillbirth 3 4 . Furthermore, a dose-dependent inverse relationship between maternal urinary cotinine levels (as a proxy for SHS exposure) and offspring birth weight has recently been described 29 . Contemporary studies assessing the impact of SHS exposure on neonatal mortality are however lacking 4 30 .…”

Differential DNA methylation profiles of infants exposed to maternal asthma during pregnancy

“…This susceptibility occurs from conception since the intra‐uterine microenvironment is pivotal in sustaining fetal development as well as re‐shaping of the epigenome. Certain exposures during pregnancy such as adverse nutrition, smoking and maternal diseases are known to effect both fetal outcomes such as still births, fetal growth restriction and predisposition to variety of diseases . Asthma is one of the most common medical illnesses to complicate pregnancy, with prevalence of 12% in Australia .…”

Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort

“…Adjusted by height at four years, maternal weight gain during pregnancy, pre-pregnancy BMI, mother passive smoke exposure during pregnancy. 2 Adjusted by height at 4 years, maternal weight gain during pregnancy, pre-pregnancy BMI, gestational age (week), maternal age, social class, parity, mother passive smoke exposure during pregnancy. 3 Adjusted by height at 4 years, maternal weight gain during pregnancy, pre-pregnancy BMI, gestational age (week), maternal age, maternal education, social class, parity, mother passive smoke exposure during pregnancy.…”

“…Tobacco use and passive smoking during pregnancy can exert multiple effects on offspring, which may persist into adulthood [ 1 , 2 ]. Passive exposure to cigarette smoke in childhood is a global public health problem associated with respiratory symptoms, increased risk of invasive meningococcal disease, and high blood pressure [ 3 , 4 , 5 ].…”