Pulmonary Effects of Maternal Smoking on the Fetus and Child: Effects on Lung Development, Respiratory Morbidities, and Life Long Lung Health

McEvoy, Cindy T.; Spindel, Eliot R.

doi:10.1016/j.prrv.2016.08.005

Cited by 153 publications

(171 citation statements)

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“…Supported by previous studies, an association was detected between maternal smoking and LRTIs in the offspring. Maternal smoking during pregnancy affects fetal lung development, inducing long‐lasting structural changes, and in addition, it may predispose to preterm delivery .…”

Section: Commentsupporting

confidence: 70%

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Hospital admissions for lower respiratory tract infections after early‐, late‐, and post‐term birth

Haataja

Korhonen

Ojala

et al. 2020

Paediatric Perinatal Epid

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Background Recent data suggest that early‐term births are associated with later respiratory morbidity (LRTI), and post‐term births may decrease this risk. Objectives The objective was to determine the impact of early‐term, late‐term, and post‐term birth on hospital admission for LRTI up to the age of seven years. Additionally, we explored maternal and perinatal factors associated with the risk of admission for LRTIs. Methods The association of early‐term (37+0‐38+6 weeks), late‐term (41+0‐41+6 weeks), and post‐term (≥42 weeks) birth with hospital admissions for lower respiratory tract infections (LRTI) in comparison with infants born full‐term (39+0‐40+6 weeks) was assessed and early predictors of LRTI were established. The register study included 948 695 infants born in Finland in 1991‐2008. Data were analysed in four‐term subgroups. Hospital admissions for bronchiolitis/bronchitis and pneumonia were collected up to 7 years of age. Adjusted Cox proportional hazards models were used to assess risk factors of LRTI admissions. Results The rates of hospital admission in the early‐, full‐, late‐, and post‐term groups were 6.7%, 5.5%, 5.1%, and 4.8% for bronchiolitis/bronchitis, and 2.8%, 2.4%, 2.3%, and 2.3% for pneumonia. Early‐term birth was associated with an increased risk of admission for bronchiolitis/bronchitis (hazard ratio HR 1.21, 95% confidence interval CI 1.18, 1.23) and pneumonia (HR 1.16, 95% CI 1.12, 1.20), while late‐term (HR 0.93, 95% CI 0.91, 0.95) and post‐term births (HR 0.89, 95% CI 0.85, 0.93) were associated with a decreased risk of bronchiolitis/bronchitis admission compared with the full‐term group. Maternal age ≤ 20 years, smoking during pregnancy, male sex, caesarean delivery, small for gestational age, 1‐minute Apgar score < 4, ventilator support, and neonatal antibiotic therapy were associated with an increased risk of LRTI admission, while being firstborn, born in a level‐II hospital and in the Northern region was associated with decreased risk. Conclusion Early‐term birth was associated with a higher risk of all LRTI admissions while late‐term and post‐term births were associated with lower risk of bronchiolitis/bronchitis admission. Modifiable risk factors of LRTIs were smoking during pregnancy, birth by elective caesarean delivery, neonatal ventilator support, and antibiotic therapy.

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Section: Commentsupporting

confidence: 70%

“…Maternal smoking during pregnancy affects fetal lung development, inducing long-lasting structural changes, and in addition, it may predispose to preterm delivery. 24 Likewise, male sex appeared to increase the risk of hospital admission for both bronchiolitis/bronchitis 23 and pneumonia in the whole study population.…”

Section: Discussionmentioning

confidence: 84%

Hospital admissions for lower respiratory tract infections after early‐, late‐, and post‐term birth

Haataja

Korhonen

Ojala

et al. 2020

Paediatric Perinatal Epid

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“…Fewer and larger saccules that are more compliant and have reduced parenchymal tissue, septal crests, and markedly decreased surface area available for gas exchange were noted in the hypoplastic fetal lungs of in utero smoke‐exposed rat fetuses (Collins et al, ). Not only are structural changes seen, but also effects on pulmonary function (decreased passive respiratory compliance, decreases in forced expiratory flows, and altered tidal volume patterns) (Hanrahan et al, ; Hoo et al, ; McEvoy & Spindel, ), as well as increased susceptibility to respiratory infections (Gibbs, Collaco, & McGrath‐Morrow, ; McEvoy & Spindel, ) have been noted. Interestingly, in a well‐established rat model of perinatal nicotine exposure‐induced asthma, the changes are more pronounced in males (Liu et al, ).…”

Section: Perinatal Smoke Exposure and Offspring Lung Phenotypementioning

confidence: 99%

The impact of perinatal nicotine exposure on fetal lung development and subsequent respiratory morbidity

Kuniyoshi

Rehan

2019

Birth Defects Research

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Maternal smoking during pregnancy remains as a significant public health crisis as it did decades ago. Although its prevalence is decreasing in high‐income countries, it has worsened globally, along with a concerning emergence of electronic‐cigarette usage within the last two decades. Extensive epidemiologic and experimental evidence exists from both human and animal studies, demonstrating the detrimental long‐term pulmonary outcomes in the offspring of mothers who smoke during pregnancy. Even secondhand and thirdhand smoke exposure to the developing lung might be as or even more harmful than firsthand smoke exposure. Furthermore, these effects are not limited only to the exposed progeny, but can also be transmitted transgenerationally. There is compelling evidence to support that the majority of the effects of perinatal smoke exposure on the developing lung, including the transgenerational transmission of asthma, is mediated by nicotine. Nicotine exposure induces cell‐specific molecular changes in lungs, which offers a unique opportunity to prevent, halt, and/or reverse the resultant damage through targeted molecular interventions. Experimentally, the proposed interventions, such as administration of peroxisome proliferator‐activated receptor gamma (PPARγ) agonists can not only block but also potentially reverse the perinatal nicotine exposure‐induced respiratory morbidity in the exposed offspring. However, the development of a safe and effective intervention is still many years away. In the meantime, electropuncture at specific acupoints appears to be emerging as a more practical and safe physiologic approach to block the harmful pulmonary consequences of perinatal nicotine exposure.

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“…This created confidence in physicians and nurses who were in charge of the mother and infant with respect to clinical care and recruitment for the cohort study. Population‐based data covering perinatal and child health in rural populations are unique in Germany . Finally, the study has substantial geographic overlap with one of Europe's largest and most comprehensive, prospective studies of health in an adult sample, the “Study of Health in Pomerania (SHIP),” that is allowing comparison of health and risk factors of pregnant women on the background of the representative sample of the local population.…”

Section: Commentmentioning

confidence: 99%

Survey of Neonates in Pomerania (SNiP): Study design and cohort update

Kantorczyk

Lange

Ittermann

et al. 2020

Paediatric Perinatal Epid

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Background The health status of newborns is a major concern for parents and medical personnel. Recent studies have provided increasing evidence that factors from the foetal and perinatal periods of life influence health later in life. The “Follow‐up of the Survey of Neonates in Pomerania” (SNiP‐I‐Follow‐up) is the first follow‐up of the population‐based birth cohort study, SNiP‐I, established in north‐east Germany. Objectives The primary aim of SNiP‐I‐Follow‐up study was the collection of longitudinal data on children and adolescents. The associations will be analysed between risk factors in pregnancy and the perinatal period and health status in infancy and later childhood. Population The population‐based cohort study SNiP‐I was conducted in Pomerania in north‐east Germany between February 2002 and November 2008. All mothers from the SNiP‐I birth cohort were recontacted when their children were from 9 to 15 years of age. Design The SNiP‐I‐Follow‐up study was carried out between December 2016 and August 2017 and is a questionnaire‐based survey. Methods Physical development, health status, and social behaviour (school and leisure behaviour) of children were analysed using a questionnaire comprising medical, epidemiological, and socio‐economic data, associated health care risk factors, and life circumstances of newborns, children, and their parents. Preliminary results Out of 5725 children invited to participate in the SNiP‐I‐Follow‐up study between December 2016 and August 2017, 29% (n = 1665) children participated in the SNiP‐I‐Follow‐up study, providing data on 1665 mothers‐child dyads. Responders had higher socio‐economic status, especially in relation to maternal education status. Conclusion As a longitudinal birth cohort from rural Germany, the SNiP cohort will be a resource to address urgent research needs and contribute to overall population health.

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Pulmonary Effects of Maternal Smoking on the Fetus and Child: Effects on Lung Development, Respiratory Morbidities, and Life Long Lung Health

Cited by 153 publications

References 67 publications

Hospital admissions for lower respiratory tract infections after early‐, late‐, and post‐term birth

Hospital admissions for lower respiratory tract infections after early‐, late‐, and post‐term birth

The impact of perinatal nicotine exposure on fetal lung development and subsequent respiratory morbidity

Survey of Neonates in Pomerania (SNiP): Study design and cohort update

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