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3. 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

Author

Philips, E.M. Santos, S. Trasande, L. Aurrekoetxea, J.J. Barros, H. von Berg, A. Bergström, A. Bird, P.K. Brescianini, S. Chaoimh, C.N. Charles, M.-A. Chatzi, L. Chevrier, C. Chrousos, G.P. Costet, N. Criswell, R. Crozier, S. Eggesbø, M. Fantini, M.P. Farchi, S. Forastiere, F. van Gelder, M.M.H.J. Georgiu, V. Godfrey, K.M. Gori, D. Hanke, W. Heude, B. Hryhorczuk, D. Iñiguez, C. Inskip, H. Karvonen, A.M. Kenny, L.C. Kull, I. Lawlor, D.A. Lehmann, I. Magnus, P. Manios, Y. Melén, E. Mommers, M. Morgen, C.S. Moschonis, G. Murray, D. Nohr, E.A. Nybo Andersen, A.-M. Oken, E. Oostvogels, A.J.J.M. Papadopoulou, E. Pekkanen, J. Pizzi, C. Polanska, K. Porta, D. Richiardi, L. Rifas-Shiman, S.L. Roeleveld, N. Rusconi, F. Santos, A.C. Sørensen, T.I.A. Standl, M. Stoltenberg, C. Sunyer, J. Thiering, E. Thijs, C. Torrent, M. Vrijkotte, T.G.M. Wright, J. Zvinchuk, O. Gaillard, R. Jaddoe, V.W.V.

Abstract

Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers’ median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02–1.35], P value = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02–1.15], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52–2.34] instead of OR 2.20 [95% CI 2.02–2.42] when reducing from 5–9 to ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations. Conclusions We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy. © 2020 Philips et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Published
2020

4. Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America

Author

Philips, E.M. (Elise), Santos, S.M.S. (Susana), Trasande, L. (Leonardo), Aurrekoetxea, J.J. (Juan José), Barros, A.I. (Ana), Berg, A. (Andrea) von, Bergström, A. (Anna), Bird, P.K. (Philippa K.), Brescianini, S. (Sonia), Ní Chaoimh, C. (Carol), Charles, M.A., Chatzi, L. (Leda), Chevrier, C. (Cécile), Chrousos, G.P., Costet, N. (Nathalie), Criswell, R. (Rachel), Crozier, S. (Sarah), Eggesbø, M. (Merete), Fantini, M.P. (Maria), Farchi, S. (Sara), Forastiere, F. (Francesco), van Gelder, M.M.H.J. (Marleen M H J), Georgiu, V. (Vagelis), Godfrey, N., Gori, D. (Davide), Hanke, W. (Wojciech), Heude, B. (Barbara), Hryhorczuk, D.O. (Daniel), Iñiguez, C. (Carmen), Inskip, H.M. (Hazel), Karvonen, S.L., Kenny, L.C. (Louise C.), Kull, C.A. (Christian), Lawlor, D.A. (Debbie), Lehmann, I. (Irina), Magnus, P. (Per), Manios, Y., Melén, E. (Erik), Mommers, M. (Monique), Morgen, C.S. (Camilla S.), Moschonis, G. (George), Murray, D. (Deirdre), Nohr, C. (Christian), Nybo Andersen, A.-M. (Anne-Marie), Oken, E. (Emily), Oostvogels, A.J.J.M. (Adriëtte J J M), Papadopoulou, E. (Eleni), Pekkanen, J. (Juha), Pizzi, C. (Costanza), Polanska, K. (Kinga), Porta, D. (Daniela), Richiardi, L. (Lorenzo), Rifas-Shiman, S.L. (Sheryl), Roeleveld, N. (Nel), Rusconi, F. (Franca), Santos, A.C. (Ana Cristina), Sørensen, T.I.A. (Thorkild), Standl, M. (Marie), Stoltenberg, C. (Camilla), Sunyer, J. (Jordi), Thiering, E. (Elisabeth), Thijs, C. (Carel), Torrent, M. (Maties), Vrijkotte, T.G.M. (Tanja), Wright, J. (John), Zvinchuk, O. (Oleksandr), Gaillard, R. (Romy), Jaddoe, V.W.V. (Vincent), Philips, E.M. (Elise), Santos, S.M.S. (Susana), Trasande, L. (Leonardo), Aurrekoetxea, J.J. (Juan José), Barros, A.I. (Ana), Berg, A. (Andrea) von, Bergström, A. (Anna), Bird, P.K. (Philippa K.), Brescianini, S. (Sonia), Ní Chaoimh, C. (Carol), Charles, M.A., Chatzi, L. (Leda), Chevrier, C. (Cécile), Chrousos, G.P., Costet, N. (Nathalie), Criswell, R. (Rachel), Crozier, S. (Sarah), Eggesbø, M. (Merete), Fantini, M.P. (Maria), Farchi, S. (Sara), Forastiere, F. (Francesco), van Gelder, M.M.H.J. (Marleen M H J), Georgiu, V. (Vagelis), Godfrey, N., Gori, D. (Davide), Hanke, W. (Wojciech), Heude, B. (Barbara), Hryhorczuk, D.O. (Daniel), Iñiguez, C. (Carmen), Inskip, H.M. (Hazel), Karvonen, S.L., Kenny, L.C. (Louise C.), Kull, C.A. (Christian), Lawlor, D.A. (Debbie), Lehmann, I. (Irina), Magnus, P. (Per), Manios, Y., Melén, E. (Erik), Mommers, M. (Monique), Morgen, C.S. (Camilla S.), Moschonis, G. (George), Murray, D. (Deirdre), Nohr, C. (Christian), Nybo Andersen, A.-M. (Anne-Marie), Oken, E. (Emily), Oostvogels, A.J.J.M. (Adriëtte J J M), Papadopoulou, E. (Eleni), Pekkanen, J. (Juha), Pizzi, C. (Costanza), Polanska, K. (Kinga), Porta, D. (Daniela), Richiardi, L. (Lorenzo), Rifas-Shiman, S.L. (Sheryl), Roeleveld, N. (Nel), Rusconi, F. (Franca), Santos, A.C. (Ana Cristina), Sørensen, T.I.A. (Thorkild), Standl, M. (Marie), Stoltenberg, C. (Camilla), Sunyer, J. (Jordi), Thiering, E. (Elisabeth), Thijs, C. (Carel), Torrent, M. (Maties), Vrijkotte, T.G.M. (Tanja), Wright, J. (John), Zvinchuk, O. (Oleksandr), Gaillard, R. (Romy), and Jaddoe, V.W.V. (Vincent)

Abstract

BACKGROUND: Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. METHODS AND FINDINGS: We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers' median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02-1.35], P value = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02-1.15], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07-2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35-1.48], P value < 0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.

Published
2020
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5. 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

Author

Philips, E.M., Santos, S., Trasande, L., Aurrekoetxea, J.J., Barros, H., von Berg, A., Bergström, A., Bird, P.K., Brescianini, S., Ní Chaoimh, C., Charles, M.-A., Chatzi, L., Chevrier, C., Chrousos, G.P., Costet, N., Criswell, R., Crozier, S., Eggesbø, M., Fantini, M.P., Farchi, S., Forastiere, F., van Gelder, M.M.H.J., Georgiu, V., Godfrey, K.M., Gori, D., Hanke, W., Heude, B., Hryhorczuk, D., Iñiguez, C., Inskip, H., Karvonen, A.M., Kenny, L.C., Kull, I., Lawlor, D.A., Lehmann, Irina, Magnus, P., Manios, Y., Melén, E., Mommers, M., Morgen, C.S., Moschonis, G., Murray, D., Nohr, E.A., Nybo Andersen, A.-M., Oken, E., Oostvogels, A.J.J.M., Papadopoulou, E., Pekkanen, J., Pizzi, C., Polanska, K., Porta, D., Richiardi, L., Rifas‐Shiman, S.L., Roeleveld, N., Rusconi, F., Santos, A.C., Sørensen, T.I.A., Standl, M., Stoltenberg, C., Sunyer, J., Thiering, E., Thijs, C., Torrent, M., Vrijkotte, T.G.M., Wright, J., Zvinchuk, O., Gaillard, R., Jaddoe, V.W.V., Philips, E.M., Santos, S., Trasande, L., Aurrekoetxea, J.J., Barros, H., von Berg, A., Bergström, A., Bird, P.K., Brescianini, S., Ní Chaoimh, C., Charles, M.-A., Chatzi, L., Chevrier, C., Chrousos, G.P., Costet, N., Criswell, R., Crozier, S., Eggesbø, M., Fantini, M.P., Farchi, S., Forastiere, F., van Gelder, M.M.H.J., Georgiu, V., Godfrey, K.M., Gori, D., Hanke, W., Heude, B., Hryhorczuk, D., Iñiguez, C., Inskip, H., Karvonen, A.M., Kenny, L.C., Kull, I., Lawlor, D.A., Lehmann, Irina, Magnus, P., Manios, Y., Melén, E., Mommers, M., Morgen, C.S., Moschonis, G., Murray, D., Nohr, E.A., Nybo Andersen, A.-M., Oken, E., Oostvogels, A.J.J.M., Papadopoulou, E., Pekkanen, J., Pizzi, C., Polanska, K., Porta, D., Richiardi, L., Rifas‐Shiman, S.L., Roeleveld, N., Rusconi, F., Santos, A.C., Sørensen, T.I.A., Standl, M., Stoltenberg, C., Sunyer, J., Thiering, E., Thijs, C., Torrent, M., Vrijkotte, T.G.M., Wright, J., Zvinchuk, O., Gaillard, R., and Jaddoe, V.W.V.

Abstract

Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers’ median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02–1.35], P value = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02–1.15], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout preg

Published
2020

8. Characterisation of exposure to non-ionising electromagnetic fields in the Spanish INMA birth cohort: Study protocol

Author

Gallastegi, M. (Mara), Guxens Junyent, M. (Mònica), Jiménez-Zabala, A. (Ana), Calvente, I. (Irene), Fernández, M. (Marta), Birks, L. (Laura), Struchen, B. (Benjamin), Vrijheid, M. (Martine), Estarlich, M. (Marisa), Fernandez, M.F. (Mariana), Torrent, M. (Maties), Ballester, F. (Ferran), Aurrekoetxea, J.J. (Juan José), Ibarluzea, J.M. (Jesús), Guerra, D. (David), González, J. (Julián), Röösli, M. (Martin), Santa-Marina, L. (Loreto), Gallastegi, M. (Mara), Guxens Junyent, M. (Mònica), Jiménez-Zabala, A. (Ana), Calvente, I. (Irene), Fernández, M. (Marta), Birks, L. (Laura), Struchen, B. (Benjamin), Vrijheid, M. (Martine), Estarlich, M. (Marisa), Fernandez, M.F. (Mariana), Torrent, M. (Maties), Ballester, F. (Ferran), Aurrekoetxea, J.J. (Juan José), Ibarluzea, J.M. (Jesús), Guerra, D. (David), González, J. (Julián), Röösli, M. (Martin), and Santa-Marina, L. (Loreto)

Abstract

Background: Analysis of the association between exposure to electromagnetic fields of non-ionising radiation (EMF-NIR) and health in children and adolescents is hindered by the limited availability of data, mainly due to the difficulties on the exposure assessment. This study protocol describes the methodologies used for characterising exposure of children to EMF-NIR in the INMA (INfancia y Medio Ambiente- Environment and Childhood) Project, a prospective cohort study. Methods/Design: Indirect (proximity to emission sources, questionnaires on sources use and geospatial propagation models) and direct methods (spot and fixed longer-term measurements and personal measurements) were conducted in order to assess exposure levels of study participants aged between 7 and 18 years old. The methodology used varies depending on the frequency of the EMF-NIR and the environment (homes, schools and parks). Questionnaires assessed the use of sources contributing both to Extremely Low Frequency (ELF) and Radiofrequency (RF) exposure levels. Geospatial propagation models (NISMap) are implemented and validated for environmental outdoor sources of RFs using spot measurements. Spot and fixed longer-term ELF and RF measurements were done in the environments where children spend most of the time. Moreover, personal measurements were taken in order to assess individual exposure to RF. The exposure data are used to explore their relationships with proximity and/or use of EMF-NIR sources. Discussion: Characterisation of the EMF-NIR exposure by this combination of methods is intended to overcome problems encountered in other research. The assessment of exposure of INMA cohort children and adolescents living in different regions of Spain to the full frequency range of EMF-NIR extends the characterisation of environmental exposures in this cohort. Together with other data obtained in the project, on socioeconomic and family characteristics and development of the children and adolescents, this

Published
2016
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9. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children

Author

Vardavas, C.I., primary, Hohmann, C., additional, Patelarou, E., additional, Martinez, D., additional, Henderson, A.J., additional, Granell, R., additional, Sunyer, J., additional, Torrent, M., additional, Fantini, M.P., additional, Gori, D., additional, Annesi-Maesano, I., additional, Slama, R., additional, Duijts, L., additional, de Jongste, J.C., additional, Aurrekoetxea, J.J., additional, Basterrechea, M., additional, Morales, E., additional, Ballester, F., additional, Murcia, M., additional, Thijs, C., additional, Mommers, M., additional, Kuehni, C.E., additional, Gaillard, E.A., additional, Tischer, C., additional, Heinrich, J., additional, Pizzi, C., additional, Zugna, D., additional, Gehring, U., additional, Wijga, A., additional, Chatzi, L., additional, Vassilaki, M., additional, Bergström, A., additional, Eller, E., additional, Lau, S., additional, Keil, T., additional, Nieuwenhuijsen, M., additional, and Kogevinas, M., additional

Published
2016
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11. Occupational exposures and Mycosis Fungoides. A European multicentre case-control study (Europe)

Author

Morales-Suarez-Varela, M.M., Olsen, J., Johansen, P., Kaerlev, L., Guenel, P., Arveux, P., Wingren, Gun, Hardell, L., Ahrens, W., Stang, A., Llopis, A., Merletti, F., Aurrekoetxea, J.J., Masala, G., Morales-Suarez-Varela, M.M., Olsen, J., Johansen, P., Kaerlev, L., Guenel, P., Arveux, P., Wingren, Gun, Hardell, L., Ahrens, W., Stang, A., Llopis, A., Merletti, F., Aurrekoetxea, J.J., and Masala, G.

Abstract

Objectives: Mycosis Fungoides (MF) is a rare disease with an occurrence indicating that occupational exposures may play a role. To estimate the association between MF and occupational exposures as measured by means of an job-exposure matrix (JEM). Methods: A European multicenter case-control study was conducted from 1995 to 1997 and included seven rare cancers, one of which was MF. Patients between 35 and 69 years of age, diagnosed with MF (n = 140), were recruited and the diagnoses were checked by a reference pathologist who classified 83 cases as definite, 35 cases as possible and 22 cases as not accepted. Among the 118 accepted cases, 104 cases were interviewed, of which 76 were definite cases. We selected population controls and colon cancer controls to serve all seven case groups. Altogether 833 colon cancer controls and 2071 population controls were interviewed. Based on the reported occupational experiences, a team of industrial hygiene specialists identified five potential exposures and developed an JEM. This JEM was used to estimate the odds ratios (OR) for MF as a function of these exposures. The JEM included aromatic and/or halogenated hydrocarbons (AAHs), chrome (VI) and its salts, electromagnetic radiations, silica and pesticides. Results: Exposures to AHHs (OR 6.3, C.I 2.4-16.7 for male) were associated with a high MF risk. Conclusions: The study supports the hypothesis that some MFs have an occupational etiology but only a small fraction of exposed workers are apparently susceptible since the disease is so rare. © Springer 2005.

Published
2005
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13. Serum levels of polychlorinated dibenzodioxins and dibenzofurans and PCBs in the general population living near an urban waste treatment plant in Biscay, Basque Country

Author

Zubero, M.B., primary, Ibarluzea, J.M., additional, Aurrekoetxea, J.J., additional, Rivera, J., additional, Parera, J., additional, Abad, E., additional, Goñi, F., additional, López, R., additional, Etxeandia, A., additional, Rodríguez, C., additional, and Sáenz, J.R., additional

Published
2009
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14. THE INFLUENCE OF ENVIRONMENTAL FACTORS ON MICROBIOLOGICAL INDICATORS OF COASTAL WATER POLLUTION.

Author

Serrano, E., Moreno, B., Solaun, M., Aurrekoetxea, J.J., and Ibarluzea, J.

Subjects
SEWAGE, WATER pollution
Abstract

Studies the relationships between bacteriological and viral indicators of sewage pollution and environmental variables in coastal water and weather. Microbiological indicators in bathing water presenting high counts associated with various conditions; High correlations between microbiological indicators.

Published
1998
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15. Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America

Author

Andrea von Berg, Per Magnus, Camilla Stoltenberg, George P. Chrousos, Cécile Chevrier, Costanza Pizzi, Marleen M.H.J. van Gelder, Tanja G. M. Vrijkotte, Oleksandr Zvinchuk, Elise M. Philips, Daniel O. Hryhorczuk, Vincent W. V. Jaddoe, Philippa K Bird, Deirdre M. Murray, Elisabeth Thiering, Marie Standl, Merete Eggesbø, Sara Farchi, Daniela Porta, Lorenzo Richiardi, Maria Pia Fantini, Francesco Forastiere, Carel Thijs, Vagelis Georgiu, Camilla Schmidt Morgen, Yannis Manios, Leda Chatzi, Henrique Barros, Irina Lehmann, Juan J. Aurrekoetxea, Thorkild I. A. Sørensen, Juha Pekkanen, Emily Oken, Adriette J. J. M. Oostvogels, Nel Roeleveld, Jordi Sunyer, Anne-Marie Nybo Andersen, Ellen A. Nohr, Romy Gaillard, Anna Bergström, Sheryl L. Rifas-Shiman, George Moschonis, Monique Mommers, Ana Cristina Santos, Hazel Inskip, Sonia Brescianini, Wojciech Hanke, Kinga Polańska, Louise C. Kenny, Leonardo Trasande, Debbie A Lawlor, Inger Kull, Anne M. Karvonen, Nathalie Costet, Marie-Aline Charles, Susana Santos, Sarah Crozier, John Wright, Barbara Heude, Carmen Iñiguez, Erik Melén, Maties Torrent, Davide Gori, Rachel Criswell, Eleni Papadopoulou, Franca Rusconi, Keith M. Godfrey, Carol Ní Chaoimh, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), European Commission733206United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USAR01ES022972United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Environmental Health Sciences (NIEHS)P30ES007048R21ES029681R01ES029944R01ES030364R21ES028903UK MRC fundingMC_UU_12013/5Portuguese Foundation for Science and TechnologyEuropean CommissionIF/01060/2015Netherlands Heart Foundation2017T013Dutch Diabetes Foundation2017.81.002Netherlands Organization for Health Research and Development543003109European Research Council (ERC)European CommissionERC-2014-CoG-64891, Epidemiologie, RS: CAPHRI - R5 - Optimising Patient Care, Philips E.M., Santos S., Trasande L., Aurrekoetxea J.J., Barros H., von Berg A., Bergstrom A., Bird P.K., Brescianini S., Chaoimh C.N., Charles M.-A., Chatzi L., Chevrier C., Chrousos G.P., Costet N., Criswell R., Crozier S., Eggesbo M., Fantini M.P., Farchi S., Forastiere F., van Gelder M.M.H.J., Georgiu V., Godfrey K.M., Gori D., Hanke W., Heude B., Hryhorczuk D., Iniguez C., Inskip H., Karvonen A.M., Kenny L.C., Kull I., Lawlor D.A., Lehmann I., Magnus P., Manios Y., Melen E., Mommers M., Morgen C.S., Moschonis G., Murray D., Nohr E.A., Nybo Andersen A.-M., Oken E., Oostvogels A.J.J.M., Papadopoulou E., Pekkanen J., Pizzi C., Polanska K., Porta D., Richiardi L., Rifas-Shiman S.L., Roeleveld N., Rusconi F., Santos A.C., Sorensen T.I.A., Standl M., Stoltenberg C., Sunyer J., Thiering E., Thijs C., Torrent M., Vrijkotte T.G.M., Wright J., Zvinchuk O., Gaillard R., Jaddoe V.W.V., Department of Public Health, University of Helsinki, Instituto de Saúde Pública da Universidade do Porto, Erasmus MC other, Pediatrics, Graduate School, Public and occupational health, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, ARD - Amsterdam Reproduction and Development, and APH - Methodology

Subjects
Male, Parents, embarazo, Epidemiology, Maternal Health, Social Sciences, CHILDREN, 0302 clinical medicine, Pregnancy, nacimiento prematuro, Smoking/adverse effects, Psychology, MATERNAL SMOKING, estudios de cohortes, Body mass index, education.field_of_study, General Medicine, ASSOCIATION, 16. Peace & justice, 3. Good health, Prenatal Exposure Delayed Effects, Medicine, GROWTH, efectos diferidos por exposición prenatal, Cohort study, Human, PRETERM BIRTH, Europe/epidemiology, 03 medical and health sciences, Humans, Smoking habits, Risk factor, education, Behavior, Biology and Life Sciences, Infant, Odds ratio, hábito de fumar, medicine.disease, Pregnancy Complications, CESSATION, Demography, Pediatric Obesity, Physiology, humanos, 030204 cardiovascular system & hematology, Overweight, North America/epidemiology, Cohort Studies, Habits, Risk Factors, Medicine and Health Sciences, 030212 general & internal medicine, DNA METHYLATION, Smoking, Obstetrics and Gynecology, Gestational age, edad gestacional, Prenatal Exposure Delayed Effects/diagnosis, 3142 Public health care science, environmental and occupational health, obesidad pediátrica, Pediatric Obesity/diagnosis, Europe, Physiological Parameters, Female, Gestational Age, Infant, Newborn, North America, Premature Birth, OBESITY, medicine.symptom, Research Article, Birth weight, Population, Premature Birth/diagnosis, padres, Prenatal Exposure Delayed Effect, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], All institutes and research themes of the Radboud University Medical Center, medicine, factores de riesgo, EXPOSURE, lactante, business.industry, Risk Factor, Body Weight, Newborn, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Medical risk factors, 3121 General medicine, internal medicine and other clinical medicine, Birth, Women's Health, WEIGHT, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers’ median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02–1.35], P value = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02–1.15], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52–2.34] instead of OR 2.20 [95% CI 2.02–2.42] when reducing from 5–9 to ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations. Conclusions We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy., Elise Philips and co-workers investigate parental smoking and associated birth and child outcomes., Author summary Why was this study done? Maternal smoking during pregnancy is an important risk factor for various birth complications and childhood overweight. It is not clear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy. The associations of paternal smoking with birth and childhood outcomes also remain unknown. What did the researchers do and find? We conducted an individual participant data meta-analysis using data from 229,158 families from 28 pregnancy and birth cohorts from Europe and North America to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. We observed that smoking in the first trimester only did not increase the risk of preterm birth and small size for gestational age but was associated with a higher risk of childhood overweight, as compared to nonsmoking. Reducing the number of cigarettes during pregnancy, without quitting, was still associated with higher risks of these adverse outcomes. Paternal smoking seems to be associated, independently of maternal smoking, with the risks of childhood overweight. What do these findings mean? Population strategies should focus on parental smoking prevention before or at the start of, rather than during, pregnancy. Future studies are needed to assess the specific associations of smoking in the preconception and childhood periods with offspring outcomes.

Published
2020

16. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children

Author

Maria Vassilaki, Alet H. Wijga, Daniela Zugna, Erol A. Gaillard, I. Annesi-Maesano, Claudia E. Kuehni, Mikel Basterrechea, Monique Mommers, Davide Gori, Carel Thijs, Liesbeth Duijts, Leda Chatzi, Susanne Lau, J. J. Aurrekoetxea, Rémy Slama, Anna Bergström, Raquel Granell, Mark J. Nieuwenhuijsen, Maria Pia Fantini, Constantine I. Vardavas, Costanza Pizzi, Jordi Sunyer, M. Torrent, David Martinez, Thomas Keil, Evridiki Patelarou, C. Hohmann, Ferran Ballester, Ulrike Gehring, J. C. de Jongste, A. J. Henderson, Esben Eller, Mario Murcia, Joachim Heinrich, Manolis Kogevinas, Eva Morales, Christina Tischer, Epidemiologie, RS: CAPHRI - R5 - Optimising Patient Care, RS: NUTRIM - R4 - Gene-environment interaction, Complexe Genetica, Epidemiology, Pediatrics, Vardavas, C.I., Hohmann, C., Patelarou, E., Martinez, D., Henderson, A.J., Granell, R., Sunyer, J., Torrent, M., Fantini, M.P., Gori, D., Annesi-Maesano, I., Slama, R., Duijts, L., De Jongste, J.C., Aurrekoetxea, J.J., Basterrechea, M., Morales, E., Ballester, F., Murcia, M., Thijs, C., Mommers, M., Kuehni, C.E., Gaillard, E.A., Tischer, C., Heinrich, J., Pizzi, C., Zugna, D., Gehring, U., Wijga, A., Chatzi, L., Vassilaki, M., Bergström, A., Eller, E., Lau, S., Keil, T., Nieuwenhuijsen, M., Kogevinas, M., LS IRAS EEPI ME (Milieu epidemiologie), Geneeskunde van gezelschapsdieren, and dIRAS RA-2

Subjects
Male, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Passive smoking, Tobacco Smoke Pollution/adverse effects, medicine.disease_cause, Tobacco smoke, 03 medical and health sciences, Prenatal Exposure Delayed Effects/epidemiology, 0302 clinical medicine, Pregnancy, Risk Factors, Wheeze, Smoking/adverse effects, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Respiratory sounds, Risk factor, Family history, 610 Medicine & health, Maternal Exposure/adverse effects, medicine.diagnostic_test, business.industry, Respiratory Sounds/etiology, Infant, Newborn, Infant, medicine.disease, Passive Smoke Exposure, Europe, Logistic Models, 030228 respiratory system, Child, Preschool, Female, medicine.symptom, business, 360 Social problems & social services
Abstract

Maternal smoking during pregnancy increases childhood asthma risk, but health effects in children of nonsmoking mothers passively exposed to tobacco smoke during pregnancy are unclear. We examined the association of maternal passive smoking during pregnancy and wheeze in children aged ≤2 years.Individual data of 27 993 mother–child pairs from 15 European birth cohorts were combined in pooled analyses taking into consideration potential confounders.Children with maternal exposure to passive smoking during pregnancy and no other smoking exposure were more likely to develop wheeze up to the age of 2 years (OR 1.11, 95% CI 1.03–1.20) compared with unexposed children. Risk of wheeze was further increased by children's postnatal passive smoke exposure in addition to their mothers' passive exposure during pregnancy (OR 1.29, 95% CI 1.19–1.40) and highest in children with both sources of passive exposure and mothers who smoked actively during pregnancy (OR 1.73, 95% CI 1.59–1.88). Risk of wheeze associated with tobacco smoke exposure was higher in children with an allergic versus nonallergic family history.Maternal passive smoking exposure during pregnancy is an independent risk factor for wheeze in children up to the age of 2 years. Pregnant females should avoid active and passive exposure to tobacco smoke for the benefit of their children's health.

Published
2016

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