Snus in pregnancy and infant birth size: a mother-child birth cohort study

Ina Kreyberg; Katarina Hilde; Karen Eline S Bains; Kai-Håkon Carlsen; Berit Granum; Guttorm Haugen; Gunilla Hedlin; Christine M Jonassen; Live S Nordhagen; Björn Nordlund; Corina S Rueegg; Katrine D Sjøborg; Håvard O Skjerven; Anne C Staff; Riyas Vettukattil; Karin C Lødrup Carlsen; PreventADALL Study Group

doi:10.1183/23120541.00255-2019

Snus in pregnancy and infant birth size: a mother-child birth cohort study

ERJ Open Res. 2019 Dec 2;5(4):00255-2019. doi: 10.1183/23120541.00255-2019. eCollection 2019 Oct.

Authors

Ina Kreyberg^{1

2}, Katarina Hilde^{1

3}, Karen Eline S Bains^{1

2}, Kai-Håkon Carlsen^{1

2}, Berit Granum⁴, Guttorm Haugen^{1

3}, Gunilla Hedlin^{5

6}, Christine M Jonassen^{7

8}, Live S Nordhagen^{1

2

9}, Björn Nordlund^{5

6}, Corina S Rueegg¹⁰, Katrine D Sjøborg¹¹, Håvard O Skjerven^{1

2}, Anne C Staff^{1

3}, Riyas Vettukattil¹, Karin C Lødrup Carlsen^{1

2}; PreventADALL Study Group

Affiliations

¹ Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
² Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
³ Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway.
⁴ Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway.
⁵ Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
⁶ Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
⁷ Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.
⁸ Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.
⁹ VID Specialized University, Oslo, Norway.
¹⁰ Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Oslo, Norway.
¹¹ Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway.

Abstract

Rationale: While recent studies show that maternal use of snus during pregnancy is increasing, the potential effects on infant birth size is less investigated, with conflicting results.

Objectives: We aimed to determine if maternal use of snus during pregnancy influences the infant anthropometric and proportional size measures at birth.

Methods: In 2313 mother-child pairs from the population-based, mother-child birth cohort PreventADALL (Preventing Atopic Dermatitis and ALLergies) in Norway and Sweden, we assessed nicotine exposure by electronic questionnaire(s) at 18 and 34 weeks of pregnancy, and anthropometric measurements at birth. Associations between snus exposure and birth size outcomes were analysed by general linear regression.

Results: Birthweight was not significantly different in infants exposed to snus in general, and up to 18 weeks of pregnancy in particular, when adjusting for relevant confounders including maternal age, gestational age at birth, pre-pregnancy body mass index, parity, fetal sex and maternal gestational weight gain up to 18 weeks. We found no significant effect of snus use on the other anthropometric or proportional size measures in multivariable linear regression models. Most women stopped snus use in early pregnancy.

Conclusion: Exposure to snus use in early pregnancy, with most women stopping when knowing about their pregnancy, was not associated with birth size. We were unable to conclude on effects of continued snus use during pregnancy because of lack of exposure in our cohort.