Quantity and timing of maternal prenatal smoking on neonatal body composition: the Healthy Start study

J Pediatr. 2014 Oct;165(4):707-12. doi: 10.1016/j.jpeds.2014.06.031. Epub 2014 Jul 22.

Abstract

Objective: To examine the dose-dependent and time-specific relationships of prenatal smoking with neonatal body mass, fat mass (FM), fat-free mass (FFM), and FM-to-FFM ratio, as measured by air-displacement plethysmography (PEA POD system).

Study design: We analyzed 916 mother-neonate pairs participating in the longitudinal prebirth cohort Healthy Start study. Maternal prenatal smoking information was collected in early, middle, and late pregnancy by self-report. Neonatal body composition was measured with the PEA POD system after delivery. Multiple general linear regression models were adjusted for maternal and neonatal characteristics.

Results: Each additional pack of cigarettes smoked during pregnancy was associated with significant decreases in neonatal body mass (adjusted mean difference, -2.8 g; 95% CI, -3.9 to -1.8 g; P < .001), FM (-0.7 g; 95% CI, -1.1 to -0.3 g; P < .001), and FFM (-2.1 g; 95% CI, -2.9 to -1.3 g; P < .001). Neonates exposed to prenatal smoking throughout pregnancy had significantly lower body mass (P < .001), FM (P < .001), and FFM (P < .001) compared with those not exposed to smoking. However, neonates of mothers who smoked only before late pregnancy had no significant differences in body mass (P = .47), FM (P = .43), or FFM (P = .59) compared with unexposed offspring.

Conclusion: Exposure to prenatal smoking leads to systematic growth restriction. Smoking cessation before late pregnancy may reduce the consequences of exposure to prenatal smoking on body composition. Follow-up of this cohort is needed to determine the influence of catch-up growth on early-life body composition and the risk of childhood obesity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Body Composition / drug effects*
  • Body Weight / drug effects
  • Female
  • Humans
  • Infant, Newborn
  • Linear Models
  • Longitudinal Studies
  • Male
  • Maternal Age
  • Maternal Exposure*
  • Plethysmography / methods
  • Pregnancy
  • Pregnancy Complications
  • Prospective Studies
  • Smoking / adverse effects*
  • Time Factors