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Does Maternal Exposure to Secondhand Tobacco Smoke During Pregnancy Increase the Risk for Preterm or Small-for-Gestational Age Birth?

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Abstract

Introduction While associations between active smoking and various adverse birth outcomes (ABOs) have been reported in the literature, less is known about the impact of secondhand smoke (SHS) on many pregnancy outcomes. Methods We examined the relationship between maternal exposure to SHS during pregnancy and preterm (< 37 weeks gestation) and small-for-gestational age (SGA; assessed using sex-, race/ethnic-, and parity-specific growth curves) singleton births using non-smoking controls from the National Birth Defects Prevention Study (1997–2011). Multivariable logistic regression models for household, workplace/school, and combined SHS exposure—controlled for maternal education, race/ethnicity, pre-pregnancy body mass index, and high blood pressure—were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Interaction was assessed for maternal folic acid supplementation, alcohol use, age at delivery, and infant sex. Results Infants of 8855 mothers were examined in the preterm birth analysis with 666 (7.5%) categorized as preterm, 574 moderately preterm (32–36 weeks), and 92 very preterm (< 32 weeks). For the SGA analysis, infants of 8684 mothers were examined with 670 (7.7%) categorized as SGA. The aORs for mothers reporting both household and workplace/school SHS were elevated for preterm (aOR 1.99; 95% CI 1.13–3.50) and moderately preterm birth (32–36 weeks) (aOR 2.17; 95% CI 1.22–3.88). No results for the SGA analysis achieved significance, nor was evidence of interaction evident. Conclusion The findings suggest an association between SHS from multiple exposure sources and preterm birth, but no evidence for association with SGA births. Continued study of SHS and ABOs is needed to best inform public health prevention programs.

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References

  • Ananth, C. V., & Vintzileos, A. M. (2011). Ischemic placental disease: Epidemiology and risk factors. European Journal of Obstetrics and Gynecology and Reproductive Biology, 159(1), 77–82.

    Article  PubMed  Google Scholar 

  • Anderka, M., Romitti, P. A., Sun, L., Druschel, C., Carmichael, S., & Shaw, G. (2010). Patterns of tobacco exposure before and during pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 89(4), 505–514.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ashford, K. B., Hahn, E., Hall, L., Rayens, M. K., Noland, M., & Ferguson, J. E. (2010). The effects of prenatal secondhand smoke exposure on preterm birth and neonatal outcomes. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 39(5), 525–535.

    Article  Google Scholar 

  • Bakker, R., Timmermans, S., Steegers, E. A. P., Hofman, A., & Jaddoe, V. W. (2011). Folic acid supplements modify the adverse effects of maternal smoking on fetal growth and neonatal complications. The Journal of Nutrition, 141(12), 2172–2179.

    Article  CAS  PubMed  Google Scholar 

  • Chan, D., Caprara, D., Blanchette, P., Klein, J., & Koren, G. (2004). Recent developments in meconium and hair testing methods for the confirmation of gestational exposures to alcohol and tobacco smoke. Clinical Biochemistry, 37(6), 429–438.

    Article  CAS  PubMed  Google Scholar 

  • Chan, P. Y., Morris, J. M., Leslie, G. I., Kelly, P. J., & Gallery, E. D. (2010). The long-term effects of prematurity and intrauterine growth restriction on cardiovascular, renal, and metabolic function. International Journal of Pediatrics. https://doi.org/10.1155/2010/280402.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crane, J. M. G., Keough, M., Murphy, P., Burrage, L., & Hutchens, D. (2011). Effects of environmental tobacco smoke on perinatal outcomes: A retrospective cohort study. British Journal of Obstetrics and Gynaecology, 118(7), 865–871.

    Article  CAS  PubMed  Google Scholar 

  • Cui, H., Gong, T.-T., Liu, C.-X., & Wu, Q.-J. (2016). Associations between passive maternal smoking during pregnancy and preterm birth: Evidence from a meta-analysis of observational studies. PLoS ONE, 11(1), e0147848.

    Article  PubMed Central  PubMed  Google Scholar 

  • DeLorenze, G. N., Kharrazi, M., Kaufman, F. L., Eskenazi, B., & Bernert, J. T. (2002). Exposure to environmental tobacco smoke in pregnant women: The association between self-report and serum cotinine. Environmental Research, 90(1), 21–32.

    Article  CAS  PubMed  Google Scholar 

  • Fantuzzi, G., Vaccaro, V., Aggazzotti, G., Righi, E., Kanitz, S., Barbone, F., et al. (2008). Exposure to active and passive smoking during pregnancy and severe small for gestational age at term. Journal of Maternal-Fetal & Neonatal Medicine, 21(9), 643–647.

    Article  Google Scholar 

  • Genbacev, O., Mcmaster, M. T., Lazic, J., Nedeljkovic, S., Cvetkovic, M., Joslin, R., et al. (2000). Concordant in situ and in vitro data show that maternal cigarette smoking negatively regulates placental cytotrophoblast passage through the cell cycle. Reproductive Toxicology, 14(6), 495–506.

    Article  CAS  PubMed  Google Scholar 

  • Hawkins, S. S., Baum, C. F., Oken, E., & Gillman, M. W. (2014). Associations of tobacco control policies with birth outcomes. Journal of the American Medical Association Pediatrics, 168(11), e142365.

    PubMed  Google Scholar 

  • Heller, M., & Burd, L. (2014). Review of ethanl dispersion, distribution, elimination from the fetal compartment. Birth Defects Research Part A: Clinical and Molecular Teratology, 100(4), 277–283.

    Article  CAS  PubMed  Google Scholar 

  • Howson, C. P., Kinney, M. V., McDougall, L., & Lawn, J. E. & the Born Too Soon Preterm Birth Action Group. (2013). Born too soon: Preterm birth matters. Reproductive Health. https://doi.org/10.1186/1742-4755-10-S1-S1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Institute of Medicine (US). (2007). Committee on understanding premature birth and assuring healthy outcomes; R. E. Behrman & A. S. Butler (Eds.) Preterm birth: Causes, consequences, and prevention. Washington, DC: National Academies Press.

    Google Scholar 

  • Ion, R. C., Wills, A. K., & Bernal, A. L. (2015). Environmental tobacco smoke exposure in pregnancy is associated with earlier delivery and reduced birth weight. Reproductive Sciences, 22(12), 1603–1611.

    Article  CAS  PubMed  Google Scholar 

  • Jaakkola, J. J., Jaakkola, N., & Zahlsen, K. (2001). Fetal growth and length of gestation in relation to prenatal exposure to environmental tobacco smoke assessed by hair nicotine concentration. Environmental Health Perspectives, 109(6), 557–561.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Khader, Y. S., Al-Akour, N., AlZubi, I. M., & Lataifeh, I. (2011). The association between second hand smoke and low birth weight and preterm delivery. Maternal and Child Health Journal, 15(4), 453–459.

    Article  PubMed  Google Scholar 

  • Ko, T.-J., Tsai, L.-Y., Chu, L.-C., Yeh, S.-J., Leung, C., Chen, C.-Y., et al. (2014). Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: A birth cohort study. Pediatrics & Neonatology, 55(1), 20–27.

    Article  Google Scholar 

  • Lawn, J. E., Gravett, M. G., Nunes, T. M., Rubens, C. E., & Stanton, C. & the GAPPS Review Group. (2010). Global report on preterm birth and stillbirth (1 of 7): Definitions, description of the burden and opportunities to improve data. British Medical Journal Pregnancy Childbirth https://doi.org/10.1186/1471-2393-10-S1-S1.

    Article  Google Scholar 

  • Leonardi-Bee, J., Smyth, A., Britton, J., & Coleman, T. (2008). Environmental tobacco smoke and fetal health: Systematic review and meta-analysis. Archives of Disease in Childhood Fetal and Neonatal Edition, 93(5), F351–F361.

    Article  CAS  PubMed  Google Scholar 

  • Lieberman, E., Gremy, I., Lang, J. M., & Cohen, A. P. (1994). Low birthweight at term and the timing of fetal exposure to maternal smoking. American Journal of Public Health, 84(7), 1127–1131.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Martin, J. A., Hamilton, B. E., Osterman, M. J. K., Curtin, S., & Mathews, T. J. (2015). Births: Final data for 2013. National Vital Statistics Reports, 64(1), 1–68.

    PubMed  Google Scholar 

  • Mathews, T. J., MacDorman, M. F., & Thoma, M. (2015). Infant mortality statistics from the 2013 period linked birth/infant death data set. National Vital Statistics Reports, 64(9), 1–30.

    Google Scholar 

  • Miyake, Y., Tanaka, K., & Arakawa, M. (2013). Active and passive maternal smoking during pregnancy and birth outcomes: The Kyushu Okinawa Maternal and Child Health Study. BMC Pregnancy Childbirth, 13, 157.

    Article  PubMed Central  PubMed  Google Scholar 

  • Oberg, M., Jaakkola, M. S., Woodward, A., Peruga, A., & Prüss-Ustün, A. (2011). Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries. Lancet, 377(9760), 139–146.

    Article  PubMed  Google Scholar 

  • Office on Smoking and Health (US). (2006). The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention.

    Google Scholar 

  • Overpeck, M. D., Hediger, M. L., Zhang, J., Trumble, A. C., & Klebanoff, M. A. (1999). Birth weight for gestational age of Mexican American infants born in the United States. Obstetrics & Gynecology, 93(6), 943–947.

    CAS  Google Scholar 

  • Qiu, J., He, X., Cui, H., Zhang, C., Zhang, H., et al. (2014). Passive smoking and preterm birth in urban China. American Journal of Epidemiology, 180(1), 94–102.

    Article  PubMed Central  PubMed  Google Scholar 

  • Reefhuis, J., Gilboa, S. M., Anderka, M., Browne, M. L., Feldkamp, M. L., et al. (2015). The National Birth Defects Prevention Study: A review of the methods. Birth Defects Research Part A: Clinical and Molecular Teratology, 103(8), 656–669.

    Article  CAS  PubMed  Google Scholar 

  • Sastry, B. V., Chance, M. B., Hemontolor, M. E., & Goddijn-Wessel, T. A. (1998). Formation and retention of cotinine during placental transfer of nicotine in human placental cotyledon. Pharmacology, 57(2), 104–116.

    Article  CAS  PubMed  Google Scholar 

  • Tinker, S. C., Gibbs, C., Strickland, M. J., Devine, O. J., Crider, K. S., et al. (2013). Impact of time to maternal interview on interview responses in the National Birth Defects Prevention Study. American Journal of Epidemiology, 177(11), 1225–1235.

    Article  PubMed Central  PubMed  Google Scholar 

  • Vambergue, A., & Fajardy, I. (2011). Consequences of gestational and pregestational diabetes on placental function and birth weight. World Journal of Diabetes, 2(11), 196–203.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wen, S. W., Goldenberg, R. L., Cutter, G. R., Hoffman, H. J., Cliver, S. P., et al. (1990). Smoking, maternal age, fetal growth, and gestational age at delivery. American Journal of Obstetrics and Gynecology, 162(1), 53–58.

    Article  CAS  PubMed  Google Scholar 

  • Zhang, J., & Bowes, W. Jr. (1995). Birth weight-for-gestational-age patterns by race, sex, and parity in the United States population. Obstetrics & Gynecology, 86(2), 200–208.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This publication was supported in part through a cooperative agreement (Grant No. U01DD000494) between the Centers for Disease Control and Prevention and the Texas Department of State Health Services (DSHS). The creation of caffeine variables used was supported by Grant No. DK56350 from the Nutrition Epidemiology Core of the University of North Carolina Clinical Nutrition Research Center. The authors thank the assistance of Dr. Michele L. Herdt and Mr. Jean-Pierre Munsie, funded by the New York State Department of Health, who provided assistance with code used to select working mothers and students in the NBDPS. We also thank the assistance of Mr. Shady Al-Sayyed and Ms. Van Le who assisted with preparing the manuscript for journal submission. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, 1100 W. 49th St., Austin, TX, 78714-9347, USA

    Adrienne T. Hoyt & Mark A. Canfield

  2. Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA

    Paul A. Romitti

  3. Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    Lorenzo D. Botto, Sergey V. Krikov & Marcia L. Feldkamp

  4. Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA

    Marlene T. Anderka

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  1. Adrienne T. Hoyt
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  2. Mark A. Canfield
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  7. Marcia L. Feldkamp
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Correspondence to Adrienne T. Hoyt.

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Hoyt, A.T., Canfield, M.A., Romitti, P.A. et al. Does Maternal Exposure to Secondhand Tobacco Smoke During Pregnancy Increase the Risk for Preterm or Small-for-Gestational Age Birth?. Matern Child Health J 22, 1418–1429 (2018). https://doi.org/10.1007/s10995-018-2522-1

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  • DOI: https://doi.org/10.1007/s10995-018-2522-1

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