Maternal smoking during pregnancy and offspring overweight: is there a dose–response relationship? An individual patient data meta-analysis

Lucia Albers (Corresponding Author), Christina Sobotzki, Oliver Kuß, Teresa Ajslev, Rosangela Batista, Heloisa Bettiol, Bernard Brabin, Stephen Buka, Viviane Cardoso, Vicki L Clifton, Graham Devereux, Stephen Gilman, Luke E Grzeskowiak, Joachim Heinrich, Sandra Hummel, Geir Jacobsen, Graeme Jones, Gibby Koshy, Camilla Schmidt Morgen, Emily Oken & 10 others Tomas Paus, Zdenka Pausova, Sherly Rifas-Shiman, Andrea Sharma, Antônio da Silva, Thorkild Soerensen, Elisabeth Thiering, Stephen Turner, Torstein Vik, Rüdiger von Kries

Research output: Contribution to journalReview article

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Abstract

Background/objectives
A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose–response relationship across number of cigarettes and whether this differs by sex remains unclear.

Subject/methods
Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex.

Results
Of 26 identified studies, 16 authors provided data on a total of 238,340 mother–child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02–1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results.

Conclusions
A linear dose–response relationship of maternal smoking was observed in the range of 1–15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.
Original languageEnglish
Pages (from-to)1249-1264
Number of pages15
JournalInternational Journal of Obesity
Volume42
Early online date28 Feb 2018
DOIs
Publication statusPublished - 2018

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Tobacco Products
Meta-Analysis
Smoking
Mothers
Pregnancy
Obesity
Nonlinear Dynamics
Sex Education
Advisory Committees
Breast Feeding
Weights and Measures

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Maternal smoking during pregnancy and offspring overweight : is there a dose–response relationship? An individual patient data meta-analysis. / Albers, Lucia (Corresponding Author); Sobotzki, Christina; Kuß, Oliver; Ajslev, Teresa; Batista, Rosangela; Bettiol, Heloisa; Brabin, Bernard; Buka, Stephen; Cardoso, Viviane; Clifton, Vicki L; Devereux, Graham; Gilman, Stephen; Grzeskowiak, Luke E; Heinrich, Joachim; Hummel, Sandra; Jacobsen, Geir; Jones, Graeme; Koshy, Gibby; Schmidt Morgen, Camilla; Oken, Emily; Paus, Tomas; Pausova, Zdenka; Rifas-Shiman, Sherly; Sharma, Andrea; da Silva, Antônio; Soerensen, Thorkild; Thiering, Elisabeth; Turner, Stephen; Vik, Torstein; von Kries, Rüdiger.

In: International Journal of Obesity, Vol. 42, 2018, p. 1249-1264.

Research output: Contribution to journalReview article

Albers, L, Sobotzki, C, Kuß, O, Ajslev, T, Batista, R, Bettiol, H, Brabin, B, Buka, S, Cardoso, V, Clifton, VL, Devereux, G, Gilman, S, Grzeskowiak, LE, Heinrich, J, Hummel, S, Jacobsen, G, Jones, G, Koshy, G, Schmidt Morgen, C, Oken, E, Paus, T, Pausova, Z, Rifas-Shiman, S, Sharma, A, da Silva, A, Soerensen, T, Thiering, E, Turner, S, Vik, T & von Kries, R 2018, 'Maternal smoking during pregnancy and offspring overweight: is there a dose–response relationship? An individual patient data meta-analysis' International Journal of Obesity, vol. 42, pp. 1249-1264. https://doi.org/10.1038/s41366-018-0050-0
Albers, Lucia ; Sobotzki, Christina ; Kuß, Oliver ; Ajslev, Teresa ; Batista, Rosangela ; Bettiol, Heloisa ; Brabin, Bernard ; Buka, Stephen ; Cardoso, Viviane ; Clifton, Vicki L ; Devereux, Graham ; Gilman, Stephen ; Grzeskowiak, Luke E ; Heinrich, Joachim ; Hummel, Sandra ; Jacobsen, Geir ; Jones, Graeme ; Koshy, Gibby ; Schmidt Morgen, Camilla ; Oken, Emily ; Paus, Tomas ; Pausova, Zdenka ; Rifas-Shiman, Sherly ; Sharma, Andrea ; da Silva, Antônio ; Soerensen, Thorkild ; Thiering, Elisabeth ; Turner, Stephen ; Vik, Torstein ; von Kries, Rüdiger. / Maternal smoking during pregnancy and offspring overweight : is there a dose–response relationship? An individual patient data meta-analysis. In: International Journal of Obesity. 2018 ; Vol. 42. pp. 1249-1264.
@article{bfa9897359ce487b94572e79f37d9d79,
title = "Maternal smoking during pregnancy and offspring overweight: is there a dose–response relationship? An individual patient data meta-analysis",
abstract = "Background/objectivesA number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose–response relationship across number of cigarettes and whether this differs by sex remains unclear.Subject/methodsStudies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex.ResultsOf 26 identified studies, 16 authors provided data on a total of 238,340 mother–child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95{\%} CI = [1.02–1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results.ConclusionsA linear dose–response relationship of maternal smoking was observed in the range of 1–15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.",
author = "Lucia Albers and Christina Sobotzki and Oliver Ku{\ss} and Teresa Ajslev and Rosangela Batista and Heloisa Bettiol and Bernard Brabin and Stephen Buka and Viviane Cardoso and Clifton, {Vicki L} and Graham Devereux and Stephen Gilman and Grzeskowiak, {Luke E} and Joachim Heinrich and Sandra Hummel and Geir Jacobsen and Graeme Jones and Gibby Koshy and {Schmidt Morgen}, Camilla and Emily Oken and Tomas Paus and Zdenka Pausova and Sherly Rifas-Shiman and Andrea Sharma and {da Silva}, Ant{\^o}nio and Thorkild Soerensen and Elisabeth Thiering and Stephen Turner and Torstein Vik and {von Kries}, R{\"u}diger",
note = "We want to thank the funders of the individual studies: the UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol, the Danish National Research Foundation, Pharmacy Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation, the US NICHD (contracts no. 1-HD-4-2803 and no. 1-HD-1-3127, R01 HD HD034568), the NHMRC, the CNPq (Portuguese acronym for the National Research Council—grant 523474/96-2) and FAPESP (Portuguese acronym for the S{\~a}o Paulo State Research Council—grant 00/0908-7). We would like to thank the participating families of all studies for the use of data. For the ASPAC study, we want to thank the midwives for their help in recruiting families, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. This work was supported by the Deutschen Forschungsgesellschaft (German Research Foundation, DFG) [KR 1926/9-1, KU1443/4-1]. Dr. Gilman’s contribution was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.",
year = "2018",
doi = "10.1038/s41366-018-0050-0",
language = "English",
volume = "42",
pages = "1249--1264",
journal = "International Journal of Obesity",
issn = "0307-0565",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Maternal smoking during pregnancy and offspring overweight

T2 - is there a dose–response relationship? An individual patient data meta-analysis

AU - Albers, Lucia

AU - Sobotzki, Christina

AU - Kuß, Oliver

AU - Ajslev, Teresa

AU - Batista, Rosangela

AU - Bettiol, Heloisa

AU - Brabin, Bernard

AU - Buka, Stephen

AU - Cardoso, Viviane

AU - Clifton, Vicki L

AU - Devereux, Graham

AU - Gilman, Stephen

AU - Grzeskowiak, Luke E

AU - Heinrich, Joachim

AU - Hummel, Sandra

AU - Jacobsen, Geir

AU - Jones, Graeme

AU - Koshy, Gibby

AU - Schmidt Morgen, Camilla

AU - Oken, Emily

AU - Paus, Tomas

AU - Pausova, Zdenka

AU - Rifas-Shiman, Sherly

AU - Sharma, Andrea

AU - da Silva, Antônio

AU - Soerensen, Thorkild

AU - Thiering, Elisabeth

AU - Turner, Stephen

AU - Vik, Torstein

AU - von Kries, Rüdiger

N1 - We want to thank the funders of the individual studies: the UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol, the Danish National Research Foundation, Pharmacy Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation, the US NICHD (contracts no. 1-HD-4-2803 and no. 1-HD-1-3127, R01 HD HD034568), the NHMRC, the CNPq (Portuguese acronym for the National Research Council—grant 523474/96-2) and FAPESP (Portuguese acronym for the São Paulo State Research Council—grant 00/0908-7). We would like to thank the participating families of all studies for the use of data. For the ASPAC study, we want to thank the midwives for their help in recruiting families, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. This work was supported by the Deutschen Forschungsgesellschaft (German Research Foundation, DFG) [KR 1926/9-1, KU1443/4-1]. Dr. Gilman’s contribution was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

PY - 2018

Y1 - 2018

N2 - Background/objectivesA number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose–response relationship across number of cigarettes and whether this differs by sex remains unclear.Subject/methodsStudies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex.ResultsOf 26 identified studies, 16 authors provided data on a total of 238,340 mother–child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02–1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results.ConclusionsA linear dose–response relationship of maternal smoking was observed in the range of 1–15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.

AB - Background/objectivesA number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose–response relationship across number of cigarettes and whether this differs by sex remains unclear.Subject/methodsStudies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex.ResultsOf 26 identified studies, 16 authors provided data on a total of 238,340 mother–child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02–1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results.ConclusionsA linear dose–response relationship of maternal smoking was observed in the range of 1–15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.

U2 - 10.1038/s41366-018-0050-0

DO - 10.1038/s41366-018-0050-0

M3 - Review article

VL - 42

SP - 1249

EP - 1264

JO - International Journal of Obesity

JF - International Journal of Obesity

SN - 0307-0565

ER -