title: Associations of maternal prenatal smoking with child adiposity and blood pressure.
abstract: OBJECTIVE
  To examine the extent to which maternal prenatal smoking is associated with adiposity, central adiposity, and blood pressure in 3-year-old children.
  
  
  METHODS
  We studied 746 mother-child pairs in Project Viva, a prospective cohort study, and categorized mothers as never, early pregnancy, or former smokers. Main outcome measures were overweight (BMI for age and sex > 85th percentile), BMI z-score, sum of subscapular (SS) and triceps (TR) skinfolds, SS:TR skinfold ratio, and systolic blood pressure (SBP).
  
  
  RESULTS
  One hundred sixty-one (22%) mothers quit smoking before pregnancy, 71 (10%) smoked in early pregnancy, and 514 (69%) never smoked. At age 3 years, 204 (27%) children were overweight. On multivariable analysis, compared with children of never smokers, children of early pregnancy smokers had an elevated risk for overweight [odds ratio (OR), 2.2; 95% confidence interval (CI), 1.2, 3.9] and higher BMI z-score (0.30 units; 95% CI, 0.05, 0.55), SS + TR (2.0 mm; 95% CI, 0.9, 3.0), and SBP (2.4 mm Hg; 95% CI, -0.1, 4.9). Children of former smokers were not more overweight (BMI z-score, 0.02 units; 95% CI, -0.15, 0.19) but had higher SBP (1.5 mm Hg; 95% CI, -0.1, 3.2). We saw no relationship of smoking with central adiposity (SS:TR).
  
  
  CONCLUSIONS
  Former and early pregnancy smokers had children with somewhat higher SBP, but only early pregnancy smokers had children who were more overweight. Mechanisms linking smoking with child adiposity and blood pressure may differ. A long-term impact of maternal smoking on offspring cardiovascular risk provides further reason to reduce smoking in women.
authors.affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Boston, MA 02215, USA. emily_oken@hphc.org
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.forename: Susanna Y
authors.initials: SY
authors.lastname: Huh
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
mesh_terms: D050154:Adiposity; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008425:Maternal Behavior; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D011247:Pregnancy / Q000502:physiology*; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology*