title: Effects of maternal smoking in pregnancy on prenatal brain development. The Generation R Study.
abstract: Nicotine, as has been shown in animal studies, is a neuroteratogen, even in concentrations that do not cause growth retardation. In humans, there is only indirect evidence for negative influences of nicotine on brain development from studies on the association between maternal smoking in pregnancy and behavioural and cognitive development in the offspring. We investigated the associations of maternal smoking in pregnancy with foetal head growth characteristics in 7042 pregnant women. This study was embedded in the Generation R Study, a population-based prospective cohort study from foetal life until adulthood. Maternal smoking was assessed by questionnaires in early, mid- and late pregnancy. Head circumference, biparietal diameter, transcerebellar diameter and atrial width of lateral ventricles were repeatedly measured by ultrasound. When mothers continued to smoke during pregnancy, foetal head circumference showed a growth reduction of 0.13 mm [95% confidence interval (CI): -0.18, -0.09] per week compared to foetuses of mothers who never smoked during pregnancy. Biparietal diameter of foetuses with smoking mothers grew 0.04 mm (95% CI: -0.05, -0.02) less per week than that of foetuses of nonsmoking mothers. Atrial width of lateral ventricle was 0.12 mm (95% CI: -0.22, -0.02) smaller and transcerebellar diameter was 0.08 mm (95% CI: -0.15, -0.00) smaller if mothers smoked, but growth per week of these characteristics was not affected by maternal smoking in pregnancy. In conclusion, continuing to smoke during pregnancy leads to reduced growth of the foetal head. Further research should focus on the causal pathway from prenatal cigarette exposure via brain development to behavioural and cognitive functions.
authors.affiliation: The Generation R Study Group, Erasmus MC University Medical Centre Rotterdam, The Netherlands.
authors.forename: Sabine J
authors.initials: SJ
authors.lastname: Roza
authors.forename: Bero O
authors.initials: BO
authors.lastname: Verburg
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000328:Adult; D001921:Brain / Q000196:embryology*; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000196:embryology; D015331:Cohort Studies; D004453:Echoencephalography; D005260:Female; D047109:Fetal Development; D006257:Head / Q000000981:diagnostic imaging / Q000196:embryology; D006801:Humans; D020547:Lateral Ventricles / Q000000981:diagnostic imaging / Q000196:embryology; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000196:embryology; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation