title: Dose-response associations between maternal smoking during pregnancy and subsequent childhood obesity: effect modification by maternal race/ethnicity in a low-income US cohort.
abstract: Studies suggest that children exposed to cigarette smoke in utero are at risk of becoming obese. Few researchers have evaluated the dose-response association between maternal smoking during pregnancy and childhood obesity or whether this association varies by maternal race/ethnicity. The authors obtained retrospective cohort data by linking records from the Pregnancy Nutrition Surveillance System and the Pediatric Nutrition Surveillance System on 155,411 low-income children born during 1995-2001 in 9 US states and 2 tribal nations. The authors examined maternal smoking status, duration of smoking, quantity of smoking, and both duration and quantity combined. Childhood obesity was based on a body mass index greater than or equal to the 95th percentile for sex and age, assessed at age 2-4 years. Maternal race/ethnicity modified the association between smoking during pregnancy and childhood obesity. Among non-Hispanic White mothers, both duration and quantity of smoking were positively associated with childhood obesity in a dose-response manner. Among non-Hispanic Black mothers, only heavy smoking was positively associated with childhood obesity. Among Hispanics, American Indians/Alaska Natives, and Asians/Pacific Islanders, smoking was not associated with childhood obesity. The inconsistent association between smoking during pregnancy and childhood obesity across race/ethnicity categories merits further investigation into potential explanations for this variation, which may include confounding, reporting bias, or unexplored biologic mechanisms.
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-25, Atlanta, GA 30341-3724, USA. AJSharma@cdc.gov
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Sharma
authors.forename: Mary E
authors.initials: ME
authors.lastname: Cogswell
authors.forename: Ruowei
authors.initials: R
authors.lastname: Li
mesh_terms: D000328:Adult; D002675:Child, Preschool; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008499:Medical Records; D009765:Obesity / Q000453:epidemiology / Q000209:etiology*; D011159:Population Surveillance / Q000379:methods*; D011203:Poverty; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology