title: Maternal smoking during pregnancy and childhood obesity: results from the CESAR Study.
abstract: Childhood obesity is a worldwide public health concern. Recent studies from high income countries have demonstrated associations between maternal smoking during pregnancy and children's excess body weight. We examine associations between maternal smoking during pregnancy and children's overweight or obesity, in six countries in the less affluent Central/Eastern European region. Questionnaire data were analysed, for 8,926 singleton children aged 9-12 years. Country-specific odds ratios for effects of maternal smoking during pregnancy on being overweight, and on obesity, were estimated using logistic regression. Heterogeneity between country-specific results, and mean effects (allowing for heterogeneity) were estimated. Positive associations between maternal smoking and overweight were seen in all countries but Romania. While not individually statistically significant, the mean odds ratio was 1.26 (95% CI 1.03-1.55), with no evidence of between-country heterogeneity. Obese children were few (2.7%), and associations between obesity and maternal smoking during pregnancy were more heterogeneous, with odds ratios ranging from 0.71 (0.32-1.57) in Poland to 5.49 (2.11-14.30) in Slovakia. Between-country heterogeneity was strongly related to average persons-per-room, a possible socioeconomic indicator, with stronger associations where households were less crowded. Estimates of dose-response relationships tended to be small and non-significant, even when pooled. Our results provide evidence of a link between maternal smoking in pregnancy and childhood overweight. Associations with obesity, though strong in some countries, were less consistent. Maternal smoking may confer an addition to a child's potential for obesity, which is more likely to be realised in affluent conditions.
authors: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E7HT, UK.
authors: Krisztian
authors: K
authors: Gorog
authors: Sam
authors: S
authors: Pattenden
authors: Temenuga
authors: T
authors: Antova
authors: Emilia
authors: E
authors: Niciu
authors: Peter
authors: P
authors: Rudnai
authors: Salome
authors: S
authors: Scholtens
authors: Anna
authors: A
authors: Splichalova
authors: Katarina
authors: K
authors: Slotova
authors: Zoltán
authors: Z
authors: Vokó
authors: Renata
authors: R
authors: Zlotkowska
authors: Danny
authors: D
authors: Houthuijs
mesh_terms: D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D009035:Mothers; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D011795:Surveys and Questionnaires