title: Parental smoking during pregnancy, early growth, and risk of obesity in preschool children: the Generation R Study.
abstract: BACKGROUND
  Maternal smoking during pregnancy seems to be associated with obesity in offspring. Not much is known about the specific critical exposure periods or underlying mechanisms for this association.
  
  
  OBJECTIVE
  We assessed the associations of active maternal and paternal smoking during pregnancy with early growth characteristics and risks of overweight and obesity in preschool children.
  
  
  METHODS
  This study was a population-based, prospective cohort study from early fetal life until the age of 4 y in 5342 mothers and fathers and their children. Growth characteristics [head circumference, length, weight, and body mass index (BMI; in kg/m(2))] and overweight and obesity were repeatedly measured at the ages of 1, 2, 3, and 4 y.
  
  
  RESULTS
  In comparison with children from nonsmoking mothers, children from mothers who continued smoking during pregnancy had persistently smaller head circumferences and heights until the age of 4 y, whereas their weights were lower only until the age of 3 mo. This smaller length and normal to higher weight led to an increased BMI [SD score difference: 0.11; 95% CI: 0.02, 0.20; P < 0.05)] and an increased risk of obesity (odds ratio: 1.61; 95% CI: 1.03, 2.53; P < 0.05) at the age of 4 y. In nonsmoking mothers, paternal smoking was not associated with postnatal growth characteristics or risk of obesity in offspring. Maternal smoking during pregnancy was associated with a higher BMI at the age of 4 y in children with a normal birth weight and in those who were small for gestational age at birth.
  
  
  CONCLUSIONS
  Our findings suggest that direct intrauterine exposure to smoke until late pregnancy leads to different height and weight growth adaptations and increased risks of overweight and obesity in preschool children.
authors: Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands.
authors: Büsra
authors: B
authors: Durmus
authors: Claudia J
authors: CJ
authors: Kruithof
authors: Matthew H
authors: MH
authors: Gillman
authors: Sten P
authors: SP
authors: Willemsen
authors: Albert
authors: A
authors: Hofman
authors: Hein
authors: H
authors: Raat
authors: Paul H C
authors: PH
authors: Eilers
authors: Eric A P
authors: EA
authors: Steegers
authors: Vincent W V
authors: VW
authors: Jaddoe