Parental smoking during pregnancy and total and abdominal fat distribution in school-age children: the Generation R Study.
OBJECTIVE
Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children.


METHODS
We performed a population-based prospective cohort study among 5243 children followed from early pregnancy onward in the Netherlands. Information about parental smoking was obtained by questionnaires during pregnancy. At the median age of 6.0 years (90% range: 5.7-7.4), we measured anthropometrics, total fat and android/gynoid fat ratio by dual-energy X-ray absorptiometry, and preperitoneal and subcutaneous abdominal fat were measured by ultrasound.


RESULTS
The associations of maternal smoking during pregnancy were only present among girls (P-value for sex interaction<0.05). Compared with girls from mothers who did not smoke during pregnancy, those from mothers who smoked during the first trimester only had a higher android/gynoid fat ratio (difference 0.23 (95% confidence interval (CI): 0.09-0.37) s.d. scores (SDS). Girls from mothers who continued smoking throughout pregnancy had a higher body mass index (difference: 0.24 (95% CI: 0.14-0.35) SDS), total fat mass (difference: 0.23 (95% CI: 0.14-0.33) SDS), android/gynoid fat ratio (difference: 0.34 (95% CI: 0.22-0.46) SDS), subcutaneous abdominal fat (difference: 0.22 (95% CI: 0.11-0.33) SDS) and preperitoneal abdominal fat (difference: 0.20 (95% CI: 0.08-0.31) SDS). Similar associations with body fat distribution outcomes were observed for paternal smoking during pregnancy. Both continued maternal and paternal smoking during pregnancy may be associated with an increased risk of childhood overweight. The corresponding odds ratios were 1.19 (95% CI: 0.98-1.46) and 1.32 (1.10-1.58), respectively.


CONCLUSIONS
Maternal and paternal smoking during pregnancy are associated with an adverse body and abdominal fat distribution and increased risk of overweight in children. Similar effects of maternal and paternal smoking suggest that direct intrauterine mechanisms and common family-based lifestyle-related factors explain the associations.
1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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B
Durmuş
1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
D H M
DH
Heppe
1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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HR
Taal
Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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R
Manniesing
Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
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H
Raat
Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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A
Hofman
Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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EA
Steegers
1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
R
R
Gaillard
1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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VW
Jaddoe
D050153:Abdominal Fat / Q000473:pathology*; D000328:Adult; D050218:Body Fat Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D015430:Weight Gain