title: Parental smoking during pregnancy and offspring cardio-metabolic risk factors at ages 17 and 32.
abstract: OBJECTIVE
  To examine the association of maternal and/or paternal smoking during pregnancy with offspring cardio-metabolic risk (CMR) factors at adolescence and early adulthood, taking into account socio-demographic, medical and lifestyle characteristics of parents and offspring, as well as offspring common genetic variation.
  
  
  METHODS
  We used a population-based cohort of all 17 003 births in Jerusalem during 1974-76, with available archival data on parental and birth characteristics. Measurements at age 17 were assessed at military induction examinations for 11 530 offspring. 1440 offspring from the original 1974-1976 birth cohort were sampled using a stratified sampling approach, and were interviewed and examined at age 32. Parental smoking during pregnancy (i.e. maternal, paternal and any parent) was primarily defined dichotomously (any number of cigarettes smoked daily by mother or father during pregnancy vs. non-smokers). Additionally, smoking was assessed by quantity of cigarettes smoked daily. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with various offspring CMR factors, after controlling for potential confounders and for genetic variation in candidate genes.
  
  
  RESULTS
  Prevalence of exposure to parental smoking in-utero (i.e. smoking of any parent) was 53.2% and 48.4% among the 17 years old and 32 years old samples, respectively. At age 17, smoking of at least one parent during pregnancy was significantly associated with weight (B = 1.39), height (B = 0.59), BMI (B = 0.32) and pulse rate (B = -0.78) (p-values < 0.001). At age 32, parental smoking, adjusted for covariates, was associated with 2.22 kg higher mean offspring weight, 0.95 cm higher mean offspring height, 0.57 kg/m(2) higher BMI, and 1.46 cm higher waist-circumference (p-values ≤ 0.02). Similar results, reflecting a dose response, were observed when maternal and paternal smokings were assessed by number of cigarettes smoked daily.
  
  
  CONCLUSIONS
  This prospective study demonstrates a potential long-term adverse effect of parental smoking during pregnancy on offspring health and calls for increasing efforts to promote smoking cessation of both parents before pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel; Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel. Electronic address: uri.dior@gmail.com.
authors.forename: Uri P
authors.initials: UP
authors.lastname: Dior
authors.affiliation: Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
authors.forename: Gabriella M
authors.initials: GM
authors.lastname: Lawrence
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Medicine, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Sitlani
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Enquobahrie
authors.affiliation: Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
authors.forename: Orly
authors.initials: O
authors.lastname: Manor
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101, USA; Department of Medicine, University of Washington, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Seattle, WA 98101, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
authors.forename: Yechiel
authors.initials: Y
authors.lastname: Friedlander
authors.affiliation: Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
authors.forename: Hagit
authors.initials: H
authors.lastname: Hochner
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008425:Maternal Behavior; D024821:Metabolic Syndrome / Q000209:etiology*; D050177:Overweight; D010332:Paternal Behavior; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D055105:Waist Circumference
keywords: Cohort study; Obesity; Pregnancy; Risk factors; Smoking