title: Mother's smoking and complex lung function of offspring in middle age: A cohort study from childhood.
abstract: Existing evidence that supports maternal smoking to be a potential risk factor for chronic obstructive pulmonary disease (COPD) for adult offspring has barely been mentioned in major guideline documents, suggesting a need for more robust and consistent data. We aimed to examine whether such early life exposure can predispose to COPD in middle age, possibly through its interaction with personal smoking.
  
  
  
  The fifth-decade follow-up of the Tasmanian Longitudinal Health Study cohort, which was first studied in 1968 (n = 8583), included a 2004 postal survey (n = 5729 responses) and subsequent laboratory attendance (n = 1389) for comprehensive lung function testing between 2006 and 2008. Multivariable linear and logistic regression models included sampling weights.
  
  
  
  Post-bronchodilator airflow obstruction (less than fifth percentile) was detected for 9.3% (n = 123) of middle-aged offspring. Its association with heavy maternal smoking (>20 cigarettes/day) during childhood was 2.7-fold higher than for those without exposure (95% confidence interval [1.3, 5.7] P = 0.009). Maternal smoking per se approximately doubled the adverse effect of personal smoking on gas transfer factor (z-score -0.46 [-0.6 to -0.3] vs -0.25 [-0.4 to -0.1], P[interaction] = 0.048) and was paradoxically associated with reduced residual volumes for non-smokers.
  
  
  
  Heavy maternal smoking during childhood appears to predispose to spirometrically defined COPD. The interplay between maternal and personal smoking on gas transfer factor suggests that early life exposure increases an individual's susceptibility to adult smoking exposure. These findings provide further evidence to suggest that maternal smoking might be a risk factor for COPD and reinforce the public health message advocating smoking abstinence.
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.|Department of Respiratory and Sleep Medicine, Austin Hospital.|Institute for Breathing and Sleep (IBAS).
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Perret
authors.affiliation: 'Breathe Well' Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, Tasmania.|School of Medicine, University of Notre Dame.
authors.forename: Haydn
authors.initials: H
authors.lastname: Walters
authors.affiliation: 'Breathe Well' Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, Tasmania.
authors.forename: David
authors.initials: D
authors.lastname: Johns
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.
authors.forename: Lyle
authors.initials: L
authors.lastname: Gurrin
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.
authors.forename: John
authors.initials: J
authors.lastname: Burgess
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.
authors.forename: Adrian
authors.initials: A
authors.lastname: Lowe
authors.affiliation: Institute for Breathing and Sleep (IBAS).|Allergy, Immunology and Respiratory Medicine, The Alfred Hospital.|Department of Medicine, Monash University.
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
authors.affiliation: Launceston General Hospital, Launceston, Tasmania.
authors.forename: James
authors.initials: J
authors.lastname: Markos
authors.affiliation: Department of Medicine, University of Queensland, Brisbane, Queensland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morrison
authors.affiliation: Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Department of Respiratory and Sleep Medicine, Austin Hospital.|Institute for Breathing and Sleep (IBAS).
authors.forename: Christine
authors.initials: C
authors.lastname: McDonald
authors.affiliation: 'Breathe Well' Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, Tasmania.
authors.forename: Richard
authors.initials: R
authors.lastname: Wood-Baker
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.|Department of Public Health, Seoul National University, Seoul, Korea.
authors.forename: John
authors.initials: J
authors.lastname: Hopper
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.|Cancer Epidemiology Centre, Cancer Council Victoria.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Giles
authors.affiliation: Allergy, Immunology and Respiratory Medicine, The Alfred Hospital.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Abramson
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.
authors.forename: Melanie
authors.initials: M
authors.lastname: Matheson
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne.
authors.forename: Shyamali
authors.initials: S
authors.lastname: Dharmage
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology
keywords: adult offspring; airflow obstruction; gas transfer factor; interaction; maternal smoking