title: Maternal Smoking and Newborn Cytokine and Immunoglobulin Levels.
abstract: BACKGROUND
  Prenatal smoking exposure may lead to permanent changes in neonatal inflammation and immune response that have lifelong implications, including increased risks for atopy and respiratory disorders.
  
  
  METHODS
  The effect of maternal smoking on neonatal biomarkers of inflammation and immune response was assessed among 3459 singletons and twins in the Upstate KIDS Study. The following inflammatory biomarkers were measured using newborn dried blood spots (DBSs): interleukin (IL)-1α, IL-1 receptor antagonist, IL-6, IL-8, C-reactive protein, and tumor necrosis factor alpha. Immunoglobulins (IgE, IgA, IgM, and IgG subclasses) were also assessed. We used generalized estimating equations to calculate mean differences (β) in biomarker levels by timing of pregnancy smoking, cigarette load, and secondhand smoke exposure after adjusting for sociodemographic and lifestyle factors including maternal body mass index.
  
  
  RESULTS
  Of the 344 (12%) women reporting smoking during pregnancy, about 40% continued throughout pregnancy and 13% reported smoking more than 1 pack per day. After covariate adjustment and Bonferroni correction for multiple comparisons, maternal smoking throughout pregnancy remained significantly associated with increased levels of IL-8 (β = 0.20, 95% confidence interval: 0.07, 0.32; p < .003). No significant associations were found with cigarette load or secondhand smoke exposure. Higher IgG3 levels were also associated with maternal smoking throughout pregnancy, although the association became nominally significant after adjustment for covariates (β = 0.09; 95% confidence interval: 0.0007, 0.17; p < .05).
  
  
  CONCLUSIONS
  Maternal smoking throughout pregnancy was independently associated with increased IL-8 levels in newborns. Importantly, neonates of women who stopped smoking anytime in pregnancy did not have increased IL-8 levels.
  
  
  CONCLUSIONS
  This study evaluated a range of inflammatory biomarkers and immunoglobulins in association with maternal smoking and timing/duration of smoking along with secondhand smoke exposure. By using DBSs, we present data from a large cohort of children born in Upstate New York. Our findings suggest that early differences in immunoregulation of neonates exposed to maternal smoking for full duration in utero may already be detected at birth.
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Nikhita
authors.initials: N
authors.lastname: Chahal
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: McLain
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Akhgar
authors.initials: A
authors.lastname: Ghassabian
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Kara A
authors.initials: KA
authors.lastname: Michels
authors.affiliation: Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY.|Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Bell
authors.affiliation: Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY.|Wadsworth Center, New York State Department of Health, Albany, NY.
authors.forename: David A
authors.initials: DA
authors.lastname: Lawrence
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Edwina H
authors.initials: EH
authors.lastname: Yeung
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood*; D008297:Male; D009518:New York; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood; D012907:Smoking / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007136:Immunoglobulins