Association of maternal smoking with overweight at age 3 y in American Indian children

Abstract

Background: Prevalence rates of overweight are higher among American Indian children than among any other ethnic group, but little research has explored contributing influences.

Objective: The objective was to determine the prevalence and predictors of body mass index (BMI; in kg/m2) > or = 85th percentile in American Indian children in Wisconsin.

Design: A retrospective analysis was conducted with linked pediatric and pregnancy nutrition surveillance systems and birth records from 1997 through 2001. Participants were American Indian mothers and children (aged 0-3 y) who were participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Outcome measurements included indicators of BMI > or = 85th percentile identified by using binary logistic regression.

Results: Of the 3-y-olds, 22.2% were overweight and 18.7% were at risk of overweight. Of their mothers, 42.5% had smoked during pregnancy. Smoking at the initial prenatal visit significantly predicted overweight and risk of overweight in children at age 3 y (odds ratio: 2.16; 95% CI: 1.05, 4.47). Despite being smaller at birth, the children of smoking mothers had a significantly (P < 0.05) greater increase in weight-for-length z score between birth and age 3 y than did children of nonsmokers. This greater increase was due to a significantly (P < 0.02) greater increase in weight in children of smokers than in those of nonsmokers and not to a relatively slower increase in height.

Conclusions: Our findings suggest the early influence of maternal smoking on the prevalence of overweight at age 3 y in a high-risk American Indian population and provide evidence that interventions to reduce smoking in pregnant women may be warranted.