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. 2015:49:41.
doi: 10.1590/S0034-8910.2015049005423. Epub 2015 Jul 31.

Effect of the exposure to maternal smoking during pregnancy and childhood on the body mass index until adolescence

Ana Paula Muraro  1 , Regina Maria Veras Gonçalves-Silva  2 , Márcia Gonçalves Ferreira  2 , Gulnar Azevedo E Silva  3 , Rosely Sichieri  3
Affiliations

Effect of the exposure to maternal smoking during pregnancy and childhood on the body mass index until adolescence

Ana Paula Muraro et al. Rev Saude Publica. 2015.

Abstract
in English, Portuguese

OBJECTIVE Investigate the effect of exposure to smoking during pregnancy and early childhood on changes in the body mass index (BMI) from birth to adolescence. METHODS A population-based cohort of children (0-5 years old) from Cuiabá, Midwest Brazil, was assessed in 1999-2000 (n = 2,405). Between 2009 and 2011, the cohort was re-evaluated. Information about birth weight was obtained from medical records, and exposure to smoking during pregnancy and childhood was assessed at the first interview. Linear mixed effects models were used to estimate the association between exposure to maternal smoking during pregnancy and preschool age, and the body mass index of children at birth, childhood and adolescence. RESULTS Only 11.3% of the mothers reported smoking during pregnancy, but most of them (78.2%) also smoked during early childhood. Among mothers who smoked only during pregnancy (n = 59), 97.7% had smoked only in the first trimester. The changes in body mass index at birth and in childhood were similar for children exposed and those not exposed to maternal smoking. However, from childhood to adolescence the rate of change in the body mass index was higher among those exposed only during pregnancy than among those who were not exposed. CONCLUSIONS Exposure to smoking only during pregnancy, especially in the first trimester, seems to affect changes in the body mass index until adolescence, supporting guidelines that recommend women of childbearing age to stop smoking.

OBJETIVO: Analisar se a exposição ao tabagismo materno durante a gravidez e no início da infância afeta as mudanças no índice de massa corporal entre o nascimento e a adolescência.

MÉTODOS: Realizado estudo de coorte de base populacional com 2.405 crianças (0 a 5 anos) nascidas em Cuiabá, Brasil, e avaliadas de 1999 a 2000. De 2009 a 2011, esse grupo foi reavaliado. Peso ao nascer foi obtido a partir de registros médicos e a exposição ao tabagismo durante a gravidez e infância foi avaliada na primeira entrevista. Modelos lineares de efeitos mistos foram utilizados para estimar a associação entre a exposição ao tabagismo materno, durante a gravidez e a fase pré-escolar, e o índice de massa corporal das crianças ao nascer e durante a infância e adolescência.

RESULTADOS: Apenas 11,3% das mães relataram fumar durante a gravidez, sendo que a maioria delas (78,2%) também fumou durante a fase pré-escolar da criança. Entre as mães que fumaram exclusivamente durante a gravidez (n = 59), 97,7% fumaram somente no primeiro trimestre. As mudanças de índice de massa corporal entre o nascimento e a infância foram semelhantes entre as crianças expostas e não expostas ao tabagismo materno. Entretanto, entre a infância e a adolescência, a taxa de variação do índice de massa corporal foi maior entre os expostos ao tabagismo materno apenas durante a gravidez quando comparado aos não expostos.

CONCLUSÕES: A exposição ao fumo apenas durante a gravidez, especialmente no primeiro trimestre, pode afetar as mudanças no índice de massa corporal até a adolescência, apoiando a recomendação de cessação do tabagismo entre as mulheres em idade fértil.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Flow chart of study population.
Figure 2
Figure 2. Predicted means of body mass index from birth to adolescence, for exposure to maternal smoking adjusted for gender, socioeconomic position at preschool age, and breastfeeding.
See this image and copyright information in PMC

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