The independent effects of second hand smoke exposure and maternal body mass index on the anthropometric measurements of the newborn

BMC Public Health

Amel A Fayed¹  Ahmed A Bahnassy³  Rasmieh A Alzeidan²  Ahmed A Mandil⁴  Hayfaa A Wahabi² 

[1] College of Health Sciences, King Saud Ben AbdulAziz University, Riyadh, Kingdom of Saudi Arabia;Sheikh Bahamdan Research Chair of Evidence-based Healthcare and Knowledge translation, College of Medicine, King Saud University, P.O Box 102799, Riyadh 11685, Kingdom of Saudi Arabia;Department of Family and Community Medicine, College of Medicine, King Fahad Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia;Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia

关键词: Saudi Arabia;    Newborn anthropometry;    Maternal body mass index;    Secondhand smoke;   

Others  :  1161569
DOI  :  10.1186/1471-2458-13-1058

 received in 2013-07-12, accepted in 2013-11-07,  发布年份 2013

【 摘 要 】

Background

Exposure to tobacco smoke during pregnancy, whether as active smoking or by exposure to secondhand smoke (SHS), is associated with adverse pregnancy outcomes including low birth weight (LBW) and small for gestational age infants due to the effect of tobacco on the anthropometric measurements of the newborn. This effect might be masked by maternal obesity as it increases fetal weight. The objectives of this study were to estimate the independent effects of maternal exposure to SHS and maternal body mass index (BMI) on the anthropometric measurements and on the prevalence of macrosomia and LBW among term infants.

Methods

Data were collected from women in the postnatal ward following delivery. Participants were stratified into six groups based on the BMI (underweight <18 kg/m², non-obese 18–29.9 kg/m², and obese ≥30 kg/m²) and the SHS exposure status (exposed and non- exposed), to examine the independent effects of BMI and SHS on infants’ anthropometry. Multiple regression analysis was used to explore the independent associations between the six groups and the risk of delivering a macrosomic or LBW infant.

Results

Infants of women exposed to SHS had significantly reduced anthropometric measurements compared to infants of unexposed women. The odds of delivering a macrosomic baby increased to 9-fold for women with BMI of ≥30 kg/m² compared to non-obese women; odds ratio (OR) 9.18, 95% Confidence Interval (CI) (1.01, 9.37); p = 0.04, this risk was attenuated to 1.5-fold in women exposed to SHS, OR 1.53, 95% CI (1.19, 12.1); p < 0.0001. The odds of delivering an LBW infant were more than doubled in underweight women compared to non-obese women, OR 2.15, 95% CI (1.001, 4.57); p = 0.034, and were further increased to almost 3-fold for women who were exposed to SHS, OR 2.71, 95% CI (1.82,4.045); p = 0.02.

Conclusion

Exposure to SHS was associated with reduced anthropometric measurements of the newborn and increased rate of LBW infants, irrespective of maternal BMI. Maternal obesity was associated with increased risk of delivering a macrosomic infant; conversely maternal underweight was associated with increased risk of delivering an LBW infant.

【 授权许可】

   
2013 Wahabi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Salmasi G, Grady R, Jones J, McDonald SD: Environmental tobacco smoke exposure and perinatal outcomes: a systematic review and meta-analyses. Acta Obstet Gynecol Scand 2010, 89:423-441.
• [2]Hayashi K, Matsuda Y, Kawamichi Y, Shiozaki A, Saito S: Smoking during pregnancy increases risks of various obstetric complications: a case-cohort study of the Japan Perinatal Registry Network database. J Epidemiol 2011, 21:61-66.
• [3]Wahabi HA, Alzeidan RA, Fayed AA, Mandil A, Al-Shaikh G, Esmaeil SA: Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women. BMC Public Health 2013, 13:341. BioMed Central Full Text
• [4]Chiolero A, Bovet P, Paccaud F: Association between maternal smoking and low birth weight in Switzerland: the EDEN study. Swiss Med Wkly 2005, 135:525-530.
• [5]Athukorala C, Rumbold AR, Willson KJ, Crowther CA: The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth 2010, 10:56. BioMed Central Full Text
• [6]Wilcox AJ: On the importance–and the unimportance–of birthweight. Int J Epidemiol 2001, 30:1233-1241.
• [7]Voigt M, Jorch G, Briese V, Kwoll G, Borchardt U, Straube S: The combined effect of maternal body mass index and smoking status on perinatal outcomes - an analysis of the german perinatal survey. Z Geburtshilfe Neonatol 2011, 215:23-28.
• [8]Watanabe H, Inoue K, Doi M, Matsumoto M, Ogasawara K, Fukuoka H, et al.: Risk factors for term small for gestational age infants in women with low prepregnancy body mass index. J Obstet Gynaecol Res 2010, 36:506-512.
• [9]Wadi MA, Al-Sharbatti SS: Relationship between birth weight and domestic maternal passive smoking exposure. East Mediterr Health J 2011, 17:290-296.
• [10]Chaaya M, Awwad J, Campbell OM, Sibai A, Kaddour A: Demographic and psychosocial profile of smoking among pregnant women in Lebanon: public health implications. Matern Child Health J 2003, 7:179-186.
• [11]El-Gilany AH, Hammad S: Body mass index and obstetric outcomes in pregnant in Saudi Arabia: a prospective cohort study. Ann Saudi Med 2010, 30:376-380.
• [12]Zdravkovic T, Genbacev O, McMaster MT, Fisher SJ: The adverse effects of maternal smoking on the human placenta: a review. Placenta 2005, 26(Suppl A):S81-S86.
• [13]Leonardi-Bee J, Smyth A, Britton J, Coleman T: Environmental tobacco smoke and fetal health: systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2008, 93:F351-F361.
• [14]Voigt M, Zels K, Guthmann F, Hesse V, Gorlich Y, Straube S: Somatic classification of neonates based on birth weight, length, and head circumference: quantification of the effects of maternal BMI and smoking. J Perinat Med 2011, 39:291-297.
• [15]Bergen HT: Exposure to smoke during development: fetal programming of adult disease. Tob Induc Dis 2006, 3:5-16. BioMed Central Full Text
• [16]Romani F, Lanzone A, Tropea A, Tiberi F, Catino S, Apa R: Nicotine and cotinine affect the release of vasoactive factors by trophoblast cells and human umbilical vein endothelial cells. Placenta 2011, 32:153-160.
• [17]Retnakaran R, Ye C, Hanley AJ, Connelly PW, Sermer M, Zinman B, et al.: Effect of maternal weight, adipokines, glucose intolerance and lipids on infant birth weight among women without gestational diabetes mellitus. CMAJ 2012, 184:1353-1360.
• [18]Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N: Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J Clin Endocrinol Metab 2002, 87:4231-4237.
• [19]Han Z, Mulla S, Beyene J, Liao G, McDonald SD: Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol 2011, 40:65-101.
• [20]Sahu MT, Agarwal A, Das V, Pandey A: Impact of maternal body mass index on obstetric outcome. J Obstet Gynaecol Res 2007, 33:655-659.
• [21]Sewell MF, Huston-Presley L, Amini SB, Catalano PM: Body mass index: a true indicator of body fat in obese gravidas. J Reprod Med 2007, 52:907-911.
• [22]Bo S, Menato G, Signorile A, Bardelli C, Lezo A, Gallo ML, et al.: Obesity or diabetes: what is worse for the mother and for the baby? Diabetes Metab 2003, 29:175-178.
• [23]Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE, et al.: The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 2012, 35:780-786.
• [24]Suresh A, Liu A, Poulton A, Quinton A, Amer Z, Mongelli M, et al.: Comparison of maternal abdominal subcutaneous fat thickness and body mass index as markers for pregnancy outcomes: A stratified cohort study. Aust N Z J Obstet Gynaecol 2012, 52:420-426.
• [25]George L, Granath F, Johansson AL, Cnattingius S: Self-reported nicotine exposure and plasma levels of cotinine in early and late pregnancy. Acta Obstet Gynecol Scand 2006, 85:1331-1337.
• [26]Connor GS, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M: The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 2009, 11:12-24.
• [27]Baheiraei A, Banihosseini SZ, Heshmat R, Mota A, Mohsenifar A: Association of self-reported passive smoking in pregnant women with cotinine level of maternal urine and umbilical cord blood at delivery. Paediatr Perinat Epidemiol 2012, 26:70-76.