Maternal smoking during pregnancy and asthma during the first year of life: a comparative study between smokers and nonsmoker mothers
Main Article Content
Keywords
smoking, pregnancy, asthma, bronchiolitis, atopic dermatitis, food allergy, birth weight
Abstract
Background: We investigated the relationship between maternal smoking in pregnancy and health care problems in the offspring during the first year of life, particularly asthma.
Material and Methods: A cohort of 648 consecutive infants born at term and alive at Hospital de Sagunto (Valencia, Spain) over one year period was followed for 12 months. Clinical data of the infants were prospectively collected from the database of ambulatory medical records (ABUCASIS) of the Valencia health system.
Results: Smoking during pregnancy was recorded in 164 (25.3%) mothers. During the first year of life, asthma was diagnosed in 101 infants, with an incidence of 15.7%. The diagnoses of asthma (25.6% vs. 12.3%; P < 0.0001) and bronchiolitis (44.5% vs. 28.6%; P = 0.0002) during the first year of life were more common among infants in the smoking group. The probability of developing asthma during the first year of life was two-fold higher for the male gender and 2.5 times higher when mothers smoked while pregnant. Up to 52% of asthma cases could have been avoided in infants born to smoking mothers if they did not smoke during pregnancy. Infants in the smoking group showed a lower weight and length at birth than infants in the nonsmoking group differences almost disappeared at 6 months and 12 months.
Conclusion: Asthma during the first year of life showed a clear relationship with maternal smoking in pregnancy. Pregnant women should be advised of the significant perinatal risk for respiratory diseases associated with tobacco use.
References
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26. Scherman A, Tolosa JE, McEvoy C. Smoking cessation in pregnancy: A continuing challenge in the United States. Ther Adv Drug Saf. 2018;9(8):457–74. 10.1177/2042098618775366
27. Grant A, Morgan M, Gallagher D, Mannay D. Smoking during pregnancy, stigma and secrets: Visual methods exploration in the UK. Women Birth. 2020;33(1):70–6. 10.1016/j.wombi.2018.11.012
28. Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, et al. Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants. Respir Res. 2015;16:152. 10.1186/s12931-015-0312-5
29. Cano Fernández J, Zabaleta Camino C, de la Torre Montes de Neira E, Yep Chullen GA, Melendi Crespo JM, Sánchez Bayle M. Pre and postnatal tobacco exposure and bronchiolitis. An Pediatr (Barc). 2003;58(2):115–20. 10.1016/s1695-4033(03)78014-x
30. Fuentes-Leonarte V, Estarlich M, Ballester F, Murcia M, Esplugues A, Aurrekoetxea JJ, et al. Pre-and postnatal exposure to tobacco smoke and respiratory outcomes during the first year. Indoor Air. 2015;25(1):4–12. 10.1111/ina.12128
31. Bantz SK, Zhu Z, Zheng T. The atopic march: Progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2):202. 10.4172/2155-9899.1000202
32. Spergel JM. Epidemiology of atopic dermatitis and atopic march in children. Immunol Allergy Clin North Am. 2010;30(3):269–80. 10.1016/j.iac.2010.06.003
33. von Kobyletzki LB, Bornehag CG, Hasselgren M, Larsson M, Lindström CB, Svensson Å. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol. 2012;12:11. 10.1186/1471-5945-12-11
34. Abraham M, Alramadhan S, Iniguez C, Duijts L, Jaddoe VW, Den Dekker HT, et al. A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PLoS One. 2017;12(2):e0170946. 10.1371/journal.pone.0170946
35. Pereira PP, Da Mata FA, Figueiredo AC, de Andrade KR, Pereira MG. Maternal active smoking during pregnancy and low birth weight in the Americas: A systematic review and meta-analysis. Nicotine Tob Res. 2017;19(5):497–505. 10.1093/ntr/ntw228
36. Malta MB, de Barros Leite Carvalhaes MA, de Lima Parada CMG. Smoking during pregnancy and harm reduction in birth weight: A cross-sectional study. BMC Pregnancy Childbirth. 2018;18(1):67. 10.1186/s12884-018-1694-4
37. Moral L, Vizmanos G, Torres-Borrego J, Praena-Crespo M, Tortajada-Girbés M, Pellegrini FJ, Asensio Ó. Asthma diagnosis in infants and preschool children: A systematic review of clinical guidelines. Allergol Immunopathol (Madr). 2019;47(2):107–21. 10.1016/j.aller.2018.05.002
38. Erickson AC, Arbour LT. Heavy smoking during pregnancy as a marker for other risk factors of adverse birth outcomes: A population-based study in British Columbia, Canada. BMC Public Health..2012;6(12):102. 10.1186/1471-2458-12-102
39. Harju M, Keski-Nisula L, Georgiadis L, Heinonen S. Parental smoking and cessation during pregnancy and the risk of childhood asthma. BMC Public Health. 2016 May 24;16:428. 10.1186/s12889-016-3029-6
2. Cnattingius S. The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res. 2004;6 (Suppl 2):S125–40. 10.1080/14622200410001669187
3. Shea AK, Steiner M. Cigarette smoking during pregnancy. Nicotine Tob Res. 2008;10(2):267–278. 10.1080/14622200701825908
4. Brion MJ, Victora C, Matijasevich A, Horta B, Anselmi L, Steer C, et al. Maternal smoking and child psychological problems: Disentangling causal and noncausal effects. Pediatrics. 2010;126(1):e57–65. 10.1542/peds.2009-2754
5. Indredavik MS, Brubakk AM, Romundstad P, Vik T. Prenatal smoking exposure and psychiatric symptoms in adolescence. Acta Paediatr. 2007;96(3):377–82. 10.1111/j.1651-2227.2006.00148.x
6. von Kries R, Toschke AM, Koletzko B, Slikker W Jr. Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol. 2002;156(10):954–61. 10.1093/aje/kwf128
7. Hayatbakhsh MR, Sadasivam S, Mamun AA, Najman JM, Williams GM, O’Callaghan MJ. Maternal smoking during and after pregnancy and lung function in early adulthood: A prospective study. Thorax. 2009;64(9):810–14. 10.1136/thx.2009.116301
8. Milner AD, Rao H, Greenough A. The effects of antenatal smoking on lung function and respiratory symptoms in infants and children. Early Hum Dev. 2007;83(11):707–11. 10.1016/j.earlhumdev.2007.07.014
9. Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli G, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: A descriptive review. J Transl Med. 2015;13:327. 10.1186/s12967-015-0690-y
10. Lange S, Probst C, Rehm J, Popova S. National, regional, and global prevalence of smoking during pregnancy in the general population: A systematic review and meta-analysis. Lancet Glob Health. 2018;6(7):e769–76. 10.1016/S2214-109X(18)30223-7
11. Dietz PM, Homa D, England LJ, Burley K, Tong VT, Dube SR, et al. Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. Am J Epidemiol. 2011;173(3):355–9. 10.1093/aje/kwq381.
12. Drake P, Driscoll AK, Mathews TJ. Cigarette smoking during pregnancy: United States 2016. NCHS Data Brief. 2018; Feb;(305):1–8.
13. Tappin D, MacAskill S, Bauld L, Eadie D, Shipton D, Galbraith L. Smoking prevalence and smoking cessation services for pregnant women in Scotland. Subst Abuse Treat Prev Pol. 2010;5:1.
14. Drake AJ, O’Shaughnessy PJ, Bhattacharya S, Monteiro A, Kerrigan D, Goetz S, et al. In utero exposure to cigarette chemicals induces sex-specific disruption of one-carbon metabolism and DNA methylation in the human fetal liver. BMC Med. 2015;13:18. 10.1186/s12916-014-0251-x
15. McEvoy CT, Spindel ER. Pulmonary effects of maternal smoking on the fetus and child: Effects on lung development, respiratory morbidities, and life long lung health. Paediatr Respir Rev. 2017;21:27–33. 10.1016/j.prrv.2016.08.005
16. Gilliland FD, Li YF, Peters JM. Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med. 2001;163(2):429–36. 10.1164/ajrccm.163.2.2006009
17. De Queiroz Andrade E, Da Silva Sena CR, Collison A, Murphy VE, Gould GS, Bonevski B, et al.. Association between active tobacco use during pregnancy and infant respiratory health: A systematic review and meta-analysis. BMJ Open. 2020;10(9):e037819. 10.1136/bmjopen-2020-037819
18. Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: Systematic review and meta-analysis. Pediatrics. 2012;129(4):735–44. 10.1542/peds.2011-2196
19. Toppila-Salmi S, Luukkainen AT, Xu B, Lampi J, Auvinen J, Dhaygude K, et al. Maternal smoking during pregnancy affects adult onset of asthma in offspring: A follow up from birth to age 46 years. Eur Respir J. 2020;55(6):1901857. 10.1183/13993003.01857-2019
20. Neuman Å, Hohmann C, Orsini N, Pershagen G, Eller E, Kjaer HF, et al. Maternal smoking in pregnancy and asthma in preschool children: A pooled analysis of eight birth cohorts. Am J Respir Crit Care Med. 2012;186(10):1037–43. 10.1164/rccm.201203-0501OC
21. Zacharasiewicz A. Maternal smoking in pregnancy and its influence on childhood asthma. ERJ Open Res. 2016;2(3):042–2016. 10.1183/23120541.00042-2016
22. García-Sempere A, Orrico-Sánchez A, Muñoz-Quiles C, Hurtado I, Peiró S, Sanfélix-Gimeno G, et al. Data Resource Profile: The Valencia Health System Integrated Database (VID). Int J Epidemiol. 2020;49(3):740–1e. 10.1093/ije/dyz266
23. Servicio de Planificación y Evaluación de Políticas de Salud. Encuesta de salud de la Comunidad Valenciana 2016. Principales resultados. Conseleria de Sanitat i Salut Pública, València, 2017.
24. Lannerö E, Wickman M, Pershagen G, Nordvall L. Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE). Respir Res. 2006;7(1):3. 10.1186/1465-9921-7-3
25. Gilliland FD, Berhane K, Li YF, Rappaport EB, Peters JM. Effects of early onset asthma and in utero exposure to maternal smoking on childhood lung function. Am J Respir Crit Care Med. 2003;167(6):917–24. 10.1164/rccm.200206-616OC
26. Scherman A, Tolosa JE, McEvoy C. Smoking cessation in pregnancy: A continuing challenge in the United States. Ther Adv Drug Saf. 2018;9(8):457–74. 10.1177/2042098618775366
27. Grant A, Morgan M, Gallagher D, Mannay D. Smoking during pregnancy, stigma and secrets: Visual methods exploration in the UK. Women Birth. 2020;33(1):70–6. 10.1016/j.wombi.2018.11.012
28. Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, et al. Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants. Respir Res. 2015;16:152. 10.1186/s12931-015-0312-5
29. Cano Fernández J, Zabaleta Camino C, de la Torre Montes de Neira E, Yep Chullen GA, Melendi Crespo JM, Sánchez Bayle M. Pre and postnatal tobacco exposure and bronchiolitis. An Pediatr (Barc). 2003;58(2):115–20. 10.1016/s1695-4033(03)78014-x
30. Fuentes-Leonarte V, Estarlich M, Ballester F, Murcia M, Esplugues A, Aurrekoetxea JJ, et al. Pre-and postnatal exposure to tobacco smoke and respiratory outcomes during the first year. Indoor Air. 2015;25(1):4–12. 10.1111/ina.12128
31. Bantz SK, Zhu Z, Zheng T. The atopic march: Progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2):202. 10.4172/2155-9899.1000202
32. Spergel JM. Epidemiology of atopic dermatitis and atopic march in children. Immunol Allergy Clin North Am. 2010;30(3):269–80. 10.1016/j.iac.2010.06.003
33. von Kobyletzki LB, Bornehag CG, Hasselgren M, Larsson M, Lindström CB, Svensson Å. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol. 2012;12:11. 10.1186/1471-5945-12-11
34. Abraham M, Alramadhan S, Iniguez C, Duijts L, Jaddoe VW, Den Dekker HT, et al. A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PLoS One. 2017;12(2):e0170946. 10.1371/journal.pone.0170946
35. Pereira PP, Da Mata FA, Figueiredo AC, de Andrade KR, Pereira MG. Maternal active smoking during pregnancy and low birth weight in the Americas: A systematic review and meta-analysis. Nicotine Tob Res. 2017;19(5):497–505. 10.1093/ntr/ntw228
36. Malta MB, de Barros Leite Carvalhaes MA, de Lima Parada CMG. Smoking during pregnancy and harm reduction in birth weight: A cross-sectional study. BMC Pregnancy Childbirth. 2018;18(1):67. 10.1186/s12884-018-1694-4
37. Moral L, Vizmanos G, Torres-Borrego J, Praena-Crespo M, Tortajada-Girbés M, Pellegrini FJ, Asensio Ó. Asthma diagnosis in infants and preschool children: A systematic review of clinical guidelines. Allergol Immunopathol (Madr). 2019;47(2):107–21. 10.1016/j.aller.2018.05.002
38. Erickson AC, Arbour LT. Heavy smoking during pregnancy as a marker for other risk factors of adverse birth outcomes: A population-based study in British Columbia, Canada. BMC Public Health..2012;6(12):102. 10.1186/1471-2458-12-102
39. Harju M, Keski-Nisula L, Georgiadis L, Heinonen S. Parental smoking and cessation during pregnancy and the risk of childhood asthma. BMC Public Health. 2016 May 24;16:428. 10.1186/s12889-016-3029-6
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