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Childhood obesity is associated with maternal smoking in pregnancy
André Michael Toschke1, Berthold Koletzko, William Slikker
1Department of Paediatric Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Heiglhofstrasse 63, 81377 Munich, Germany.
Insights
Maternal smoking during pregnancy is linked to childhood obesity. This study found a higher obesity risk in children whose mothers smoked during gestation, indicating intrauterine smoke exposure is a key factor.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Overweight and obesity are significant global public health concerns.
- Childhood obesity frequently persists into adulthood, posing long-term health risks.
- Previous research suggests a link between maternal smoking during pregnancy and adult obesity.
Purpose of the Study:
- To investigate the association between maternal smoking during pregnancy and obesity in preschool children.
- To identify the critical period of intrauterine exposure to smoke products during pregnancy related to childhood obesity.
- To determine if the association holds true in a German preschool population.
Main Methods:
- Analysis of questionnaire data from 8,765 German children aged 5.00 to 6.99 years.
- Obesity defined as a body mass index (BMI) above the 97th percentile.
- Statistical analysis including odds ratios to assess the association between maternal smoking habits and childhood obesity, adjusting for confounding factors.
Main Results:
- Children born to mothers who smoked throughout pregnancy had a significantly higher prevalence of obesity (6.2%) compared to those whose mothers never smoked (2.8%).
- Maternal smoking before pregnancy but not throughout also showed an increased odds ratio for childhood obesity (adjusted OR 1.74).
- Smoking after pregnancy was not associated with increased childhood obesity prevalence.
Conclusions:
- The association between maternal smoking during pregnancy and childhood obesity is detectable at school entry.
- Intrauterine exposure to smoke products during pregnancy, rather than postnatal family lifestyle, appears to be the primary driver of this association.
- Early intrauterine exposure to maternal smoking plays a significant role in the development of childhood obesity.
Unlabelled:
Overweight and obesity are major public health issues. Childhood obesity often persists throughout adulthood. Recently a higher prevalence of obesity in adults whose mothers smoked during pregnancy was reported. The aim of this study was to assess whether this association is also detectable in pre-school children in a different setting and to identify the critical period for intrauterine exposure to inhaled smoke products in pregnancy. We analysed questionnaire data on early feeding and lifestyle factors of 8,765 German children aged 5.00 to 6.99 years. Obesity was defined as a body mass index >97th percentile. The prevalence estimates for obesity were: mother never smoked 2.8% (95% CI 2.4%-3.2%), smoked after pregnancy only 1.6% (95%CI 0.4%-4.1%), smoked throughout pregnancy 6.2% (95% CI 4.5%-8.3%), smoked before pregnancy, but not throughout 4.5% (95%CI 3.6%-5.7%). These associations could not be explained by confounding due to a number of constitutional, sociodemographic and lifestyle factors. The unadjusted/adjusted odds ratios were: smoked during pregnancy: 2.32 (95% CI 1.63%-3.30%)/1.92 (95% CI 1.29%-2.86%); smoked before, but not throughout pregnancy: 1.67 (95%CI 1.26%-2.22%)/1.74 (95%CI 1.29%-2.34%).
Conclusion:
the association of maternal smoking in pregnancy and obesity was also detectable in children at school entry. Since smoking after pregnancy was not associated with childhood obesity, intrauterine exposure rather than family lifestyle factors associated with smoking appears to be instrumental. There appears to be a role for early intrauterine exposure.