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Prepregnancy body mass index, smoking during pregnancy, and infant birth weight

Michele La Merrill1, Cheryl R Stein, Philip Landrigan

  • 1Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY. michele.lamerrill@mssm.edu

Annals of Epidemiology
|March 23, 2011
PubMed

Insights

Prenatal smoking increases risks for small for gestational age (SGA) and low birth weight, but this effect is reduced in women with higher prepregnancy body mass index (BMI). Overweight and obese women who smoke during pregnancy show minimal impact on SGA risk.

Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Perinatal Medicine

Background:

  • Prenatal smoking is a known risk factor for adverse birth outcomes, including small for gestational age (SGA) and low birth weight.
  • Elevated prepregnancy body mass index (BMI) is generally associated with decreased SGA risk and increased birth weight.

Purpose of the Study:

  • To investigate the combined effects of prenatal smoking and prepregnancy BMI on the risk of SGA and on birth weight.
  • To determine if prepregnancy BMI modifies the impact of smoking during pregnancy on fetal growth.

Main Methods:

  • Analysis of 34,928 singleton, term pregnancies in New York City residents (1995-2003).
  • Utilized multivariable regression models to assess birth weight and SGA risk.
  • Categorized participants based on prepregnancy BMI (underweight, normal, overweight, obese).

Main Results:

  • Increasing prepregnancy BMI was associated with reduced SGA risk and increased birth weight.
  • The negative impact of prenatal smoking on birth weight and SGA risk diminished with higher prepregnancy BMI.
  • Prenatal smoking significantly decreased mean birth weight in underweight and normal weight women, but not significantly in overweight or obese women.

Conclusions:

  • The adverse effects of smoking during pregnancy on SGA and birth weight are most pronounced in underweight and normal weight women.
  • Prepregnancy obesity and overweight status appear to mitigate the negative impact of smoking on fetal growth.
  • These findings highlight the complex interplay between maternal BMI and smoking in determining birth outcomes.
Abstract

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