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Maternal Smoking and Newborn Cytokine and Immunoglobulin Levels
Nikhita Chahal1, Alexander C McLain2, Akhgar Ghassabian1
1Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
Insights
Maternal smoking throughout pregnancy is linked to higher IL-8 levels in newborns. Stopping smoking during pregnancy prevents these increases, highlighting the importance of quitting for infant health.
Area of Science:
- Neonatal immunology
- Environmental health
- Reproductive health
Background:
- Prenatal exposure to tobacco smoke can cause lasting changes in infant inflammation and immune responses.
- These changes increase the risk of lifelong conditions like atopy and respiratory illnesses.
Purpose of the Study:
- To investigate the association between maternal smoking during pregnancy and neonatal inflammatory biomarkers and immunoglobulins.
- To examine the impact of smoking timing, cigarette load, and secondhand smoke exposure on these biomarkers.
Main Methods:
- Analyzed dried blood spots (DBSs) from 3459 infants in the Upstate KIDS Study.
- Measured inflammatory biomarkers (IL-1α, IL-1 receptor antagonist, IL-6, IL-8, C-reactive protein, TNF-α) and immunoglobulins (IgE, IgA, IgM, IgG subclasses).
- Used generalized estimating equations to assess associations, adjusting for covariates.
Main Results:
- Maternal smoking throughout pregnancy was significantly associated with elevated IL-8 levels in newborns (β = 0.20).
- No significant associations were found with smoking load or secondhand smoke exposure.
- Higher IgG3 levels were also linked to smoking throughout pregnancy, reaching nominal significance (β = 0.09).
Conclusions:
- Maternal smoking throughout pregnancy is independently associated with increased neonatal IL-8 levels.
- Infants born to mothers who quit smoking during pregnancy did not show elevated IL-8 levels.
- Findings suggest detectable differences in neonatal immunoregulation due to full-term prenatal smoke exposure.
Introduction:
Prenatal smoking exposure may lead to permanent changes in neonatal inflammation and immune response that have lifelong implications, including increased risks for atopy and respiratory disorders.
Methods:
The effect of maternal smoking on neonatal biomarkers of inflammation and immune response was assessed among 3459 singletons and twins in the Upstate KIDS Study. The following inflammatory biomarkers were measured using newborn dried blood spots (DBSs): interleukin (IL)-1α, IL-1 receptor antagonist, IL-6, IL-8, C-reactive protein, and tumor necrosis factor alpha. Immunoglobulins (IgE, IgA, IgM, and IgG subclasses) were also assessed. We used generalized estimating equations to calculate mean differences (β) in biomarker levels by timing of pregnancy smoking, cigarette load, and secondhand smoke exposure after adjusting for sociodemographic and lifestyle factors including maternal body mass index.
Results:
Of the 344 (12%) women reporting smoking during pregnancy, about 40% continued throughout pregnancy and 13% reported smoking more than 1 pack per day. After covariate adjustment and Bonferroni correction for multiple comparisons, maternal smoking throughout pregnancy remained significantly associated with increased levels of IL-8 (β = 0.20, 95% confidence interval: 0.07, 0.32; p < .003). No significant associations were found with cigarette load or secondhand smoke exposure. Higher IgG3 levels were also associated with maternal smoking throughout pregnancy, although the association became nominally significant after adjustment for covariates (β = 0.09; 95% confidence interval: 0.0007, 0.17; p < .05).
Conclusions:
Maternal smoking throughout pregnancy was independently associated with increased IL-8 levels in newborns. Importantly, neonates of women who stopped smoking anytime in pregnancy did not have increased IL-8 levels.
Implications:
This study evaluated a range of inflammatory biomarkers and immunoglobulins in association with maternal smoking and timing/duration of smoking along with secondhand smoke exposure. By using DBSs, we present data from a large cohort of children born in Upstate New York. Our findings suggest that early differences in immunoregulation of neonates exposed to maternal smoking for full duration in utero may already be detected at birth.
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