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The effects of in utero exposure to teratogens on organ size: a prospective paediatric study
J J A De Smidt1, H J Odendaal2, D G Nel3
1Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa.
Insights
Maternal smoking during pregnancy was linked to smaller kidney and pancreas sizes in children at age 5 in a low-income population. This in utero teratogen exposure may impact long-term health and cardiometabolic risk.
Area of Science:
- Pediatric Health
- Environmental Health
- Developmental Biology
Background:
- Prospective data on combined in utero teratogen exposure effects are scarce in low-income countries.
- Understanding these effects is crucial for early health interventions and risk assessment.
Purpose of the Study:
- To investigate the impact of in utero teratogen exposure, specifically maternal smoking and alcohol consumption, on kidney and pancreas size at 5 years of age.
- To establish ultrasound reference values for pediatric kidney and pancreas measurements in a low-income setting.
Main Methods:
- A cohort of 500 mother-child pairs from a low-income setting was studied.
- Ultrasound measurements of kidney and pancreas size were taken at age 5.
- Anthropometric and clinical data, including maternal factors, were collected and analyzed using multiple regression.
Main Results:
- Children exposed in utero to maternal smoking had significantly smaller left and right kidney lengths and pancreas body measurements at age 5.
- Waist circumference showed a significant association with pancreas head and tail measurements, influenced by in utero exposure, sex, and BMI.
Conclusions:
- In utero exposure to nicotine (maternal smoking) negatively affects kidney and pancreas size in children by age 5.
- These organ size differences may contribute to future cardiometabolic risk.
- The study provides valuable ultrasound reference data for this pediatric population.
Abstract:
In low-income countries, prospective data on combined effects of in utero teratogen exposure are lacking and necessitates new research. The aim of the present study was to explore the effect of in utero teratogen exposure on the size of the kidneys and pancreas 5 years after birth in a low-income paediatric population. Data was collected from 500 mother-child pairs from a low-income setting. Anthropometric measurements included body weight, (BW) body height, mid-upper arm and waist circumference (WC). Clinical measurements included blood pressure (BP), mean arterial pressure and heart rate. Ultrasound measurements included pancreas, and kidney measurements at age 5 years. The main outcome of interest was the effect of maternal smoking and alcohol consumption on ultrasound measurements of organ size at age 5 years. Left and right kidney length measurements were significantly lower in smoking exposed children compared to controls (p = 0.04 and p = 0.03). Pancreas body measurements were significantly lower in smoking exposed children (p = 0.04). Multiple regression analyses were used to examine the associations between the independent variables (IDVs), maternal age, body mass index (BMI), mid-upper arm circumference (MUAC) and BW of the child, on the dependent variables (DVs) kidney lengths and kidney volumes. Also, the association between in utero exposure to alcohol and nicotine and pancreas size. WC was strongest (r = 0.28; p < 0.01) associated with pancreas head [F (4, 454) = 13.44; R2 = 0.11; p < 0.01] and tail (r = 0.30; p < 0.01) measurements at age 5 years, with in utero exposure, sex of the child and BMI as covariates. Kidney length and pancreas body measurements are affected by in utero exposure to nicotine at age 5 years and might contribute to cardiometabolic risk in later life. Also, findings from this study report on ultrasound reference values for kidney and pancreas measurements of children at age 5 years from a low-income setting.
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