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Maternal smoking around birth and its influence on offspring allergic diseases: A mendelian randomization study
Qiqi Ruan1, Yu Jiang2, Yuan Shi1
1Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, People's Republic of China.
Insights
Maternal smoking around birth (MSAB) significantly increases offspring risks for childhood asthma and atopic dermatitis. Breastfeeding, however, reduces childhood asthma risk, highlighting the importance of smoking cessation and continued breastfeeding.
Area of Science:
- Genetics and Epidemiology
- Environmental Health
- Pediatric Allergy
Background:
- Maternal smoking around birth (MSAB) is a potential risk factor for childhood allergic diseases, but its causal link remains unclear.
- Existing studies have not fully elucidated the independent and combined effects of MSAB and breastfeeding on offspring allergic conditions.
- Understanding these relationships is crucial for developing effective public health interventions.
Purpose of the Study:
- To investigate the causal effect of maternal smoking around birth (MSAB) on offspring allergic diseases, including childhood asthma (CA), allergic rhinitis (AR), allergic conjunctivitis (AC), and atopic dermatitis (AD).
- To assess the independent and adjusted effects of MSAB and breastfeeding on these allergic conditions using a rigorous Mendelian randomization approach.
- To provide robust evidence to inform public health strategies regarding smoking cessation and infant feeding practices.
Main Methods:
- Utilized two-sample Mendelian randomization (TSMR) with large-scale genome-wide association study (GWAS) data for MSAB, breastfeeding, and offspring allergic diseases.
- Employed inverse variance weighted (IVW), MR Egger regression, and weighted median methods for causal inference, with IVW as the primary analysis.
- Conducted multivariate MR (MVMR) to adjust for breastfeeding effects and employed sensitivity analyses (Cochran Q test, MR-Egger, leave-one-out) to ensure result reliability.
Main Results:
- Maternal smoking around birth (MSAB) was causally associated with increased risks of childhood asthma (OR: 1.018) and atopic dermatitis (OR: 8.293) in offspring.
- Breastfeeding showed a protective effect, significantly reducing the risk of childhood asthma (OR: 0.946).
- Even after adjusting for breastfeeding, MSAB remained a significant risk factor for childhood asthma and atopic dermatitis.
Conclusions:
- This study provides strong evidence that maternal smoking around birth adversely affects offspring, increasing the risk of childhood asthma and atopic dermatitis.
- The findings underscore the critical importance of smoking cessation programs for expectant mothers.
- Promoting breastfeeding, even among mothers who smoke, is recommended to mitigate risks for childhood asthma.
Objective:
The influence of maternal smoking around birth (MSAB) on offspring allergic diseases, specifically childhood asthma (CA), allergic rhinitis (AR), allergic conjunctivitis (AC), and atopic dermatitis (AD) remains incompletely understood. We performed a rigorous mendelian randomization (MR) study to obtain the unconfounded association between MSAB and allergic diseases in offspring with and without adjustment for the effect of breastfeeding.
Methods:
Utilizing publicly available information of MSAB, breastfeeding, CA, AR, AC, and AD from large-scale genome-wide association studies (GWAS), we performed a two-sample mendelian randomization (TSMR) analysis to assess the respective causal relationship of MSAB and breastfeeding to allergic diseases in offspring. To get a reliable conclusion, MR Egger regression, weighted median, and inverse variance weighted (IVW) were employed to estimate the causality, with IVW as the primary analysis. Multivariate MR (MVMR) analysis was used to assess the effect of MSAB on allergic diseases after adjusting for breastfeeding's impact. Sensitivity analysis was conducted using the Cochran Q test, MR-Egger, and leave-one-out approaches to ensure the reliability and stability of results.
Results:
The TSMR analysis demonstrated MSAB increased the risks of CA (PIVW = 0.013, OR: 1.018, 95%CI: 1.004 to 1.033) and AD (PIVW = 0.006, OR: 8.293, 95%CI: 1.815 to 37.884) in offspring. Conversely, breastfeeding decreased the risk of CA (PIVW <0.001, OR: 0.946, 95%CI: 0.918 to 0.974). MSAB still increased the risks of CA (P = 0.0497, OR: 1.013, 95%CI: 1.000017 to 1.026) and AD (P = 0.003, OR: 13.800, 95%CI: 2.490 to 269.246) after adjusting for breastfeeding. We observed no strong indication of a negative causality between MSAB and AC and AR.
Conclusion:
Our findings provided robust evidence of the adverse effects of MSAB on offspring. We emphasized the urgency of smoking cessation around birth and the importance of breastfeeding even in smoking mothers.
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