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Does fetal smoke exposure affect childhood bone mass? The Generation R Study

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Abstract

Summary

We assessed the intrauterine influence of maternal smoking on childhood bone mass by comparing parental prenatal and postnatal smoking habits. We observed higher bone mass in children exposed to maternal smoking, explained by higher body weight. Maternal smoking or related lifestyle factors may affect childhood weight gain rather than skeletal growth.

Introduction

Maternal smoking during pregnancy may adversely affect bone health in later life. By comparing the associations of maternal and paternal smoking and of prenatal and postnatal exposure with childhood bone measures, we aimed to explore whether the suggested association could be explained by fetal programming or reflects confounding by familial factors.

Methods

In 5565 mothers, fathers and children participating in a population-based prospective cohort study, parental smoking habits during pregnancy and current household smoking habits were assessed by postal questionnaires. Total body bone mineral content (BMC), bone area (BA) and bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DXA) at the median age of 6.0 years (IQR 0.37).

Results

In confounder-adjusted models, maternal smoking during pregnancy was associated with a higher BMC of 11.6 g (95 % confidence interval (CI) 5.6, 17.5), a larger BA of 9.7 cm2 (95 % CI 3.0, 16.4), a higher BMD of 6.7 g/cm2 (95 % CI 2.4, 11.0) and a higher BMC of 5.4 g (95 % CI 1.3, 9.6) adjusted for BA of the child. Current weight turned out to mediate these associations. Among mothers who did not smoke, paternal smoking did not show evident associations with childhood bone measures. Also, household smoking practices during childhood were not associated with childhood bone measures.

Conclusions

Our results do not support the hypothesis of fetal smoke exposure affecting childhood bone mass via intrauterine mechanisms. Maternal smoking or related lifestyle factors may affect childhood weight gain rather than skeletal growth.

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Acknowledgments

The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam; the Municipal Health Service, Rotterdam area; and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. We gratefully acknowledge the contribution of general practitioners, hospitals, midwives and pharmacies in Rotterdam.

Funding

The general design of the Generation R Study was made possible by financial support from the Erasmus Medical Center, Rotterdam; the Erasmus University Rotterdam; the Dutch Ministry of Health, Welfare and Sport; and the Netherlands Organization for Health Research and Development (ZonMw). Vincent Jaddoe and Fernando Rivadeneira received an additional grant from the Netherlands Organization for Scientific Research (VIDI 016.136.361 and VIDI 016.136.367). The funding agencies had no role in the design, implementation, analysis or interpretation of the data. All authors read and approved the final manuscript.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. The Generation R Study Group, Erasmus Medical Center, Room Ae-012, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    D. H. M. Heppe, C. Medina-Gomez, F. Rivadeneira & V. W. V. Jaddoe

  2. Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands

    D. H. M. Heppe & V. W. V. Jaddoe

  3. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

    D. H. M. Heppe, C. Medina-Gomez, A. Hofman, F. Rivadeneira & V. W. V. Jaddoe

  4. Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

    C. Medina-Gomez & F. Rivadeneira

Authors
  1. D. H. M. Heppe
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  2. C. Medina-Gomez
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  3. A. Hofman
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  4. F. Rivadeneira
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  5. V. W. V. Jaddoe
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Corresponding author

Correspondence to V. W. V. Jaddoe.

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Heppe, D.H.M., Medina-Gomez, C., Hofman, A. et al. Does fetal smoke exposure affect childhood bone mass? The Generation R Study. Osteoporos Int 26, 1319–1329 (2015). https://doi.org/10.1007/s00198-014-3011-z

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  • DOI: https://doi.org/10.1007/s00198-014-3011-z

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