Abstract
Objectives
Postnatal growth in children exposed in utero to tobacco smoke is not well understood. This study investigated growth during the first 6 years in children whose mothers smoked during pregnancy.
Materials and methods
Weight, length, and head circumference were measured annually for 6 years in 100 children in each group of smoking (study) and nonsmoking (control) mothers.
Results
Weight and head circumference were significantly smaller in the neonates whose mothers smoked ≥15 cigarettes/day, but the difference disappeared by 3 years of life. Length was significantly smaller in the study neonates at birth, followed by increasing divergence from normality up to 2 years, when the mean difference of children whose mothers smoked ≥15 cigarettes/day from control children was −3.4 cm (p ≤ 0.0001). Subsequently, they manifested catch-up growth ,and the difference from the controls at 3, 4, 5, and 6 years was −2.5 cm (p ≤ 0.0001), −2.2 cm (p = 0.005), −2.1 cm (p = 0.013), and −1.9 cm (p = 0.055), respectively.
Discussion
The delayed growth was related to smoking per se and appeared to be independent of several confounding factors. At birth, there was a significant negative correlation between the number of cigarettes smoked per day and the growth parameters studied; it remained significant up to the 6 year only for length.
Conclusion
Length exhibits the most persistent growth delay of the parameters studied, but catch-up growth occurs after the second year of life, and thus, intrauterine exposure to tobacco smoke seems to have no permanent effect on children’s growth.
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Abbreviations
- ANOVA:
-
analysis of variance
- BMI:
-
body mass index
- CI:
-
confidence interval
- DOM:
-
difference of the mean
References
Ahlsten G, Cnattingius S, Lindmark G (1993) Cessation of smoking during pregnancy improves fetal growth and reduces infant morbidity in the neonatal period. A population-based prospective study. Acta Paediatr 82(2):177–181
Barr HM, Streissguth AP, Martin DC, Herman CS (1984) Infant size at 8 months of age: relationship to maternal use of alcohol, nicotine, and caffeine during pregnancy. Pediatrics 74(3):336–341
Beratis NG, Varvarigou A, Makri M, Vagenakis AG (1994) Prolactin, growth hormone and insulin-like growth factor-I in newborn children of smoking mothers. Clin Endocrinol 40(2):179–185
Beratis NG, Varvarigou A, Christophidou M, Vassilakos P, Tsapanos V, Kourounis G (1999) Cord blood α-fetoprotein concentrations in term newborns of smoking mothers. Eur J Pediatr 158(7):583–588
Conter V, Cortinovis I, Rogari P, Riva L (1995) Weight growth in infants born to mothers who smoked during pregnancy. BMJ 310(6982):768–771
Cornelius MD, Goldsmidt L, Day NL, Larkby C (2002) Alcohol, tobacco and marijuana use among pregnant teenagers: 6-year follow-up of offspring growth effects. Neurotoxicol Teratol 24(6):703–710
Day NL, Richardson GA, Geva D, Robles N (1994) Alcohol, marijuana, and tobacco: effects of prenatal exposure on offspring growth and morphology at age six. Alcohol Clin Exp Res 18(4):786–794
Dunn HG, McBurney AK, Ingram S, Hunter CM (1976) Maternal cigarette smoking during pregnancy and the child’s subsequent development: I. Physical growth to the age of 6 1/2 years. Can J Public Health 67(6):499–505
Fogelman KR, Manor O (1988) Smoking in pregnancy and development into early adulthood. BMJ 297(6658):1233–1236
Fried PA, O’Connell CM (1987) A comparison of the effects of prenatal exposure to tobacco, alcohol, cannabis and caffeine on birth size and subsequent growth. Neurotoxicol Teratol 9(2):79–85
Fried PA, Watkinson B, Gray R (1999) Growth from birth to early adolescence in offspring prenatally exposed to cigarettes and marijuana. Neurotoxicol Teratol 21(5):513–525
Hardy JB, Mellits ED (1972) Does maternal smoking during pregnancy have a long-term effect on the child? Lancet 2(7791):1332–1336
Jones G, Riley M, Dwyer T (1999) Maternal smoking during pregnancy, growth, and bone mass in prepubertal children. J Bone Miner Res 14(1):146–151
Karatza AA, Varvarigou A, Beratis NG (2003) Growth up to 2 years in relationship to maternal smoking during pregnancy. Clin Pediatr 42(6):533–541
Lindsay CA, Thomas AJ, Catalano PM (1997) The effect of smoking tobacco on neonatal body composition. Am J Obstet Gynecol 177(5):1124–1128
Mantzoros CS, Varvarigou A, Kaklamani VG, Beratis NG, Flier JS (1997) Effect of birth weight and maternal smoking on cord blood leptin concentrations of full-term and preterm newborns. J Clin Endocrinol Metab 82(9):2856–2861
Naeye RL (1981) Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth. Obstet Gynecol 57(18):18–21
Ong KK, Preece MA, Emmett PM, Ahmed ML, Dunger DB, ALPAC Study Team (2002) Size at birth and early childhood growth in relation to maternal smoking, parity and infant breastfeeding: longitudinal birth cohort study and analysis. Pediatr Res 52(6):863–867
Peacock JL, Bland JM, Anderson HR, Brooke OG (1991) Cigarette smoking and birth weight: type of cigarette smoked and a possible threshold effect. Int J Epidemiol 20(2):405–412
Rantakallio P (1983) A Follow-up study up to the age of 14 of children whose mothers smoked during pregnancy. Acta Paediatr Scand 72(5):747–753
Varvarigou A, Beratis NG, Makri M, Vagenakis AG (1994) Increased levels and positive correlation between erythropoietin and hemoglobin concentrations in newborn children of smoking mothers. J Pediatr 124(3):480–482
Varvarigou A, Mantzoros CS, Beratis NG (1999) Cord blood leptin concentrations in relation to intrauterine growth. Clin Endocrinol 50(2):177–183
Vik T, Jacobsen G, Vatten L, Bakketeig LS (1996) Pre- and post-natal growth in children of women who smoked in pregnancy. Early Hum Dev 45(3):245–255
Voigt M, Hermanussen M, Wittwer-Backofen U, Fusch C, Hesse V (2006) Sex specific differences in birth weight due to maternal smoking during pregnancy. Eur J Pediatr [Epub ahead of print]
Wideroe M, Vik T, Jacobsen G, Bakketeig LS (2003) Does maternal smoking during pregnancy cause childhood overweight? Paediatr Perinat Epidemiol 17(2):171–179
Zaren B, Lindmark G, Gebre-Medhin M (1996) Maternal smoking and body composition of the newborn. Acta Paediatr 85(2):213–219
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Kanellopoulos, T.A., Varvarigou, A.A., Karatza, A.A. et al. Course of growth during the first 6 years in children exposed in utero to tobacco smoke. Eur J Pediatr 166, 685–692 (2007). https://doi.org/10.1007/s00431-006-0308-8
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DOI: https://doi.org/10.1007/s00431-006-0308-8