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Is low birth weight in the causal pathway of the association between maternal smoking in pregnancy and higher BMI in the offspring?

  • DEVELOPMENTAL EPIDEMIOLOGY
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Abstract

A number of cross-sectional and prospective studies suggested a priming effect of maternal smoking in pregnancy on offspring’s obesity. It has been hypothesized that this association might be explained by low birth weight and subsequent catch-up growth in the causal pathway. We therefore examined the role of birth weight in children exposed versus not exposed to cigarette smoking in utero on later body mass index (BMI). Using data of 12,383 children and adolescents (3–17 years of age) recorded in a German population-based survey (KiGGS), we assessed mean body mass index standard deviation scores (BMI-SDS) in different birth weight SDS categories, stratified for children with smoking and non-smoking mothers. We calculated spline regression models with BMI-SDS as outcome variable, cubic splines of birth weight SDS, and potential confounding factors. Children whose mothers had been smoking during pregnancy had lower birth weight SDS and higher BMI-SDS at interview compared to children of non-smoking mothers. However, we observed a linear association between birth weight SDS and BMI-SDS in crude analyses for both groups. Similarly, almost linear effects were observed in adjusted spline regression analyses, except for children with very low birth weight. The respective 95% confidence bands did not preclude a linear effect for the whole birth weight SDS distribution. Our findings suggest that low birth weight is unlikely to be the main cause for the association between intrauterine nicotine exposure and higher BMI in later life. Alternative mechanisms, such as alterations in the noradrenergic system or increased food efficiency, have to be considered.

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Acknowledgments

This work was supported by the Ludwig-Maximilians University Innovative Research Priority Project Munich Center for Health Sciences (sub-projects 1 & 2), and by grants from the DFG (Deutsche Forschungsgemeinschaft, grant KR 1926/3-1). AMT received grant support from the German ‘Competence Net Obesity,’ which is supported by the German Federal Ministry of Education and Research (grant number 01 GI0839). However, the hypothesis development, analysis, interpretation and conclusions contained in this study are those of the author’s alone.

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The authors had no conflicts of interest.

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Authors and Affiliations

  1. Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University of Munich, Heiglhofstrasse 63, 81377, Munich, Germany

    Andreas Beyerlein, Simon Rückinger & Rüdiger von Kries

  2. Department of Medical Informatics, Biometry and Epidemiology (IBE) and Munich Centre of Health Sciences (MC-Health), Ludwig-Maximilians University of Munich, Munich, Germany

    André Michael Toschke

  3. Robert Koch-Institute, Berlin, Germany

    Angelika Schaffrath Rosario

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  1. Andreas Beyerlein
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  2. Simon Rückinger
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  3. André Michael Toschke
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  5. Rüdiger von Kries
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Correspondence to Andreas Beyerlein.

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Beyerlein, A., Rückinger, S., Toschke, A.M. et al. Is low birth weight in the causal pathway of the association between maternal smoking in pregnancy and higher BMI in the offspring?. Eur J Epidemiol 26, 413–420 (2011). https://doi.org/10.1007/s10654-011-9560-y

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