Abstract
Objective
Maternal smoking in pregnancy is a known risk factor for several birth defects, and long-term behavioral and cognitive problems in the offspring. Our objective was to investigate whether maternal smoking increases the risk for long-term gastrointestinal (GI) morbidity in the offspring.
Study Design
A population-based cohort study of deliveries in 1991-2014 was conducted, comparing incidence of pediatric GI related hospitalizations in offspring of mothers self-reported to have been smoking during pregnancy vs. mothers who did not. Congenital malformations and multiple gestations were excluded. Follow-up time was calculated from birth to either an event, death, age 18, or to the end of the study period (censored). A Kaplan-Meier survival analysis was used to estimate cumulative incidence of GI morbidity, and a Cox proportional hazards model was used to estimate the adjusted hazard ratios (aHR) for long-term independent risk for GI morbidity, controlling for relevant confounders.
Results
The study included 242,342 deliveries, of which 1.2% (n=2,861) were following a pregnancy involving maternal smoking. During the follow-up period, children of smoking mothers had significantly higher rates of long-term GI morbidity (OR=1.4; 95% CI 1.2-1.6; p<0.001; Table), as well as higher cumulative incidence of GI morbidity (Log-rank test p<0.001; Figure). Most distinctly, inflammatory bowel diseases (IBD) were diagnosed significantly more often in these children (OR=1.5; 95% CI 1.2-3.9; p=0.002, Table). The Cox model confirmed an association between prenatal maternal smoking and offspring GI morbidity, that could not be attributed to maternal age, preterm delivery, maternal diabetic disorder, and hypertensive disorder (adjusted HR =1.4; 95% CI 1.2-1.6; p<0.001).
Conclusion
Maternal smoking during pregnancy appears to be an independent risk factor for long-term GI morbidity, and specifically IBD, in the offspring. Increased risk for GI disease is possibly mediated through epigenetic modifications such as DNA methylation, previously shown to be altered following in utero maternal smoking exposure.
Maternal smoking in pregnancy is a known risk factor for several birth defects, and long-term behavioral and cognitive problems in the offspring. Our objective was to investigate whether maternal smoking increases the risk for long-term gastrointestinal (GI) morbidity in the offspring.
Study Design
A population-based cohort study of deliveries in 1991-2014 was conducted, comparing incidence of pediatric GI related hospitalizations in offspring of mothers self-reported to have been smoking during pregnancy vs. mothers who did not. Congenital malformations and multiple gestations were excluded. Follow-up time was calculated from birth to either an event, death, age 18, or to the end of the study period (censored). A Kaplan-Meier survival analysis was used to estimate cumulative incidence of GI morbidity, and a Cox proportional hazards model was used to estimate the adjusted hazard ratios (aHR) for long-term independent risk for GI morbidity, controlling for relevant confounders.
Results
The study included 242,342 deliveries, of which 1.2% (n=2,861) were following a pregnancy involving maternal smoking. During the follow-up period, children of smoking mothers had significantly higher rates of long-term GI morbidity (OR=1.4; 95% CI 1.2-1.6; p<0.001; Table), as well as higher cumulative incidence of GI morbidity (Log-rank test p<0.001; Figure). Most distinctly, inflammatory bowel diseases (IBD) were diagnosed significantly more often in these children (OR=1.5; 95% CI 1.2-3.9; p=0.002, Table). The Cox model confirmed an association between prenatal maternal smoking and offspring GI morbidity, that could not be attributed to maternal age, preterm delivery, maternal diabetic disorder, and hypertensive disorder (adjusted HR =1.4; 95% CI 1.2-1.6; p<0.001).
Conclusion
Maternal smoking during pregnancy appears to be an independent risk factor for long-term GI morbidity, and specifically IBD, in the offspring. Increased risk for GI disease is possibly mediated through epigenetic modifications such as DNA methylation, previously shown to be altered following in utero maternal smoking exposure.
| Original language | English |
|---|---|
| Pages (from-to) | S439-S440 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |