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Am J Perinatol 2021; 38(02): 166-170
DOI: 10.1055/s-0039-1695773
Original Article

Maternal Smoking during Pregnancy and the Risk for Childhood Infectious Diseases in the Offspring: A Population-Based Cohort Study

Nadav Dan
1   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Eyal Sheiner
1   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Tamar Wainstock
2   Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Kyla Marks
3   Department of Neonatal Medicine, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Roy Kessous
1   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract

Objective Infectious diseases account for up to 43% of childhood hospitalizations. Given the magnitude of infection-related hospitalizations, we aimed to evaluate the effect of maternal smoking during pregnancy on the risk for long-term childhood infectious morbidity.

Study Design This is a population-based cohort analysis comparing the long-term risk for infectious diseases, in children born to mothers who smoked during pregnancy versus those who did not. Infectious diseases were predefined based on International Classification of Diseases, Ninth Revision codes. Deliveries occurred between the years 1991 and 2014.

Results A total of 246,854 newborns met the inclusion criteria; 2,986 (1.2%) were born to mothers who smoked during pregnancy. Offspring of smokers had significantly higher risk for several infectious diseases during childhood (upper respiratory tract, otitis, viral infections, and bronchitis) as well as increased risk for total infection-related hospitalizations (odds ratio = 1.5, 95% confidence interval [CI]: 1.3–1.7; p = 0.001). Cumulative incidence of infection-related hospitalizations was significantly higher in offspring of smokers (log-rank test, p = 0.001). Controlling for maternal age, diabetes, hypertensive disorders, and gestational age at index delivery, smoking remained an independent risk factor for infectious diseases during childhood (adjusted hazard ratio = 1.5, 95% CI: 1.3–1.6; p = 0.001).

Conclusion Intrauterine exposure to maternal smoking may create an environment leading to an increased future risk for long-term pediatric infectious morbidity of the offspring.

Keywords

maternal smoking during pregnancy - intrauterine exposure - pediatric infectious morbidity

Condensation

A retrospective cohort study to investigate the association between maternal smoking during pregnancy and childhood infections disease.


Note

This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev.


Supplementary Material



Publication History

Received: 11 June 2019

Accepted: 15 July 2019

Article published online:
06 September 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Gicquel C, El-Osta A, Le Bouc Y. Epigenetic regulation and fetal programming. Best Pract Res Clin Endocrinol Metab 2008; 22 (01) 1-16
    CrossrefPubMedGoogle Scholar
  • 2 Cox NJ. Maternal component in NIDDM transmission. How large an effect?. Diabetes 1994; 43 (01) 166-168
    CrossrefPubMedGoogle Scholar
  • 3 Abokaf H, Shoham-Vardi I, Sergienko R, Landau D, Sheiner E. In utero exposure to gestational diabetes mellitus and long term endocrine morbidity of the offspring. Diabetes Res Clin Pract 2018; 144: 231-235
    CrossrefPubMedGoogle Scholar
  • 4 Krieger Y, Wainstock T, Sheiner E. et al. Long-term pediatric skin eruption-related hospitalizations in offspring conceived via fertility treatment. Int J Dermatol 2018; 57 (03) 317-323
    CrossrefPubMedGoogle Scholar
  • 5 McLaughlin CC, Baptiste MS, Schymura MJ, Nasca PC, Zdeb MS. Birth weight, maternal weight and childhood leukaemia. Br J Cancer 2006; 94 (11) 1738-1744
    CrossrefPubMedGoogle Scholar
  • 6 Charach R, Sheiner E, Beharier O, Sergienko R, Kessous R. Recurrent pregnancy loss and future risk of female malignancies. Arch Gynecol Obstet 2018; 298 (04) 781-787
    CrossrefPubMedGoogle Scholar
  • 7 Wainstock T, Walfisch A, Shoham-Vardi I. et al. Fertility treatments and pediatric neoplasms of the offspring: results of a population-based cohort with a median follow-up of 10 years. Am J Obstet Gynecol 2017; 216 (03) 314.e1-314.e14
    CrossrefPubMedGoogle Scholar
  • 8 Carter BD, Abnet CC, Feskanich D. et al. Smoking and mortality--beyond established causes. N Engl J Med 2015; 372 (07) 631-640
    CrossrefPubMedGoogle Scholar
  • 9 Das SK. Harmful health effects of cigarette smoking. Mol Cell Biochem 2003; 253 (1-2): 159-165
    CrossrefPubMedGoogle Scholar
  • 10 IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 2004; 83: 1-1438
    PubMedGoogle Scholar
  • 11 Andriani H, Kuo HW. Adverse effects of parental smoking during pregnancy in urban and rural areas. BMC Pregnancy Childbirth 2014; 14: 414
    CrossrefPubMedGoogle Scholar
  • 12 Bada HS, Das A, Bauer CR. et al. Low birth weight and preterm births: etiologic fraction attributable to prenatal drug exposure. J Perinatol 2005; 25 (10) 631-637
    CrossrefPubMedGoogle Scholar
  • 13 Spinillo A, Nicola S, Piazzi G, Ghazal K, Colonna L, Baltaro F. Epidemiological correlates of preterm premature rupture of membranes. Int J Gynaecol Obstet 1994; 47 (01) 7-15
    CrossrefPubMedGoogle Scholar
  • 14 Li YF, Langholz B, Salam MT, Gilliland FD. Maternal and grandmaternal smoking patterns are associated with early childhood asthma. Chest 2005; 127 (04) 1232-1241
    PubMedGoogle Scholar
  • 15 Gutvirtz G, Wainstock T, Landau D, Sheiner E. Maternal smoking during pregnancy and long-term neurological morbidity of the offspring. Addict Behav 2019; 88: 86-91
    CrossrefPubMedGoogle Scholar
  • 16 Leybovitz-Haleluya N, Wainstock T, Landau D, Sheiner E. Maternal smoking during pregnancy and the risk of pediatric cardiovascular diseases of the offspring: a population-based cohort study with up to 18-years of follow up. Reprod Toxicol 2018; 78: 69-74
    CrossrefPubMedGoogle Scholar
  • 17 Gorog K, Pattenden S, Antova T. et al. Maternal smoking during pregnancy and childhood obesity: results from the CESAR Study. Matern Child Health J 2011; 15 (07) 985-992
    CrossrefPubMedGoogle Scholar
  • 18 Kessous R, Wainstock T, Sheiner E. Smoking during pregnancy as a possible risk factor for pediatric neoplasms in the offspring: a population-based cohort study. Addict Behav 2019; 90: 349-353
    CrossrefPubMedGoogle Scholar
  • 19 Filippini G, Farinotti M, Ferrarini M. Active and passive smoking during pregnancy and risk of central nervous system tumours in children. Paediatr Perinat Epidemiol 2000; 14 (01) 78-84
    CrossrefPubMedGoogle Scholar
  • 20 Jaakkola JJ, Kosheleva AA, Katsnelson BA, Kuzmin SV, Privalova LI, Spengler JD. Prenatal and postnatal tobacco smoke exposure and respiratory health in Russian children. Respir Res 2006; 7: 48
    CrossrefPubMedGoogle Scholar
  • 21 Yorita KL, Holman RC, Sejvar JJ, Steiner CA, Schonberger LB. Infectious disease hospitalizations among infants in the United States. Pediatrics 2008; 121 (02) 244-252
    CrossrefPubMedGoogle Scholar
  • 22 Wisborg K, Henriksen TB, Obel C, Skajaa E, Ostergaard JR. Smoking during pregnancy and hospitalization of the child. Pediatrics 1999; 104 (04) e46
    CrossrefPubMedGoogle Scholar
  • 23 Taylor B, Wadsworth J. Maternal smoking during pregnancy and lower respiratory tract illness in early life. Arch Dis Child 1987; 62 (08) 786-791
    CrossrefPubMedGoogle Scholar
  • 24 Huang C, Roberts Z, Cannings-John R. et al. A validation and calibration process for self-reported tobacco use with participants' cotinine levels: an example from the Building Blocks trial. Nicotine Tob Res 2018 DOI: 10.1093/ntr/nty232
    CrossrefPubMedGoogle Scholar