A prospective birth cohort study of maternal prenatal cigarette smoking assessed by self-report and biomarkers on childhood risk of overweight or obesity.
A prospective birth cohort study of maternal prenatal cigarette smoking assessed by self-report and biomarkers on childhood risk of overweight or obesity.
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DOI：
10.1097/pn9.0000000000000017
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发表时间：
2022-12
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大多数关于宫内吸烟与儿童超重或肥胖(OWO)的研究都是基于母亲自我报告的吸烟状况，很少有基于客观生物标志物的研究。自我报告吸烟与吸烟的母亲和脐带血生物标志物的一致性以及它们对儿童超重和肥胖的长期风险的影响尚不清楚。在这项研究中，我们分析了波士顿出生队列中2351对母子的数据，这是一个以美国黑人、土著和有色人种为主的样本(BIPOC)，这些孩子在出生时登记，并前瞻性地跟踪到18岁。在宫内吸烟暴露通过母亲自我报告以及母亲和脐带血浆吸烟的生物标志物：可替宁和羟可替宁来衡量。我们使用多项Logistic回归分析评估了每项吸烟暴露措施和母亲Owo与儿童Owo的个体和联合关联。我们使用嵌套Logistic回归来研究在自我报告数据的基础上添加母体和脐带血浆生物标记物作为输入协变量时儿童OWO的预测效果。我们的结果表明，在子宫内，由自我报告和母体或脐带代谢物定义的吸烟暴露与长期怀孕的风险增加一致相关。脐带羟可替宁位于第四个四分位数(与第一个四分位数)的儿童超重的几率是1.66(95%可信区间1.03-2.66)，肥胖的几率是1.57(95%可信区间1.05-2.36)。如果使用自我报告吸烟，母亲OWO和吸烟对子女肥胖风险的综合影响为3.66(95%CI 2.37~5.67)。将母体和脐带血生物标志物信息添加到自我报告数据中，提高了对儿童Owo长期风险的预测准确性。美国BIPOC的这项纵向出生队列研究强调了母亲吸烟作为子女Owo风险的肥胖因素的作用。我们的发现呼吁公共卫生干预战略将重点放在母亲吸烟上--作为一个高度可改变的目标，包括戒烟和可能减轻美国和全球日益加重的肥胖负担的对策(如最佳营养)。
Most studies on the association of in utero exposure to cigarette smoking and childhood overweight or obesity (OWO) were based on maternal self-reported smoking status, and few were based on objective biomarkers. The concordance of self-report smoking, and maternal and cord blood biomarkers of cigarette smoking as well as their effects on children's long-term risk of overweight and obesity are unclear. In this study, we analyzed data from 2351 mother-child pairs in the Boston Birth Cohort, a sample of US predominantly Black, indigenous, and people of color (BIPOC) that enrolled children at birth and followed prospectively up to age 18 years. In utero smoking exposure was measured by maternal self-report and by maternal and cord plasma biomarkers of smoking: cotinine and hydroxycotinine. We assessed the individual and joint associations of each smoking exposure measure and maternal OWO with childhood OWO using multinomial logistic regressions. We used nested logistic regressions to investigate the childhood OWO prediction performance when adding maternal and cord plasma biomarkers as input covariates on top of self-reported data. Our results demonstrated that in utero cigarette smoking exposure defined by self-report and by maternal or cord metabolites was consistently associated with increased risk of long-term child OWO. Children with cord hydroxycotinine in the fourth quartile (vs. first quartile) had 1.66 (95% confidence interval [CI] 1.03–2.66) times the odds for overweight and 1.57 (95% CI 1.05–2.36) times the odds for obesity. The combined effect of maternal OWO and smoking on offspring risk of obesity is 3.66 (95% CI 2.37–5.67) if using self-reported smoking. Adding maternal and cord plasma biomarker information to self-reported data improved the prediction accuracy of long-term child OWO risk. This longitudinal birth cohort study of US BIPOC underscored the role of maternal smoking as an obesogen for offspring OWO risk. Our findings call for public health intervention strategies to focus on maternal smoking – as a highly modifiable target, including smoking cessation and countermeasures (such as optimal nutrition) that may alleviate the increasing obesity burden in the United States and globally.