Maternal Smoking: A Life Course Blood Pressure Determinant?

Abstract Introduction Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children. Methods We evaluated 4295 of Genera...

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Published in:Nicotine & tobacco research 2018-05, Vol.20 (6), p.674-680
Main Authors: Cabral, Maria, Fonseca, Maria J., González-Beiras, Camila, Santos, Ana C., Correia-Costa, Liane, Barros, Henrique
Format: Article
Language:English
Subjects:
Adult
Blood Pressure - physiology
Body Mass Index
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension - diagnosis
Hypertension - etiology
Hypertension - physiopathology
Longitudinal Studies
Male
Maternal Behavior - physiology
Maternal Behavior - psychology
Original investigations
Pregnancy
Pregnancy Trimester, Third - physiology
Prenatal Exposure Delayed Effects - diagnosis
Prenatal Exposure Delayed Effects - etiology
Prenatal Exposure Delayed Effects - physiopathology
Smoking - adverse effects
Smoking - physiopathology
Tobacco Smoke Pollution - adverse effects
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Summary:Abstract Introduction Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children. Methods We evaluated 4295 of Generation XXI children, recruited at birth in 2005–2006 and reevaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records. At 4-year follow-up, interviews were performed and children’s BP measured. Linear regression models were fitted to estimate the association between maternal smoking and children’s BP. Results Children of smoking mothers presented significantly higher BP levels. After adjustment for maternal education, gestational hypertensive disorders, and child’s body mass index, children exposed during pregnancy to maternal smoking presented a higher systolic BP (SBP) z-score (β = 0.08, 95% confidence interval [CI] 0.04 to 0.14). In crude models, maternal smoking was associated with higher SBP z-score at every assessed period. However, after adjustment, an attenuation of the association estimates occurred (β = 0.08, 95% CI 0.03 to 0.13 before conception; β = 0.07, 95%CI 0.02 to 0.12; β = 0.04, 95%CI −0.02 to 0.10; and β = 0.06, 95%CI 0.00 to 0.13 for the first, second, and third pregnancy trimesters, respectively; and β = 0.07, 95%CI 0.02 to 0.12 for current maternal smoking). No significant association was observed for diastolic BP z-score levels. Conclusion Maternal smoking before, during, and after pregnancy was independently associated with systolic BP z-score in preschool children. This study provides additional evidence to the public health relevance of maternal smoking cessation programs if early cardiovascular health of children is envisaged. Implications Using observational longitudinal data from the birth cohort Generation XXI, this study showed that exposure to maternal smoking—before pregnancy, during pregnancy, and 4 years after delivery—was associated with a systolic BP-raising effect in children at the age of 4. The findings of this study add an important insight into the need to support maternal smoke-free environments in order to provide long-term cardiovascular benefit, starting as early as possible in life.
ISSN:1462-2203
1469-994X
1469-994X
DOI:10.1093/ntr/ntx117