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Higher maternal circulating cotinine during pregnancy is associated with persistently shorter stature from birth to five years in an Asian cohort

Higher maternal circulating cotinine during pregnancy is associated with persistently shorter stature from birth to five years in an Asian cohort
Higher maternal circulating cotinine during pregnancy is associated with persistently shorter stature from birth to five years in an Asian cohort
Background

Self-reported maternal active smoking has been associated with reduced offspring birth length and shorter stature in early and late childhood.


Objective

To use circulating cotinine as an objective biomarker to investigate the association between smoking and environmental tobacco smoke (ETS) exposure in pregnancy and longitudinal measures of offspring length/height from birth to 60 months.


Methods

In 969 maternal-offspring dyads from the GUSTO cohort, maternal plasma cotinine at 26–28 weeks’ gestation was measured by LC/MS/MS and categorized into four groups: Group 1: cotinine <0.17 ng/mL (the assay’s detection limit) and no ETS exposure; Group 2: cotinine <0.17 ng/mL but self-reported ETS; Group 3: cotinine 0.17–13.99 ng/mL (ETS or light smoking); Group 4: cotinine ≥14 ng/mL (active smoking).


Results

Adjusting for infant sex, gestational age at birth, ethnicity, maternal age, education, parity, BMI, and height, Group 4 offspring were shorter at birth [z-score β = −0.42 SD units (SDs) (95% CI = −0.77 to −0.06)] than Group 1 offspring. Group 4 offspring continued to be shorter at older ages, with similar effect sizes at 3 months [−0.57 SDs (−0.95 to −0.20)], 36 months [−0.53 SDs (−0.92 to −0.15)], 48 months [−0.43 SDs (−0.81 to −0.04)], and 60 months [−0.57 SDs (−0.96 to −0.17)]. Associations were particularly marked in boys. No significant differences in stature were observed in Groups 2 or 3 compared with Group 1.


Conclusions

This Asian longitudinal study associated high prenatal cotinine with persistently shorter stature in offspring from birth and into early childhood, whilst low prenatal cotinine levels and ETS exposure showed no such association.


Implications

Little is known about the long-term effects of prenatal tobacco exposure on offspring stature in Asia where passive smoking is common. This study has used an objective biomarker to reveal that the association of prenatal tobacco exposure with offspring length/height mainly occurs at a high maternal cotinine level of greater than 14 ng/mL in pregnancy, consistent with active smoking, but no significant associations were found with lower cotinine levels, consistent with passive smoking. Encouraging women to quit smoking prior to or during pregnancy may avert the long-term negative impact on their child’s height despite appreciable prenatal ETS exposure.

1462-2203
1103–1112
Ng, Sharon
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Aris, Izzuddin M.
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Thway Tint, Mya
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Gluckman, Peter D.
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Godfrey, Keith M.
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Shek, Lynette Pei-Chi
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Yap, Fabian
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Tan, Kok Hian
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Lek, Ngee
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Teoh, Oon Hoe
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Chan, Yiong Huak
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Chong, Mary Foong-Fong
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Lee, Yung Seng
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Chong, Yap-Seng
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Kramer, Michael S.
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Chan, Shiao-Yng
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Ng, Sharon
cb549f0f-0584-4498-8c49-6023fde1fa87
Aris, Izzuddin M.
ee15a46e-ead3-4b4a-a208-d39038a85480
Thway Tint, Mya
6f8cd9a6-2667-4495-b1c9-40c7ff3ffb28
Gluckman, Peter D.
e916630e-5ae2-437c-a1d1-8e24c0e05589
Godfrey, Keith M.
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Shek, Lynette Pei-Chi
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Yap, Fabian
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Tan, Kok Hian
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Lek, Ngee
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Teoh, Oon Hoe
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Chan, Yiong Huak
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Chong, Mary Foong-Fong
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Lee, Yung Seng
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Chong, Yap-Seng
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Kramer, Michael S.
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Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293

Ng, Sharon, Aris, Izzuddin M., Thway Tint, Mya, Gluckman, Peter D., Godfrey, Keith M., Shek, Lynette Pei-Chi, Yap, Fabian, Tan, Kok Hian, Lek, Ngee, Teoh, Oon Hoe, Chan, Yiong Huak, Chong, Mary Foong-Fong, Lee, Yung Seng, Chong, Yap-Seng, Kramer, Michael S. and Chan, Shiao-Yng (2019) Higher maternal circulating cotinine during pregnancy is associated with persistently shorter stature from birth to five years in an Asian cohort. Nicotine & Tobacco Research, 21 (8), 1103–1112. (doi:10.1093/ntr/nty148).

Record type: Article

Abstract

Background

Self-reported maternal active smoking has been associated with reduced offspring birth length and shorter stature in early and late childhood.


Objective

To use circulating cotinine as an objective biomarker to investigate the association between smoking and environmental tobacco smoke (ETS) exposure in pregnancy and longitudinal measures of offspring length/height from birth to 60 months.


Methods

In 969 maternal-offspring dyads from the GUSTO cohort, maternal plasma cotinine at 26–28 weeks’ gestation was measured by LC/MS/MS and categorized into four groups: Group 1: cotinine <0.17 ng/mL (the assay’s detection limit) and no ETS exposure; Group 2: cotinine <0.17 ng/mL but self-reported ETS; Group 3: cotinine 0.17–13.99 ng/mL (ETS or light smoking); Group 4: cotinine ≥14 ng/mL (active smoking).


Results

Adjusting for infant sex, gestational age at birth, ethnicity, maternal age, education, parity, BMI, and height, Group 4 offspring were shorter at birth [z-score β = −0.42 SD units (SDs) (95% CI = −0.77 to −0.06)] than Group 1 offspring. Group 4 offspring continued to be shorter at older ages, with similar effect sizes at 3 months [−0.57 SDs (−0.95 to −0.20)], 36 months [−0.53 SDs (−0.92 to −0.15)], 48 months [−0.43 SDs (−0.81 to −0.04)], and 60 months [−0.57 SDs (−0.96 to −0.17)]. Associations were particularly marked in boys. No significant differences in stature were observed in Groups 2 or 3 compared with Group 1.


Conclusions

This Asian longitudinal study associated high prenatal cotinine with persistently shorter stature in offspring from birth and into early childhood, whilst low prenatal cotinine levels and ETS exposure showed no such association.


Implications

Little is known about the long-term effects of prenatal tobacco exposure on offspring stature in Asia where passive smoking is common. This study has used an objective biomarker to reveal that the association of prenatal tobacco exposure with offspring length/height mainly occurs at a high maternal cotinine level of greater than 14 ng/mL in pregnancy, consistent with active smoking, but no significant associations were found with lower cotinine levels, consistent with passive smoking. Encouraging women to quit smoking prior to or during pregnancy may avert the long-term negative impact on their child’s height despite appreciable prenatal ETS exposure.

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More information

Accepted/In Press date: 16 July 2018
e-pub ahead of print date: 19 July 2018
Published date: August 2019

Identifiers

Local EPrints ID: 422818
URI: http://eprints.soton.ac.uk/id/eprint/422818
ISSN: 1462-2203
PURE UUID: a4173396-6f12-432f-9e8f-98cc1423bfbb
ORCID for Keith M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 06 Aug 2018 16:30
Last modified: 26 Nov 2021 07:08

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Contributors

Author: Sharon Ng
Author: Izzuddin M. Aris
Author: Mya Thway Tint
Author: Peter D. Gluckman
Author: Lynette Pei-Chi Shek
Author: Fabian Yap
Author: Kok Hian Tan
Author: Ngee Lek
Author: Oon Hoe Teoh
Author: Yiong Huak Chan
Author: Mary Foong-Fong Chong
Author: Yung Seng Lee
Author: Yap-Seng Chong
Author: Michael S. Kramer
Author: Shiao-Yng Chan

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