Fleisch Abby F, Rifas-Shiman Sheryl L, Rokoff Lisa B, Hivert Marie-France, Mantzoros Christos S, Oken Emily
Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA.
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Metabolism. 2017 Jul;72:18-26. doi: 10.1016/j.metabol.2017.04.001. Epub 2017 Apr 8.
Maternal smoking during pregnancy is associated with low fetal growth and adverse cardiometabolic health in offspring. However, hormonal pathways underlying these associations are unclear. Therefore, we examined maternal smoking habits and umbilical cord blood hormone profiles in a large, prospective cohort.
We studied 978 mother/infant pairs in Project Viva, a Boston-area cohort recruited 1999-2002. We categorized mothers as early pregnancy smokers, former smokers, or never smokers. Outcomes were cord blood concentrations of IGF-1, IGF-2, IGFBP-3, leptin, adiponectin, insulin, and C-peptide. We used linear regression models adjusted for maternal pre-pregnancy body mass index (BMI), race/ethnicity, parity, education, and infant sex. We conducted analyses in the full cohort and stratified by infant sex.
Thirteen percent of women were early pregnancy smokers, 20% former smokers, and 68% never smokers. Infants of early pregnancy smokers had lower IGF-1 adjusted for IGFBP-3 [-5.2ng/mL (95% CI: -8.6, -1.7)], with more pronounced associations in girls [-10.7ng/mL (95% CI: -18.5, -2.9) vs. -4.0ng/mL (95% CI: -8.4, 0.4) for boys]. Early pregnancy smoking was not associated with cord blood hormones other than IGF-1. Infants of former smokers had a cord blood hormone profile similar to infants of never smokers.
As compared to mothers who never smoked, early pregnancy smokers had infants with lower cord blood IGF-1 which could prime adverse metabolic outcomes. This provides further reason to support smoking cessation programs in women of reproductive age.
孕期母亲吸烟与胎儿生长缓慢及后代不良心脏代谢健康状况相关。然而，这些关联背后的激素途径尚不清楚。因此，我们在一个大型前瞻性队列中研究了母亲的吸烟习惯和脐带血激素谱。
我们在“活力计划”中研究了978对母婴，该队列是1999年至2002年在波士顿地区招募的。我们将母亲分为孕早期吸烟者、既往吸烟者或从不吸烟者。观察指标为脐带血中胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子-2（IGF-2）、胰岛素样生长因子结合蛋白-3（IGFBP-3）、瘦素、脂联素、胰岛素和C肽的浓度。我们使用线性回归模型，并对母亲孕前体重指数（BMI）、种族/民族、产次、教育程度和婴儿性别进行了调整。我们在整个队列中进行了分析，并按婴儿性别进行了分层。
13%的女性为孕早期吸烟者，20%为既往吸烟者，68%为从不吸烟者。孕早期吸烟者的婴儿经IGFBP-3调整后的IGF-1较低[-5.2纳克/毫升（95%置信区间：-8.6，-1.7）]，女孩中的关联更为明显[-10.7纳克/毫升（95%置信区间：-18.5，-2.9），而男孩为-4.0纳克/毫升（95%置信区间：-8.4，0.4）]。孕早期吸烟与除IGF-1外的脐带血激素无关。既往吸烟者的婴儿脐带血激素谱与从不吸烟者的婴儿相似。
与从不吸烟的母亲相比，孕早期吸烟者的婴儿脐带血IGF-1较低，这可能引发不良代谢结果。这为支持育龄妇女戒烟计划提供了进一步的理由。
