Hoyt Adrienne T, Wilkinson Anna V, Langlois Peter H, Galeener Carol E, Ranjit Nalini, Sauder Katherine A, Dabelea Dana M, Moore Brianna F
Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health - Austin Regional Campus, Austin, TX, USA.
Department of Epidemiology, UTHealth School of Public Health - Austin Regional Campus, Human Genetics, and Environmental Sciences, Austin, TX, USA.
Matern Health Neonatol Perinatol. 2022 Sep 12;8(1):6. doi: 10.1186/s40748-022-00141-1.
Fetal exposure to tobacco increases the risk for many adverse birth outcomes, but whether diet mitigates these risks has yet to be explored. Here, we examined whether maternal folate intake (from foods and supplements) during pregnancy modified the association between prenatal exposure to tobacco and with preterm delivery, small-for-gestational age (SGA) births, or neonatal adiposity.
Mother-child pairs (n = 701) from Healthy Start were included in this analysis. Urinary cotinine was measured at ~ 27 weeks gestation. Diet was assessed using repeated 24-h dietary recalls. Neonatal adiposity (fat mass percentage) was measured via air displacement plethysmography. Interaction was assessed by including a product term between cotinine (< / ≥ limit of detection [LOD]) and folate (< / ≥ 25 percentile [1077 µg/day]) in separate logistic or linear regression models, adjusting for maternal age, race, ethnicity, education, pre-pregnancy body mass index, and infant sex.
Approximately 26% of women had detectable levels of cotinine. Folate intake was significantly lower among women with cotinine ≥ LOD as compared to those with cotinine < LOD (1293 µg/day vs. 1418 µg/day; p = 0.01). Folate modified the association between fetal exposure to tobacco with neonatal adiposity (p for interaction = 0.07) and SGA (p for interaction = 0.07). Among those with lower folate intake, fetal exposure to tobacco was associated with lower neonatal adiposity (mean difference: -2.09%; 95% CI: -3.44, -0.74) and increased SGA risk (OR: 4.99; 95% CI: 1.55, 16.14). Conversely, among those with higher folate intake, there was no difference in neonatal adiposity (mean difference: -0.17%; 95% CI: -1.13, 0.79) or SGA risk (OR: 1.15; 95% CI: 0.57, 2.31).
Increased folate intake during pregnancy (from foods and/or supplements) may mitigate the risk of fetal growth restriction among those who are unable to quit smoking or cannot avoid secondhand smoke during pregnancy.
胎儿暴露于烟草会增加许多不良出生结局的风险，但饮食是否能减轻这些风险尚待探索。在此，我们研究了孕期母亲从食物和补充剂中摄入的叶酸是否改变了产前烟草暴露与早产、小于胎龄儿（SGA）出生或新生儿肥胖之间的关联。
本分析纳入了来自“健康开端”项目的母婴对（n = 701）。在妊娠约27周时测量尿中可替宁。通过重复的24小时饮食回忆来评估饮食情况。通过空气置换体积描记法测量新生儿肥胖（脂肪量百分比）。在单独的逻辑回归或线性回归模型中，通过纳入可替宁（< /≥检测限[LOD]）和叶酸（< /≥第25百分位数[1077μg/天]）之间的乘积项来评估交互作用，并对母亲年龄、种族、民族、教育程度、孕前体重指数和婴儿性别进行调整。
约26%的女性尿中可替宁水平可检测到。与可替宁< LOD的女性相比，可替宁≥LOD的女性叶酸摄入量显著更低（1293μg/天对1418μg/天；p = 0.01）。叶酸改变了胎儿烟草暴露与新生儿肥胖（交互作用p = 0.07）和SGA（交互作用p = 0.07）之间的关联。在叶酸摄入量较低的人群中，胎儿暴露于烟草与较低的新生儿肥胖（平均差异：-2.09%；95%置信区间：-3.44，-0.74）和增加的SGA风险（比值比：4.99；95%置信区间：1.55，16.14）相关。相反，在叶酸摄入量较高的人群中，新生儿肥胖（平均差异：-0.17%；95%置信区间：-1.13，0.79）或SGA风险（比值比：1.15；95%置信区间：0.57，2.31）没有差异。
孕期增加叶酸摄入量（从食物和/或补充剂中）可能会降低那些在孕期无法戒烟或无法避免二手烟的人群中胎儿生长受限的风险。
