Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, USA.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
J Hum Hypertens. 2024 Feb;38(2):134-139. doi: 10.1038/s41371-023-00865-3. Epub 2023 Sep 29.
Maternal smoking during pregnancy (MSDP) is associated with lower birth weight, childhood obesity, and elevated blood pressure (BP) in offspring. We aimed to examine whether birth weight and body mass index (BMI) mediate the effect of MSDP on BP in children. The study included 14,713 children aged 8 to 15 years from the National Health and Nutrition Examination Surveys from 1999 to 2018. General third-variable models were used to examine the mediating effects of birth weight and BMI on the association of MSDP with BP. A total of 1928 (13.1%) children were exposed to MSDP. MSDP was associated with reduced birth weight (p < 0.001), increased BMI (p < 0.001), and elevated systolic BP (p = 0.005). MSDP was not associated with systolic BP after adjustment for birth weight and BMI z-score (p = 0.875), with 95.0% of the effect of MSDP on BP mediated by birth weight (39.1%) and BMI (55.9%). In conclusion, lower birth weight and increased obesity measures mediate the adverse effects of MSDP on BP in children. These findings provide novel mechanistic insight into the adverse effect of MSDP on BP in children and have implications for preventing hypertension in later life.
母亲在怀孕期间吸烟（MSDP）与后代的低出生体重、儿童肥胖和血压升高有关。我们旨在研究出生体重和体重指数（BMI）是否可以调节 MSDP 对儿童血压的影响。该研究纳入了 1999 年至 2018 年来自全国健康和营养检查调查的 14713 名 8 至 15 岁的儿童。采用一般的第三变量模型来研究出生体重和 BMI 对 MSDP 与 BP 关联的中介作用。共有 1928 名（13.1%）儿童接触到 MSDP。MSDP 与出生体重降低（p<0.001）、BMI 增加（p<0.001）和收缩压升高（p=0.005）有关。在调整出生体重和 BMI z 评分后，MSDP 与收缩压无关（p=0.875），MSDP 对 BP 的影响有 95.0%通过出生体重（39.1%）和 BMI（55.9%）来介导。总之，较低的出生体重和增加的肥胖指标介导了 MSDP 对儿童血压的不良影响。这些发现为 MSDP 对儿童血压的不良影响提供了新的机制见解，并对预防晚年高血压具有重要意义。
