孕期及孕前母亲吸烟与幼儿期后代骨密度：南安普顿妇女调查结果

Maternal smoking before and during pregnancy and offspring bone mineral density in early childhood: findings from the Southampton Women's Survey.

作者信息

Harish Snigdha, Moon Rebecca J, Harvey Nicholas C, Inskip Hazel M, Godfrey Keith M, Crozier Sarah R, Baird Janis

机构信息

Faculty of Medicine, University of Southampton, Southampton, UK.

MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.

出版信息

Osteoporos Int. 2025 Jul 2. doi: 10.1007/s00198-025-07581-3.

DOI:10.1007/s00198-025-07581-3

PMID:40600993

Abstract

UNLABELLED

Smoking in adulthood increases fracture risk. In a prospective birth cohort study including 1966 children, we found that smoking before and during pregnancy were positively associated with the offspring BMD in childhood, but with attenuation by weight. This highlights the complex relationship between maternal smoking and offspring bone development.

INTRODUCTION

Inconsistent relationships between smoking in pregnancy and offspring bone mineral density (BMD) have been reported. We investigated the relationships between maternal smoking before and during pregnancy with offspring bone outcomes measured by dual-energy X-ray absorptiometry (DXA) during early childhood.

METHODS

In the Southampton Women's Survey, maternal smoking was determined before pregnancy and at 11 and 34 weeks' gestation. Offspring had DXA at birth (whole body), 4, 6-7 and 8-9 years (whole-body-less-head). Linear regression was used to examine the associations between maternal smoking and standardised bone area (BA), bone mineral content (BMC), BMD and bone mineral apparent density (BMAD). Adjustment for maternal educational qualification, diet, ethnicity, age and parity (all identified by directed acyclic graph) and offspring age and sex was performed. The child's weight was additionally added to assess mediation of the association.

RESULTS

A total of 1966 mother-offspring dyads were included; 25.7%, 15.9% and 15.1% smoked before, in early and late pregnancy, respectively. Pre-pregnancy smoking was positively associated with offspring BMD (4 years: 0.218 SD, 95% CI 0.062, 0.373; 6-7 years: 0.133 SD, 95% CI 0.004, 0.262; 8-9 years: 0.167 SD, 95% CI 0.017, 0.317), except at birth. BMAD had similar associations but not BA or BMC. Smoking in early or late pregnancy were similarly associated. Offspring of mothers who smoked during pregnancy were lighter at birth but heavier at other ages; including weight in the models weakened the associations.

CONCLUSION

Offspring of mothers who smoked before or during pregnancy had higher BMD, but this relationship may be partly mediated by higher childhood weight.

摘要

未标注

成年后吸烟会增加骨折风险。在一项纳入1966名儿童的前瞻性出生队列研究中，我们发现孕期前及孕期吸烟与儿童期后代的骨密度呈正相关，但这种相关性会因体重而减弱。这凸显了母亲吸烟与后代骨骼发育之间的复杂关系。

引言

已有报道称孕期吸烟与后代骨矿物质密度（BMD）之间的关系并不一致。我们研究了孕期前及孕期母亲吸烟与儿童早期通过双能X线吸收法（DXA）测量的后代骨骼指标之间的关系。

方法

在南安普顿妇女调查中，在怀孕前、妊娠11周和34周时确定母亲的吸烟情况。后代在出生时（全身）、4岁、6 - 7岁和8 - 9岁时（去除头部的全身）进行DXA检查。采用线性回归分析母亲吸烟与标准化骨面积（BA）、骨矿物质含量（BMC）、骨密度和骨矿物质表观密度（BMAD）之间的关联。对母亲的教育程度、饮食、种族、年龄和产次（均通过有向无环图确定）以及后代的年龄和性别进行了调整。另外加入儿童体重以评估该关联的中介作用。

结果

共纳入1966对母婴；分别有25.7%、15.9%和15.1%的母亲在孕前、孕早期和孕晚期吸烟。孕前吸烟与后代骨密度呈正相关（4岁时：0.218标准差，95%置信区间0.062，0.373；6 - 7岁时：0.133标准差，95%置信区间0.004，0.262；8 - 9岁时：0.167标准差，95%置信区间0.017，0.317），出生时除外。BMAD有类似的关联，但BA或BMC没有。孕早期或孕晚期吸烟的关联相似。孕期吸烟母亲的后代出生时较轻，但在其他年龄段较重；在模型中纳入体重后减弱了这种关联。