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Smoking during pregnancy could adversely affect children’s HDL levels
Ayer J. Eur Heart J. 2011;doi:10.1093/eurheartj/ehr174.
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Data from a community-based longitudinal study have indicated that 8-year-old children whose mothers smoked during pregnancy had lower HDL levels while also having higher triglycerides and systolic BP.
“The prevalence of maternal smoking during pregnancy remains high, [about] 15% in many Western countries,” the researchers wrote. “The documented associations between smoking in pregnancy and childhood behavioral problems, neurocognitive deficits and sudden infant death syndrome highlight the potential for smoking to result in adverse fetal programming. The independent effect of prenatal exposure to cigarette smoke on the risk of future CVD, however, remains uncertain.”
Researchers performed a prospective analysis, culling data from questionnaires that were completed by face-to-face interviews of mothers soon after giving birth, which assessed their smoking status during the first, second and third trimesters. At the beginning of the study, 616 newborn infants were included in the analysis, and data on 405 of these children who reached 8 years of age were available.
Overall, women who smoked in pregnancy tended to have lower levels of education and shorter breast-feeding duration. At 8 years of age, children whose mothers smoked during pregnancy had lower levels of HDL (1.32 mmol/L vs. 1.50 mmol/L; P=.0005], as well as higher systolic BP (102.1 mm Hg vs. 99.9 mm Hg; P=.006) and triglycerides (1.36 mm Hg vs. 1.20 mmol/L; P=.04). However, no significant difference regarding carotid intima-media thickness was observed.
After multivariable adjustment, smoking during pregnancy remained predictive of lower HDL levels in children (P=.003), although not higher systolic BP (P=.07).
These data, the researchers concluded, “may be important for informing population-based prevention of atherosclerosis, as smoking in pregnancy remains common and HDL cholesterol has important atheroprotective functionality.”
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This is a novel study of importance that extends our knowledge about long-term adverse effects on offspring of smoking during pregnancy. Lower levels of HDL that persist in childhood is clear evidence of formative pre-natal conditioning that has long-term consequences and while the mechanistic pathway(s) are not understood, the implications are clear - smoking during pregnancy sets the child up for CVD. Renewed efforts must address the smoking epidemic among younger women today.
– C. Noel Bairey Merz, MD
Cardiology
Today Editorial Board member
Disclosures: Dr. Merz reported no relevant financial disclosures.
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