Mom's Smoking during pregnancy Affects Child's HDL Levels

[Guest guest]

Eight-year-old children of women who smoked during pregnancy were found to

have lower-than-normal levels of high-density lipoprotein cholesterol,

independent of smoke exposure after birth.

Children born to mothers who smoked had HDL levels of about 1.3 mmol/L,

compared to the more normal level of 1.5 mmol/L, n G. Ayer, MD, from

Royal Prince Alfred Hospital in Sydney, Australia, and colleagues found.

After adjustments for various confounders, the difference attributable to

mothers' smoking was about 0.15 mmol/L, according to the study published

online in *European Heart Journal*.

" Cholesterol levels tend to track from childhood to adulthood, and studies

have shown that for every 0.025 mmol/L increase in HDL levels, there is an

approximately 2% to 3% reduction in the risk of coronary heart disease, "

senior author Celermajer, MBBS, PhD, from the University of Sydney,

Australia, said in a statement.

" If we extrapolate this, we can suggest that the difference of 0.15 mmol/L

between children of smoking mothers versus non-smoking mothers might result

in a 10% to 15% higher risk for coronary disease in the children of smoking

mothers. This is an approximation only, but the best one we have, " he said.

The children in this study had been enrolled prior to birth between 1997 and

1999 into the Childhood Asthma Prevention Study, a randomized controlled

trial of house dust-mite avoidance and dietary fatty acid modification from

birth to 5 years in children at risk for asthma and allergic disease.

When the 616 children in that study turned 8, the families were asked to

participate in a cardiovascular sub-study examining the effect of the

dietary intervention on traditional vascular risk factors, whose results

have been published (*Am J Clin Nutr *2009; 90: 438–446).

Those families were subsequently asked to participate in this study, and 328

children were recruited.

Researchers asked the families detailed questions regarding smoking during

and after pregnancy, as well as questions regarding the children's

second-hand smoke exposure.

Mothers who smoked during pregnancy, as well as their husbands, had lower

levels of education. These mothers also devoted significantly less time to

breastfeeding (*P*<0.001 for both).

While gestational age, birth weight and head circumference, and height at

age 8 were similar between children of smokers and non-smokers, children of

mothers who smoked were heavier (*P*=0.003).

In the univariate analysis, smoking in pregnancy was associated with lower

HDL (1.32 versus 1.50 mmol/L, *P*=0.0005). Children of smoking mothers also

had higher triglycerides.

Researchers also found that smoking was associated with higher systolic

blood pressure and higher levels of high-sensitivity C-reactive protein.

Smoking, however, had no significant effect on carotid-intima media

thickness.

In multivariate models after adjusting for various confounders, Ayer and

colleagues found that the effect on HDL-C was independent of whether the

children had been exposed to other people's smoke after birth, suggesting

that prenatal exposure had the most impact on the children's subsequent

development.

Researchers said a limitation to the study was that they did not have

information on the children's diet and exercise. Also, they relied on

questionnaires about smoking rather than measurements of nicotine levels.

And the design of the study did not allow confirmation of the mechanisms

underlying the association between maternal smoking in pregnancy and lower

HDL.

*Primary source: *European Heart Journal

Source reference:

Celermajer D, et al. " Maternal cigarette smoking is associated with reduced

high-density lipoprotein cholesterol in healthy 8-year-old children " *Eur

Heart J* 2011; DOI:

10.1093/eurheartj/ehr174.<http://eurheartj.oxfordjournals.org/content/early/2011\

/06/11/eurheartj.ehr174.abstract>

--

Ortiz, MS, RD

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