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Albers, Lucia; Sobotzki, Christina; Kuss, Oliver; Ajslev, Teresa; Batista, Rosangela F. L.; Bettiol, Heloisa; Brabin, Bernard; Buka, Stephen L.; Cardoso, Viviane C.; Clifton, Vicki L.; Devereux, Graham; Gilman, Stephen E.; Grzeskowiak, Luke E.; Heinrich, Joachim; Hummel, Sandra; Jacobsen, Geir W.; Jones, Graeme; Koshy, Gibby; Morgen, Camilla Schmidt; Oken, Emily; Paus, Tomas; Pausova, Zdenka; Rifas-Shiman, Sheryl L.; Sharma, Andrea J.; da Silva, Antonio A. M.; Sorensen, Thorkild I. A.; Thiering, Elisabeth; Turner, Stephen; Vik, Torstein; Kries, Rüdiger von (2018): Maternal smoking during pregnancy and offspring overweight: is there a dose-response relationship? An individual patient data meta-analysis. In: International Journal of Obesity, Vol. 42, No. 7: pp. 1249-1264
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Abstract

Background/objectives A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose-response relationship across number of cigarettes and whether this differs by sex remains unclear. Subject/methods Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex. Results Of 26 identified studies, 16 authors provided data on a total of 238,340 mother-child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02-1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results. Conclusions A linear dose-response relationship of maternal smoking was observed in the range of 1-15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.