Mother’s smoking during pregnancy influence intrauterine and postnatal growth - the GrowUp 1990 Gothenburg cohort population

Anton Holmgren; Aimon Niklasson; A. Stefan Aronson; Kerstin Albertsson-Wikland

Background/Objective: Smoking during pregnancy is known to influence prenatal/postnatal growth of the offspring. We investigated the impact of smoking in the Swedish reference population for new reference for height, weight and BMI, the GrowUp1990Gothenburg cohort.

Material/Methods: The study was based on 1907 healthy children (918girls/989boys) born at term in Sweden with Nordic parents and longitudinal growth measurements. 155girls/180boys was born to mothers smoking during pregnancy. Both traditional measures and estimates from the QEPS-growth model were used for comparisons.

Results: Individuals of both sexes with smoking mothers were shorter/lighter at birth, came earlier into puberty, had earlier peak height velocity (AgeTPHV) and were 1.8-1.9cm shorter at adult height as seen in the table. The girls median weight/BMI remained lighter during infancy and childhood, whereas along +2SDS became greater from 10yrs onwards, resulting in broader ranges. The boys’ median weight/BMI remained lighter during infancy, from 2.5yrs of age heavier and with greater BMI during childhood and adolescence.


Variable	Mean NS, girls	Mean S,girls	Diff.	P-value	Mean NS,boys	Mean S,boys	Diff.	P-value
Gestatational age,days	281.1	281.7	-0.6	0.4369	281.0	280.7	0.3	0.6804
Birth weight,gram	3563	3379	184	<.0001	3691	3530	161	<.0001
Birth length,cm	50.2	49.4	0.83	<.0001	51.0	50.3	0.70	<.0001
Emax,cm	62.8	62.72	0.10	0.6877	65.1	65.1	-0.04	0.8376
Qmax,cm	98.7	97.3	1.39	0.0453	105.6	104.3	1.30	0.0491
AgeP5,yrs	9.8	9.6	-0.21	0.0130	11.8	11.6	0.24	0.0028
AgeTPHV,yrs	11.8	11.6	-0.22	0.0141	13.7	13.4	0.24	0.0028
Pmax,cm	13.0	13.1	-0.13	0.6885	17.3	17.0	0.26	0.4059
Adult height,cm	168.6	166.8	1.76	0.0020	182.0	180.1	1.90	0.0004
Mother,cm	167.2	167.1	0.10	0.8279	167.4	166.7	0.70	0.1373
Father,cm	181.7	180.3	1.38	0.0285	181.2	180.2	1.00	0.0941
NS=non smoking mothers, S=smoking mothers. E,Q,Pmax=maximum of E,Q,P-functions by the QEPS-model. AgeP5=onset of pubertal growth.

Conclusion: Growth and maturation in children born to mothers smoking during pregnancy were influenced: they were shorter, lighter at birth/during infancy than those born to non-smoking mothers, with shorter stature and increased BMI during childhood. Omitting children born to mothers smoking during pregnancy narrowing the range of ±2SDS. We therefore recommend omitting children to smoking mothers when developing new growth references^{1, 2,3}.

References: 1. Albertsson-Wikland K,et al, Acta Paediatrica,2020;109: 754-63 2. Albertsson-Wikland K,et al, Acta Paediatrica,2021;110: 537-548

3.Albertsson-Wikland K,et al, JPEM,2020;33(9): 1173-1182

ESPE Abstracts

P1-168