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In utero Smoke Exposure and Cardiometabolic Risks

Ann Epidemiol; ePub 2018 Jul 3; Stevens, et al

In utero smoke exposure appears to be associated with an increased likelihood of high waist circumference and body mass index percentiles, especially among female adolescents, according to a recent study. These results demonstrate the long-term cardiometabolic impact in offspring, highlighting the importance of pre-pregnancy smoking cessation. Participants included 7,464 adolescents aged 12–15 years identified from the National Health and Nutrition Examination Survey (1999–2014). Multiple logistic and linear regression analyses estimated sex-specific means and odds ratios (ORs) for the association between in utero smoke exposure and metabolic syndrome (MetS) and cardiometabolic risk factors. Researchers found:

  • MetS prevalence was 9.0% in exposed vs 5.9% in unexposed adolescents.
  • In utero smoke exposure was significantly associated with increased odds of MetS among males in models controlling for adolescent age, maternal age, and race/ethnicity (OR: 2.48), with attenuation of this effect in subsequent models.
  • In utero smoke exposure was also associated with significantly elevated mean body mass index and waist circumference percentiles among female adolescents across most models in regression analyses.


Stevens DR. Malek AM, Laggis C, Hunt KJ. In utero exposure to tobacco smoke, subsequent cardiometabolic risks, and metabolic syndrome among U.S. adolescents. [Published online ahead of print July 3, 2018]. Ann Epidemiol. doi:10.1016/j.annepidem.2018.06.010.