Exposure to Tobacco Smoke in Utero and Subsequent Plasma Lipids, ApoB, and CRP among Adult Women in the MoBa Cohort

Lea A. Cupul‑Uicab,¹ Rolv Skjaerven,^2,3 Kjell Haug,² Gregory S. Travlos,⁴ Ralph E. Wilson,⁴ Merete Eggesbø,⁵ Jane A. Hoppin,¹ Kristina W. Whitworth,¹ and Matthew P. Longnecker¹

¹Epidemiology Branch, Na­tional Institute of Environmental Health Sciences, Na­tional Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; ²Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway; ³Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway; ⁴Cellular and Molecular Pathology Branch, Na­tional Institute of Environmental Health Sciences, Na­tional Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; ⁵Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway


Abstract

Background: Recent findings suggest that maternal smoking during pregnancy may play a role in the development of metabolic altera­tions in offspring during childhood. However, whether such exposure increases the risk of developing similar metabolic altera­tions during adulthood is uncertain.


Objective: We evalua­ted the associa­tion of in utero exposure to maternal tobacco smoke with plasma lipids, apolipoprotein B (apoB), and C-reactive protein (CRP) in adulthood.


Methods: The study was based on a sub­sample of the Norwegian Mother and Child Cohort Study (MoBa) and included 479 pregnant women with plasma lipids, apoB, and CRP measurements. Informa­tion on in utero exposure to tobacco smoke, personal smoking, and other factors were obtained from the women by a self-completed questionnaire at enrollment, at approximately 17 weeks of gesta­tion.


Results: Women exposed to tobacco smoke in utero had higher tri­glyce­rides [10.7% higher; 95% confidence interval (CI): 3.9, 17.9] and lower high-density lipoprotein choles­terol (HDL) (–1.9 mg/dL; 95% CI: –4.3, 0.5) compared with unexposed women, after adjusting for age, physical activity, educa­tion, personal smoking, and current body mass index (BMI). Exposed women were also more likely to have tri­glyce­rides ≥ 200 mg/dL [adjusted odds ratio (aOR) = 2.5; 95% CI: 1.3, 5.1] and HDL < 50 mg/dL (aOR = 2.3; 95% CI: 1.1, 5.0). Low-density lipoprotein choles­terol, total choles­terol, and apoB were not associa­ted with the exposure. CRP was increased among exposed women; however, after adjustment for BMI, the associa­tion was completely attenua­ted.


Conclusions: In this popula­tion, in utero exposure to tobacco smoke was associa­ted with high tri­glyce­rides and low HDL in adulthood, 18–44 years after exposure.


Key words: clinical chemistry, C-reactive protein, metabolic syndrome, plasma lipids, prenatal exposure delayed effects, smoking, women. 


Environ Health Perspect 120:1532–1537 (2012). http://dx.doi.org/10.1289/ehp.1104563 [Online 19 July 2012]


Address correspondence to L.A. Cupul-Uicab, Na­tional Institute of Environmental Health Sciences, MD A3-05, 111 TW Alexander Dr., Research Triangle Park, NC 27709 USA. Telephone: (919) 541-3630. Fax: (919) 541-2511. E-mail: cupuluicabl@niehs.nih.gov


Supplemental Material is available online (http://dx.doi.org/10.1289/ehp.1104563).


We are grateful to all the participating families in Norway who take part in this ongoing cohort study.


This research was supported in part by the Intramural Research Program of the Na­tional Institutes of Health (NIH), Na­tional Institute of Environmental Health Sciences (NIEHS). The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health, contract N01-ES-75558 with the NIH/NIEHS, NIH/National Institute of Neurological Disorders and Stroke (grant 1 UO1 NS 047537-01), and the Norwegian Research Council/FUGE (grant 151918/S10).


The authors declare they have no actual or potential competing financial interests.


Received 30 September 2011; Accepted 19 July 2012; Online 19 July 2012.