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Maternal smoking during pregnancy and offspring body composition in adulthood: Results from two birth cohort studies
  1. Elma Izze da Silva Magalhães,
  2. Natália Peixoto Lima,
  3. Ana Maria Baptista Menezes,
  4. Helen Gonçalves,
  5. Fernando C Wehrmeister,
  6. Maria Cecília Formoso Assunção,
  7. Bernardo Lessa Horta
  1. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
  1. Correspondence to Elma Izze da Silva Magalhães; elmaizzenutri{at}


Objective To evaluate the association of maternal smoking during pregnancy with offspring body composition in adulthood and explore the causality of this association.

Design Birth cohort.

Setting Population-based study in Pelotas, Brazil.

Participants All newborn infants in the city’s hospitals were enrolled in 1982 and 1993. At a mean age of 30.2 and 22.6 years, the 1982 and 1993 cohorts, respectively, followed the subjects and 7222 subjects were evaluated.

Primary outcome measures Body mass index (BMI), fat mass index, android to gynoid fat ratio, waist circumference, waist to height ratio, lean mass index and height.

Results Prevalence of maternal smoking during pregnancy was 35.1% and 32.6%, in 1982 and 1993 cohorts, respectively. Offspring of smoking mothers showed higher mean BMI (β: 0.84; 95% CI: 0.55 to 1.12 kg/m2), fat mass index (β: 0.44; 95% CI: 0.23 to 0.64 kg/m2), android to gynoid fat ratio (β: 0.016; 95% CI: 0.010 to 0.023), waist circumference (β: 1.74; 95% CI: 1.15 to 2.33 cm), waist to height ratio (β: 0.013; 95% CI: 0.010 to 0.017) and lean mass index (β: 0.33; 95% CI: 0.24 to 0.42 kg/m2), whereas height was lower (β: −0.95; −1.26 to −0.65). Weight gain in the first 2 years captured most of the association of maternal smoking with BMI (96.2%), waist circumference (86.1%) and fat mass index (71.7%).

Conclusions Maternal smoking in pregnancy was associated with offspring body composition measures in adulthood.

  • maternal smoking
  • pregnancy
  • body composition
  • cohort study

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  • Contributors EISM designed the study, performed the statistical analysis, interpretation of the results and drafted the manuscript. BLH and NPL designed the study, helped the data analysis and participated in the preparation of the manuscript. BLH coordinated the follow-up of the 1982 cohort and AMBM coordinated the follow-up of the 1993 cohort. AMBM, HDG, FCW and MCA helped in the data acquisition and interpretation of the data. All authors revised and approved the final version of the manuscript. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

  • Funding This article is based on data from the study ’Pelotas Birth Cohort, 1982 and 1993' conducted by the Postgraduate Program in Epidemiology at Federal University of Pelotas with the collaboration of the Brazilian Public Health Association (ABRASCO). From 2004 to 2016, the Wellcome Trust (086974/Z/08/Z) supported the Pelotas birth cohort study. The International Development Research Center, World Health Organization, Overseas Development Administration, European Union, National Support Program for Centers of Excellence (PRONEX), the Brazilian National Research Council (CNPq) and the Brazilian Ministry of Health supported previous phases of the study. This study was financed in part by theCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) -Finance Code 001.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon reasonable request.

  • Patient consent for publication Obtained.

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