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Maternal Smoking and Risk of Childhood Overweight and Obesity: A Meta-Analysis

Authors: Martina Kanciruk, Jac W. Andrews, Tyrone Donnon


The purpose of this study was to determine the significance of maternal smoking for the development of childhood overweight and/or obesity. Accordingly, a systematic literature review of English-language studies published from 1980 to 2012 using the following data bases: MEDLINE, PsychINFO, Cochrane Database of Systematic Reviews, and Dissertation Abstracts International was conducted. The following terms were used in the search: pregnancy, overweight, obesity, smoking, parents, childhood, risk factors. Eighteen studies of maternal smoking during pregnancy and obesity conducted in Europe, Asia, North America, and South America met the inclusion criteria. A meta-analysis of these studies indicated that maternal smoking during pregnancy is a significant risk factor for overweight and obesity; mothers who smoke during pregnancy are at a greater risk for developing obesity or overweight; the quantity of cigarettes consumed by the mother during pregnancy influenced the odds of offspring overweight and/or obesity. In addition, the results from moderator analyses suggest that part of the heterogeneity discovered between the studies can be explained by the region of world that the study occurred in and the age of the child at the time of weight assessment.

Keywords: Childhood obesity, overweight, smoking, parents, risk factors.

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[1] Oken E, Gillman M. W., (2003) Fetal origins of obesity. Obesity Research, 11, pp. 496 –506.
[2] Rasmussen, K. M. (2001). The ‘‘Fetal Origins’’ Hypothesis: challenges and opportunities for maternal and child nutrition. Annual Review of Nutrition, 21, pp. 73–95.
[3] Koshy, G., Delpisheh, A., &Brabin, B. J. (2011). Childhood obesity and parental smoking as risk factors for childhood ADHD in liverpool children. ADHD Attention Deficit & Hyperactivity Disorders, 3, pp. 21-28.
[4] Toschke, A. M., Montgomery, S. M., Pfeiffer, U., & von Kries, R. (2003). Early intrauterine exposure to tobacco-inhaled products and obesity. American Journal of Epidemiology, 158, pp. 1068-1074.
[5] vonKries, R., Toschke, A. M., Koletzko, B., &Slikker, W., Jr. (2002). Maternal smoking during pregnancy and childhood obesity. American Journal of Epidemiology, 156, pp. 954-961.
[6] .Adams, A. K., Harvey, H. E., & Prince, R. J. (2006). Association of maternal smoking with overweight at age 3 y in American Indian children. American Journal of Clinical Nutrition, 82, pp.393-398.
[7] Braun, J. M., Daniels, J. L., Poole, C., Olshan, A. F., Hornung, R., Bernert, J. T., et al. (2010). Prenatal environmental tobacco smoke exposure and early childhood body mass index. Paediatric and Perinatal Epidemiology, 24, pp. 524-534.
[8] .Tome, F. S., Cardoso, V. C., Barbieri, M. A., Silva, A. A. M., Simoes, V. M. F., Garcia, C. A., et al. (2007). Are birth weight and maternal smoking during pregnancy associated with malnutrition and excess weight among school age children? Brazilian Journal of Medical and Biological Research, 40, pp. 1221-1230.
[9] Wideroe, M., Vik, T., Jacobsen, G., &Bakketeig, L. S. (2003). Does maternal smoking during pregnancy cause childhood overweight? Paediatric and Perinatal Epidemiology, 17, pp. 171-179.
[10] Whitaker, R. C. (2004). Predicting preschooler obesity at birth: The role of maternal obesity in early pregnancy. Pediatrics, 114, pp.29-36.
[11] Ino, T., Shibuya, T., Saito, K., &Ohtani, T. (2011). Effects of maternal smoking during pregnancy on body composition in offspring. Pediatrics International, 53, pp. 851-857.
[12] Moreira, P., Padez, C., Mourao-Carvalhal, I., & Rosado, V. (2007). Maternal weight gain during pregnancy and overweight in portuguese children. International Journal of Obesity, 31, pp. 608-614.
[13] Raum, E., Kupper-Nybelen, J., Lamerz, A., Hebebrand, J., Herpertz-Dahlmann, B., & Brenner, H. (2011). Tobacco smoke exposure before, during, and after pregnancy and risk of overweight at age 6. Obesity, 19, pp. 2411-2417.
[14] Dubois, L., & Girard, M. (2006). Determinants of birthweight inequalities: Population-based study. Pediatrics International, 48, pp. 470-478.
[15] Danielzik, S., Czerwinski, M., Langnase, K., Dilba, B., & Muller, M. J. (2004). Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7y-old children: Baseline data of the kiel obesity prevention study (KOPS). International Journal of Obesity, 28, pp. 1494-1502.
[16] Reilly, J. J., Armstrong, J., Dorosty, A. R., Emmett, P. M., Ness, A., Rogers, I., et al. (2005). Early life risk factors for obesity in childhood: Cohort study. British Medical Journal, 330, pp. 1357-1359.
[17] Barlow, S.E. & the expert committee. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity. Summary report. Pediatrics, 120, pp. 164-192.
[18] Lau, K.S., Patridge, E.A., Grigorian, A., Silvescu, C.I., Reinhold, V.N., Demetriou, M., & Dennis, J. W. (2007). Comples N-glycan number and degree of branching cooperate to regulate cell proliferation and differentiation, Cell, 129, pp. 123-143.
[19] Krebs, N.F., Himes, D.J., Nicklas, T.A., Guilday, P., &Styne, D. (2007). Assessment of child and adolescent overweight and obesity. Pediatric, 120, pp. 193-228
[20] Borenstein, M., Hedges, L., &Rosthstein, H. (2007). Introduction to meta-analysis.
[21] Egger, M., & Smith, G. D. (2001). Principles and procedures for systematic reviews. In M.Egger, G. D. Smith, & D. G Altman (Eds.), Systematic reviews in health care: Meta-analysis in context (pp. 23-42). London: BMJ Publishing.
[22] Royle, P.L., Bain, N., & Waugh, N. (2005). Systematic reviews of epidemiology in diabetes: Finding evidence. BMC Medical Research Methodology, Rubin, K. H., Coplan, R. J, Bowker, J. C. (2009). Social withdrawal in childhood. Annual Review of Psychology, 60, pp. 141–71.
[23] CEBM Levels of Evidence Working Group. "The Oxford Levels of Evidence 2". Oxford Centre for Evidence-Based Medicine.
[24] Bennett D, Emberson J. (2011). Text messaging in smoking cessation: the txt2stop trial. Lancet, 378, pp. 6-7.
[25] Cooper, H. & Hedges, L. V. (1994). Research synthesis as a scientific enterprise (pp. 3-14). In H. Copper L. V. Hedges (Eds.), The Handbook of Research Synthesis. New York, NY: Russel Sage Foundation.
[26] Rosenthal, R. (1994). Science and ethics in conducting, analyzing, and reporting psychological research. Psychological Science, 5,pp. 127-134
[27] Littell, J. H., Corcoran, J., & Pillai, V. (2008). Systematic reviews and meta-analysis. New York, NY: Oxford University Press.
[28] Borenstein, M. & Rothstein, H. (1999). Comprehensive meta-analysis. Englewood, NJ: Biostat.
[29] Steel, P.D. &Kammeyer-Mueller, J. D. (2002). Comparing meta-analytic moderator estimation techniques under realistic conditions. Journal of Applied Psychology, 87, pp.96-111.
[30] Chen, J. L. & Kennedy, C., Yeh, C.H., Kools, S. (2005).Risk factors for childhood obesity in elementary school-age Taiwanese children. Progress in Cardiovascular Nursing for the Study of Obesity, 28, pp. 90-5.
[31] Bergmann, K. E., Bergmann, R. L., von Kries, R. Bohm, O., Richter, R., Dudenhausen, J.W, et al. (2003). Early determinants of childhood overweight and adiposity in a birth cohort study: Role of breast-feeding. International Journal of Obesity, 27, pp.162-172.
[32] Shields, M. (2006). Overweight and obesity among children and youth. Health Reports, 17, pp.27-42.
[33] Olds, T. S., Tomkinson, G. R., Ferrar, K. E., & Maher, C. A. (2010). Trends in the prevalence of childhood overweight and obesity in australia between 1985 and 2008. International Journal of Obesity, 34, pp.57-66.
[34] Golan, M. (2006). Parents as agents of change in childhood obesity--from research to practice. International Journal of Pediatric Obesity, 1, pp. 66-76.
[35] Oken E, Gillman M. W., (2003) Fetal origins of obesity. Obesity Research, 11, pp.496 –506.
[36] Rasmussen, K. M. (2001). The ‘‘Fetal Origins’’ Hypothesis: challenges and opportunities for maternal and child nutrition. Annual Review of Nutrition, 21, pp.73–95.
[37] Stettler, N., Zemel, B. S., Kumanyika, S., & Stallings, V. A. (2002). Infant weight gain and childhood overweight status in a multicenter, cohort study. Pediatrics, 109, pp.194-199.
[38] Kramer, M. S. (1987). Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65, pp.663-737.
[39] Anguita R. M., Sigulem D. M., Sawaya A. L. (1993) Intrauterine food restriction is associated with obesity in young rats. Journal of. Nutrition. 123, pp.1421–1428
[40] van der Meulen, J. (2002). Maternal smoking during pregnancy and obesity in the offspring. International Journal of Epidemiology, 31, pp.420-421.
[41] Holloway A. C., Lim G. E., Petrik J. J., Foster W. G., Morrison K. M., & Gerstein H. C. (2005). Fetal and neonatal exposure to nicotine in Wistarrats results in increased beta cell apoptosis at birth and postnatal endocrine and metabolic changes associated with type 2 diabetes. Diabetologia, 48, pp.2661-2666.
[42] Gao, Y. J., Holloway, A. C., Zeng, Z. H., Lim, G. E., Petrik, J. J., Foster, W. G., et al. (2005). Prenatal exposure to nicotine causes postnatal obesity and altered perivascular adipose tissue function. Obesity Research, 13, pp.687-692.
[43] Pausova, Z., Sedova, L., Berube, J., Hamet, P., Tremblay, J., Dumont, M., et al., (2003). Segment of rat chromosome 20 regulates diet-induced augmentations in adiposity, glucose intolerance, and blood pressure. Hypertension, 41, pp.1047–1055.
[44] Li, M. D., Kane, J. K., &Parker, S. L. (2000). Nicotine administration enhances NPY expression in the rat hypothalamus. Brain Research, 867, pp.157-164.
[45] Jo, Y. -.,Talmage, D. A., & Role, L. W. (2002). Nicotinic receptor-mediated effects on appetite and food intake. Journal of Neurobiology, 53, pp.618-632.
[46] Ino, T. (2010). Maternal smoking during pregnancy and offspring obesity: Meta-analysis. Pediatrics International, 52, pp. 94-99.
[47] Oken, E., Levitan, E. B., & Gillman, M. W. (2008). Maternal smoking during pregnancy and child overweight: Systematic review and meta-analysis. International Journal of Obesity, 32, pp. 201-210.
[48] National Institutes of Health, National Heart, Lung, and Blood Institute, Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report (1998). Obesity Research, 6, pp.S51- S210.
[49] .Center of Disease Control (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Retrieved from
[50] Hu, F. B. (2008). Obesity epidemiology. Boston: MA, Oxford University Press.
[51] National Center for Chronic Disease Prevention and Health Promotion (2010).
[52] CDC. Centers for Disease Control Prevention. Behavioural risk factors surveillance system survey data trends 1976-1980 through 2007-2008. (2010).
[53] Freedman, D. S., Katzmarzyk,P. T., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (2009). Relation of body mass index and skinfold thicknesses to cardiovascular disease risk factors in children: the Bogalusa Heart Study. American Journal of Clinical Nutrition, 90, pp.210-216.
[54] Rubin, K. H., Coplan, R. J, Bowker, J. C. (2009). Social withdrawal in childhood. Annual Review of Psychology, 60, 141–71.
[55] Kuhle, S., Kirk, S. F., Ohinmaa, A., &Veugelers, P. J. (2011). Comparison of ICD code-based diagnosis of obesity with measured obesity in children and the implications for health care cost estimates. BMC Medical Research Methodology, 11, pp. 173.
[56] Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., &Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999-2004. JAMA: Journal of the American Medical Association, 295, pp.1549-1555.
[57] Owen, C. G., Martin, R. M., Whincup, P. H., Smith, G. D., & Cook, D. G. (2005). Effect of infant feeding on the risk of obesity across the life course: A quantitative review of published evidence. Pediatrics, 115, pp. 1367-1377.
[58] Brisbois, T. D., Farmer, A. P., &McCargar, L. J. (2012). Early markers of adult obesity: A review. Obesity Reviews, 13(4), pp.347-367.
[59] Ong, K. K. (2006). Size at birth, postnatal growth and risk of obesity. Hormone Research, 65, 65-69.
[60] Lindsay, A. C., Sussner, K. M., Kim, J., &Gortmaker, S. L. (2006). The Role of Parents in Preventing Childhood Obesity. The Future of Children, 16, 169-186.
[61] Berk, L.E. (2000). Child development (5th ed.), Toronto: McGraw-Hill.
[62] Thompson, D., Baranowski, I., Zakeri, R., Jago, R., Davis, J., & Cullen, K. (2006). Effectiveness of school-based environmental vs. individual approaches to diet, physical activity, and sedentary behavior change among youth. In R. K Flamenbaum (Eds,). Childhood obesity and health research (pp. 157-174). Nova Science Publishes Inc. New York.
[63] Bogdanovica, I., Godfrey, F., McNeill, A., & Britton, J. (2011). Smoking prevalence in the European union: A comparison of national and transnational prevalence survey methods and results. Tobacco Control, 20, 4.
[64] Cornfield, J., Haenszel, W., Hammond, E. C., Lilienfeld, A. M., Shimkin, M. B., &Wynder, E. L. (2009). Smoking and lung cancer: Recent evidence and a discussion of some questions. International Journal of Epidemiology, 38, pp.1175-1191.