Term of Award
Doctor of Public Health in Epidemiology (Dr.P.H.)
Document Type and Release Option
Dissertation (restricted to Georgia Southern)
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This work is licensed under a Creative Commons Attribution 4.0 License.
Department of Epidemiology (COPH)
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Evidence suggesting the association between maternal smoking during pregnancy and childhood obesity has increased over the past few decades. However, the population at high risk of childhood obesity remains ill-described. Limited efforts have been made to assess gestational age in the association between maternal smoking during pregnancy and pediatric obesity. This study sought to fill this gap and assess if this association differs by gestational age. Data on maternal smoking and child overweight status from the third National Health and Nutrition Examination Survey (1988-1994) were linked with information collected from birth certificates for the children who were born in the U.S. A sample of 2,404 singletons aged 2 to 6 years were included in this study. Survey logistic regression procedures were conducted to assess effect-modification. Missing data were accounted for using multiple imputations. The association between maternal smoking during pregnancy and childhood obesity did not change by the gestational age of an offspring at birth. A statistically non-significant p-value of (P= 0.78) for the interaction term between maternal smoking and gestational age was derived from joint tests suggesting gestational age is not an effect-modifier of the association between active maternal smoking during pregnancy and pediatric obesity. Adjustment of gestational age, age and race of infant, breastfeeding status and mother’s body mass index (BMI) showed children with exposure to maternal smoking during pregnancy had 19% less odds of becoming obese compared to children without exposure to maternal smoking during pregnancy (OR= 0.81, 95% CI, 0.61,1.08). However, the association was not statistically significant. The homogeneity of effect found is confined to 32-42 weeks of gestation based on the range of gestational age available in the dataset used in the present study. The association between smoking during pregnancy and childhood obesity remained unchanged regardless of gestational age. Factors such as age and race of infant, breastfeeding status and a mother’s BMI were identified as significant predictors of childhood obesity. Hence, early life obesity prevention interventions, campaigns on healthy dietary habits among racial minorities and exclusive breastfeeding are vital in promoting optimal body size of offspring at population levels irrespective of their gestational age.
Yeboah, F., "Maternal Smoking During Pregnancy and Offspring Obesity: An Association Effect-Modified by Gestational Age" (2019). Electronic Theses and Dissertations.
Research Data and Supplementary Material
Available for download on Tuesday, July 23, 2024