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Issue 91 Item 8 Diabetes And Obesity Link To Prenatal Smoking

Cigarette smoking as a young adult is associated with an increased risk of subsequent diabetes Women who smoke during pregnancy increase the risk of their infant developing diabetes and obesity in later life.

At the same time, a study by Dr Scott Montgomery and colleagues at the Enheten for Klinisk Epidemiologi, Stockholm, Sweden, shows that cigarette smoking as a young adult is associated with an increased risk of subsequent diabetes.

Dr Montgomery and colleagues used British data on about 17,000 births from March 3 to 9, 1958 to conduct the investigation. At birth, midwives recorded information on how much the women smoked after the fourth month of pregnancy. Details of maternal smoking were again recorded in 1974. Overall group smoking behavior was recorded during interviews with them when they reached the age of 16.

Medical examinations and record reviews were conducted among the cohort at the age of seven and 16, and a personal interview at age 33 years asked about diabetes. Among those followed fully throughout childhood and adolescence to age 33, the authors identified 15 men and 13 women who had developed diabetes between 16 and 33 years, and 602 individuals (10 percent) who were obese at age 33.

The association of diabetes with maternal smoking specifically during pregnancy suggests that it is a true risk factor for early adult onset diabetes. Cigarette smoking as a young adult was also independently associated with an increased risk of subsequent diabetes.

Men and women who did not have diabetes, but whose mothers smoked during pregnancy, were significantly more likely to be obese or overweight by age 33.

It is suggested that in utero exposure to smoking results in lifelong metabolic dysregulation, possibly due to fetal malnutrition or toxicity, and stress that smoking during pregnancy should always be strongly discouraged.

The association of diabetes with maternal smoking during pregnancy "suggests that it is a true risk factor for early adult onset diabetes," the researchers conclude. "Cigarette smoking as a young adult was also independently associated with an increased risk of subsequent diabetes.