Association Between Maternal Smoking During Pregnancy and Risk of Bone Fractures in Offspring: a Systematic Review and Meta-analysis

Overview

Journal Clin Exp Pediatr

Specialty Pediatrics

Date 2020 Feb 6

PMID 32023402

Citations 4

Authors

Erfan Ayubi

Saeid Safiri

Kamyar Mansori

Affiliations

Soon will be listed here.

Abstract

This study aimed to investigate the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in the offspring through a systematic review and meta-analysis. The PubMed, Web of Science, and Scopus databases were systematically searched for relevant articles published through July 2019. According to heterogeneity, the pooled risk ratio (RR) and odds ratio (OR) and their corresponding 95% confidence interval (CI) were obtained using fixed or random effects models. The heterogeneity and quality of the included studies were assessed by the I-squared (I2 ) statistic and the Newcastle-Ottawa scale, respectively. Sensitivity analyses were performed to test the effect of MSDP misclassification on the results. The review of 842 search records yielded 5 studies including 8,746 mother-child pairs that were included in the meta-analysis. Pooling adjusted effect measures showed that MSDP was not associated with a later risk of bone fractures in the offspring (pooled RR, 1.15; 95% CI, 0.84-1.58; I2 =66.8%; P=0.049). After the adjustment for misclassification, MSDP may be associated with a 27% increased risk of bone fracture (pooled OR, 1.27; 95% CI, 1.00-1.62; I2 =0%; P=0.537). After the adjustment for misclassification, MSDP is associated with an increased risk of bone fractures among children whose mothers smoked during pregnancy.

Citing Articles

Early-life tobacco smoke elevating later-life osteoporosis risk: Mediated by telomere length and interplayed with genetic predisposition.

Di D, Zhou H, Cui Z, Zhang J, Liu Q, Yuan T J Adv Res. 2024; 68:331-340.

PMID: 38431123 PMC: 11785556. DOI: 10.1016/j.jare.2024.02.021.

Mediating Effect of Tobacco Dependence on the Association Between Maternal Smoking During Pregnancy and Chronic Obstructive Pulmonary Disease: Case-Control Study.

Li J, Xu J, Yang L, Xu Y, Zhang X, Bai C JMIR Public Health Surveill. 2024; 10:e53170.

PMID: 38386387 PMC: 10921321. DOI: 10.2196/53170.

Prevalence of inadequate vitamin D level and its predictors in children presenting with torus fractures.

Muzzammil M, Minhas M, Mughal A, Qadir A, Jahanzeb S, Jabbar S Eur J Orthop Surg Traumatol. 2022; 33(5):1767-1772.

PMID: 35947197 DOI: 10.1007/s00590-022-03354-4.

Effect of parental supervision of infants at age 4 to 6 months on injuries at age 4 to 12 months.

Lee W, Lee K, Ha E, Kim J, Shim S, Lee S Sci Rep. 2022; 12(1):10252.

PMID: 35715479 PMC: 9205875. DOI: 10.1038/s41598-022-14321-8.

Is correcting exposure misclassification bias an additional option in meta-analyses?.

Kim K Clin Exp Pediatr. 2021; 64(3):117-118.

PMID: 33445829 PMC: 7940087. DOI: 10.3345/cep.2020.00325.

References

Yan C, Avadhani N, Iqbal J . The effects of smoke carcinogens on bone. Curr Osteoporos Rep. 2011; 9(4):202-9. DOI: 10.1007/s11914-011-0068-x. View

Ma D, Jones G . Clinical risk factors but not bone density are associated with prevalent fractures in prepubertal children. J Paediatr Child Health. 2002; 38(5):497-500. DOI: 10.1046/j.1440-1754.2002.00037.x. View

Goulding A, Cannan R, Williams S, Gold E, Taylor R, Lewis-Barned N . Bone mineral density in girls with forearm fractures. J Bone Miner Res. 1998; 13(1):143-8. DOI: 10.1359/jbmr.1998.13.1.143. View

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

Demir R, Demir A, Yinanc M . Structural changes in placental barrier of smoking mother. A quantitative and ultrastructural study. Pathol Res Pract. 1994; 190(7):656-67. DOI: 10.1016/s0344-0338(11)80744-2. View

Heppe D, Medina-Gomez C, Hofman A, Rivadeneira F, Jaddoe V . Does fetal smoke exposure affect childhood bone mass? The Generation R Study. Osteoporos Int. 2015; 26(4):1319-29. DOI: 10.1007/s00198-014-3011-z. View

van den Heuvel E, Steijns J . Dairy products and bone health: how strong is the scientific evidence?. Nutr Res Rev. 2018; 31(2):164-178. DOI: 10.1017/S095442241800001X. View

Goulding A, Jones I, Taylor R, Manning P, Williams S . More broken bones: a 4-year double cohort study of young girls with and without distal forearm fractures. J Bone Miner Res. 2000; 15(10):2011-8. DOI: 10.1359/jbmr.2000.15.10.2011. View

Cooper C, Eriksson J, Forsen T, Osmond C, Tuomilehto J, Barker D . Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporos Int. 2001; 12(8):623-9. DOI: 10.1007/s001980170061. View

10.

Wong P, Christie J, Wark J . The effects of smoking on bone health. Clin Sci (Lond). 2007; 113(5):233-41. DOI: 10.1042/CS20060173. View

11.

Andersen M, Walker L, Stender S . Reduced endothelial nitric oxide synthase activity and concentration in fetal umbilical veins from maternal cigarette smokers. Am J Obstet Gynecol. 2004; 191(1):346-51. DOI: 10.1016/j.ajog.2003.12.040. View

12.

Jaddoe V, Verburg B, de Ridder M, Hofman A, Mackenbach J, Moll H . Maternal smoking and fetal growth characteristics in different periods of pregnancy: the generation R study. Am J Epidemiol. 2007; 165(10):1207-15. DOI: 10.1093/aje/kwm014. View

13.

Stang A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010; 25(9):603-5. DOI: 10.1007/s10654-010-9491-z. View

14.

Petersen S, Olsen S, Molgaard C, Granstrom C, Cohen A, Vestergaard P . Maternal vitamin D status and offspring bone fractures: prospective study over two decades in Aarhus City, Denmark. PLoS One. 2014; 9(12):e114334. PMC: 4256222. DOI: 10.1371/journal.pone.0114334. View

15.

Jones G, Hynes K, Dwyer T . The association between breastfeeding, maternal smoking in utero, and birth weight with bone mass and fractures in adolescents: a 16-year longitudinal study. Osteoporos Int. 2012; 24(5):1605-11. DOI: 10.1007/s00198-012-2207-3. View

16.

Jones I, Williams S, Goulding A . Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study. Am J Epidemiol. 2004; 159(4):343-50. DOI: 10.1093/aje/kwh052. View

17.

Zhang Z, Zeng J, Kjaergaard M, Guan N, Raun K, Nilsson C . Effects of a maternal diet supplemented with chocolate and fructose beverage during gestation and lactation on rat dams and their offspring. Clin Exp Pharmacol Physiol. 2011; 38(9):613-22. DOI: 10.1111/j.1440-1681.2011.05568.x. View

18.

Stenevi Lundgren S, Rosengren B, Dencker M, Nilsson J, Karlsson C, Karlsson M . Low physical activity is related to clustering of risk factors for fracture-a 2-year prospective study in children. Osteoporos Int. 2017; 28(12):3373-3378. PMC: 5684288. DOI: 10.1007/s00198-017-4203-0. View

19.

Vanhelst J, Vidal F, Turck D, Drumez E, Djeddi D, Devouge E . Physical activity is associated with improved bone health in children with inflammatory bowel disease. Clin Nutr. 2019; 39(6):1793-1798. DOI: 10.1016/j.clnu.2019.07.018. View

20.

Jones I, Williams S, Dow N, Goulding A . How many children remain fracture-free during growth? a longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study. Osteoporos Int. 2002; 13(12):990-5. DOI: 10.1007/s001980200137. View