Tabagismo materno durante a gestação: efeitos sobre o estado nutricional e composição corporal dos descendentes na vida adulta e no peso ao nascer da terceira geração

Abstract

Maternal smoking during pregnancy has negative consequences for maternal and child health. Besides to the effects on intrauterine growth, birth weight and morbidity and mortality in child, which are already well established in the literature, some studies indicate that exposure to smoking during pregnancy also would have consequences on the nutritional status and body composition of offspring, as well as they suggest that the effect on birth weight could extend to the third generation. However, the effect of exposure to tobacco in pregnancy and long-term and intergenerational outcomes has been poorly studied. Present thesis aims to evaluate the effects of exposure to maternal smoking in pregnancy on offspring in adulthood and in third generation of the 1982 and 1993 birth cohorts, Pelotas – RS, Brazil. Three articles compose the thesis. In the first article, was evaluated the association between maternal smoking during pregnancy and the body composition of offspring in adulthood. Results of this study showed that offspring of smoking mothers had higher body mass index (BMI), fat mass index (FMI), fat android/gynoid ratio, waist circumference, waist/height ratio and lean mass index, while stature was lower. Weight gain in the first two years of age captured most associations of the maternal smoking in pregnancy with BMI, waist circumference and FMI. The second article evaluated the association of maternal smoking during pregnancy with body mass index and overweight of offspring through systematic review and meta-analysis. Despite the high heterogeneity between the studies, results suggest that offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood. The third article investigated the effect of maternal smoking in pregnancy on birth weight of the third generation. In this study, grandmother smoking was not associated with birth weight of the grandchild. On the other hand, in crude analysis, we observed a cumulative effect when both grandmother and mother smoked during pregnancy. Thus, this thesis evidence that interventions focused on reducing maternal smoking during pregnancy will greatly reduce the effects on body composition and birth weight of the offspring.