Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Cumulative Tobacco Smoke Exposure During Pregnancy and Early Childhood Is Associated with Lung Function Deficits at Age 6 Years

Session Title
C15 - C015 BEST OF PEDIATRICS
Abstract
A1167 - Cumulative Tobacco Smoke Exposure During Pregnancy and Early Childhood Is Associated with Lung Function Deficits at Age 6 Years
Author Block: H. Knihtila1, M. Huang2, B. Stubbs3, V. Carey4, N. Laranjo1, A. A. Litonjua5, J. Lasky-Su1, S. T. Weiss6; 1Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States, 2Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States, 3Channing Division of Network Medicine, Boston, MA, United States, 4Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States, 5University of Rochester Medical Center, Rochester, NY, United States, 6Channing Division of Network Medicine, Brigham and Womens Hosp, Boston, MA, United States.
Rationale: Environmental tobacco smoke exposure has been associated with decreased lung function in children but it is unclear whether this is attributed to pre- or postnatal exposure. We aimed to clarify the effects of prospectively evaluated tobacco smoke exposure during pregnancy and childhood on child lung function at age 6 years.
Methods: The Vitamin D Antenatal Asthma Reduction Trial recruited nonsmoking pregnant women at 10-18 gestational weeks but active smoking of the women and household smoking were surveyed with questionnaires during pregnancy and at 1, 3, and 6 years after delivery. Plasma cotinine levels were measured at five timepoints using the Metabolon Platform: 10-18 and 32-38 gestational weeks and ages 1, 3, and 6 years. Cumulative tobacco smoke exposure was evaluated by calculating graded cotinine level (0/1/2 representing below limit of detection/lower 50%/upper 50%, respectively) at each time point and dividing the sum of these levels by the number of available datapoints for each subject. Lung function of the children was measured at age 6 years using spirometry and impulse oscillometry.
Results: 476 mother-child pairs were included in the present study. Among these subjects, 65 mothers (14%) reported active smoking and 103 (22%) reported other household smoking on at least one timepoint. Active smoking of the mother (p≤0.001) and household smoking (p<0.050) were associated with increased cotinine levels in the mothers during pregnancy and in the children at ages 1 and 3 years, except for household smoking at 10-18 gestational weeks which was not significantly associated with maternal cotinine level (p=0.074). Neither household smoking (p=0.29) nor active smoking of the mother (p=0.82) were associated with increased cotinine levels in the children at age 6 years. Both gestational and childhood cumulative tobacco smoke exposure, reflected by increased blood cotinine levels during pregnancy and early life, were associated with decreased lung function at age 6 years, but the strongest effects were observed with cumulation of smoke exposure from pregnancy to childhood together (Figure 1). Children who were in the upper 50% cotinine level group at all datapoints had 15% lower mean FEV1 level than those without any exposure (1.04 L vs. 1.23 L, p=0.001).
Conclusions: Tobacco smoke exposure reflected by increased blood cotinine levels during pregnancy and childhood is associated with decreased lung function at age 6 years. This decrease is evident in even minimal smoking exposures. The strongest effects are observed when considering the cumulative exposure from pregnancy to early childhood.