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Smoking during pregnancy significantly increases the risk of early atherosclerosis: a study from coalmine smoke exposure

Session Best Posters 6

Speaker Doctor Bing Zhao

Event : ESC Congress 2018

  • Topic : preventive cardiology
  • Sub-topic : Tobacco
  • Session type : Best ePosters

Authors : B Zhao (Hobart,AU), FH Johnston (Hobart,AU), M Dalton (Hobart,AU), G Williamson (Hobart,AU), T Osullivan (Hobart,AU), K Negishi (Hobart,AU)

B. Zhao1 , F.H. Johnston1 , M. Dalton1 , G. Williamson2 , T. Osullivan1 , K. Negishi1 , 1Menzies Research Institute - Hobart - Australia , 2University of Tasmania, School of Biological Sciences - Hobart - Australia ,

On behalf: the Hazelwood Health Study research team


European Heart Journal ( 2018 ) 39 ( Supplement ), 1091

Introduction: Early life exposure to air pollution has been associated with increased risk of atherosclerosis. However, the role of maternal cigarette smoking during pregnancy in modifying the impacts is unknown.

Purpose: This study aimed to assess associations between vascular structure and function in children and exposure to poor air quality while in utero or during infancy (<2 years), and the influence of maternal smoking during pregnancy.

Methods: Data were collected from children exposed to smoke from a coalmine fire that burned for 6 weeks in 2014 in Australia. 3 years after the exposure, we evaluated carotid/abdominal intima-media thickness (IMT) and pulse wave velocity (PWV). An atmospheric transport model was used to obtain fine particulate matter (PM2.5) at 1x1 km2. Daily average (AVE) and maximum (MAX) PM2.5 exposure levels were calculated based on participants' residential addresses during the fire. We tested the potential interaction in linear regression models.

Results: The study involved 154 children (age 3.9±0.8 years, 51% boys) (Table). Median [IQR] daily MAX PM2.5 level was 112.1 [121.6], with daily AVE of 8.8 [10.0]μg/m3. Carotid IMT was 0.50±0.03 and 0.41±0.07 mm for abdominal aorta, with PWV of 4.2±0.5 m/s. Although there were no significant associations between PM2.5 exposure and PWV/IMT in the entire population, there were significant interactions by maternal cigarette smoking status during pregnancy (Figure). Smoking status modified the relationships between (a) AVE PM2.5 and PWV (p=0.016); (b) MAX PM2.5 and PWV (p=0.028); and (c) AVE PM2.5 and Abdominal IMT (p=0.038). Only children whose mothers smoked cigarettes during pregnancy had significant positive associations between PM2.5 and PWV.

Conclusion: The impact of exposure to coalmine fire emissions on the vascular health of a fetus and infant was influenced by maternal cigarette smoking during pregnancy.

Characteristics of study participants
All (n=154)Maternal cigarette smoking during pregnancy (n=23)No maternal cigarette smoking during pregnancy (n=131)P value*
Male79 (51%)11 (48%)68 (52%)0.72
Age (year)3.9±0.84.1±0.83.9±0.80.18
Height (cm)100.6±8.3104.4±8.599.9±8.10.02
Weight (kg)17.4±4.420.9±7.916.8±3.1<0.001
Birth weight (g)3477.2±568.93377.4±637.63494.3±557.20.38
Gestational age (week)39.5±1.839.4±1.939.5±1.80.72
Preterm birth13 (8.4%)2 (8.7%)11 (8.4%)0.96
*Difference between smoking during pregnancy and no smoking during pregnancy.

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