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Maternal education and offspring birth weight for gestational age: the mediating effect of smoking during pregnancy

Nakamura, Aurélie, Pryor, Laura, Ballon, Morgane, Lioret, Sandrine, Heude, Barbara, Charles, Marie-Aline, Melchior, Maria, El-Khoury Lesueur, Fabienne·2020·European Journal of Public Health
DOI 10.1093/eurpub/ckaa076
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Abstract

Background: Small for gestational age (SGA) birth weight, a risk factor for infant mortality and delayed child development, is associated with maternal educational attainment. Maternal tobacco smoking during pregnancy could contribute to this association. We aimed to quantify the contribution of maternal smoking during pregnancy to social inequalities in child birth weight for gestational age (GA). Methods: Data come from the French nation-wide ELFE cohort study, which included 17 155 singletons. Birth weights for GA were calculated using z-scores. Associations between maternal educational attainment, tobacco smoking during pregnancy and child birth weight for GA were ascertained using mediation analysis. Mediation analyses were also stratified by maternal pre-pregnancy body mass index. Results: Low maternal educational attainment was associated with an increased odd of tobacco smoking during pregnancy [adjusted OR (ORa) = 2.58 (95% CI 2.34–2.84)] as well as a decrease in child birth weight for GA [RRa = 0.94 (95% CI 0.91–0.98)]. Tobacco smoking during pregnancy was associated with a decrease in offspring birth weight for GA [RRa = 0.73 (95% CI 0.70–0.76)]. Mediation analysis suggests that 39% of the effect of low maternal educational attainment on offspring birth weight for GA was mediated by smoking during pregnancy. A more important direct effect of maternal educational attainment on child birth weight for GA was observed among underweight women [RRa = 0.82 (95% CI 0.72–0.93)]. Conclusions: The relationship between maternal educational attainment and child birth weight for GA is strongly mediated by smoking during pregnancy. Reducing maternal smoking could lessen the occurrence of infant SGA and decrease socioeconomic inequalities in birth weight for GA.

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Metadata

Authors
Nakamura, A., Pryor, L., Ballon, M., Lioret, S., Heude, B., Charles, M.-A., Melchior, M., & El-Khoury Lesueur, F.
Venue
European Journal of Public Health
Publisher
Oxford University Press (OUP)
Published
2020-06-12
Volume
30
Issue
5
Pages
1001-1006
ISSN
  • 1101-1262
  • 1464-360X
DOI
10.1093/eurpub/ckaa076
Cited by
29
References
4
Language
en
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Funders
  • French Institute for Demographic Studies
  • National Institute of Health and Medical Research
  • INSERM
  • French blood transfusion service
  • Santé Publique France
  • National Institute for Statistics and Economic Studies
  • INSEE
  • DGS, part of the Ministry of Health and Social Affairs
  • Direction générale de la prévention des risques
  • DGPR, Ministry for the Environment
  • DREES, Ministry of Health and Social Affairs
  • DEPS, Ministry of Culture
  • Caisse nationale des allocations familiales
  • Ministry of Higher Education and Research and the Institut national de la jeunesse et de l’éducation populaire
  • RECONAI
  • National Research Agency under the ‘Investissements d’avenir’ programme (ANR-11-EQPX-0038)
  • SOCIALRISK_MH project funded through the ANR ‘Social determinants of health’ programme

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CoChat. (2026). Citation check: Maternal education and offspring birth weight for gestational age: the mediating effect of smoking during pregnancy. https://app.cochat.ai/papers/10.1093/eurpub/ckaa076
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Nakamura, A., Pryor, L., Ballon, M., Lioret, S., Heude, B., Charles, M.-A., Melchior, M., & El-Khoury Lesueur, F. (2020). Maternal education and offspring birth weight for gestational age: the mediating effect of smoking during pregnancy. European Journal of Public Health. https://doi.org/10.1093/eurpub/ckaa076

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