University of Oulu

Toppila-Salmi, S., Luukkainen, A. T., Xu, B., Lampi, J., Auvinen, J., Dhaygude, K., Järvelin, M.-R., & Pekkanen, J. (2020). Maternal smoking during pregnancy affects adult onset of asthma in offspring: A follow up from birth to age 46 years. European Respiratory Journal, 55(6), 1901857.

Maternal smoking during pregnancy affects adult onset of asthma in offspring : a follow up from birth to age 46 years

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Author: Toppila-Salmi, Sanna1,2; Luukkainen, Annika T.1; Xu, Baizhuang3;
Organizations: 1Medicum, Haartman Institute, University of Helsinki, Helsinki, Finland
2Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
3Environment Health Unit, National Institute for Health and Welfare, Kuopio, Finland
4Center for Life Course Health Research, Oulu, Finland
5Imperial College London, London, UK
6Dep of Public Health, University of Helsinki, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: European Respiratory Society, 2020
Publish Date: 2022-03-02


Rationale: Environmental tobacco smoke (ETS) exposure increases asthma risk in children. There is limited knowledge of prenatal ETS for adult-onset asthma.

Objectives: To determine the association between prenatal ETS and adult onset asthma.

Measurements and main results: The questionnaire and clinical data of 5200 people, free of physician-diagnosed asthma by 31 years of age, who were included in the Northern Finland Birth Cohort 1966 Study was used. The association of maternal smoking during the last 3 months of pregnancy with onset of physician-diagnosed asthma and with lung function in adult offspring was studied using adjusted multivariate regression analyses. The cumulative incidence of physician-diagnosed asthma between the ages of 31 and 46 years was 5.1% among men and 8.8% among women. Gestational smoke exposure was associated with adult-onset asthma among offspring (adjusted OR 1.54, 95% CI 1.04–2.29), namely among offspring who reported either past non-diagnosed asthma (OR 9.63, 95% CI 2.28–40.67) or past cough with wheeze (3.21, 95% CI 1.71–6.05). A significant association was detected between gestational smoke exposure and the offspring’s forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) ratio at 31 years of age. In offspring with the haplotype rs11702779-AA of RUNX1, gestational smoke exposure was associated with adult-onset asthma (5.53, 95% CI 2.11–14.52, adjusted p-value for interaction 0.10).

Conclusion: Maternal smoking during pregnancy is associated with the cumulative incidence of asthma in offspring between the ages of 31 and 46 years. The association was accentuated in offspring who at age 31, reported having past respiratory problems and/or who had haplotype rs11702779-AA. A reduction in FEV₁/FVC ratio was also observed at age 31 years in offspring with gestational smoke exposure. These results could reflect the early vulnerability of offspring’s airways to ETS and its putative long-term effects.

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Series: European respiratory journal
ISSN: 0903-1936
ISSN-E: 1399-3003
ISSN-L: 0903-1936
Volume: 55
Issue: 6
Article number: 1901857
DOI: 10.1183/13993003.01857-2019
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3141 Health care science
Funding: The study was supported in part by research grants from the Finnish Society of Allergology and Immunology, the Jane and Aatos Erkko Foundation, the Finnish Cultural Foundation, State funding for university-level health research (TYH2018103, TYH2019322), Paulo Foundation, the Tampere Tuberculosis Foundation, the Väinö and Laina Kivi Foundation. Funding information for this article has been deposited with the Crossref Funder Registry.
Copyright information: Copyright © ERS 2020. This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.