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Birth Weight and Adult Hypercholesterolemia: Subgroups of Small-for-gestational-age Based on Maternal Smoking Status During Pregnancy

Wen, Xiaozhonga,b; Triche, Elizabeth W.a,b; Hogan, Joseph W.c; Shenassa, Edmond D.d; Buka, Stephen L.a,b

doi: 10.1097/EDE.0b013e3181f20990
Perinatal: Brief Report

Background: Being born small-for-gestational-age (SGA) is associated with hypercholesterolemia in later life. It is possible that only certain subgroups of SGA are at elevated risk for hypercholesterolemia. We examined the associations between SGA subgroups based on levels of maternal smoking during pregnancy and adult hypercholesterolemia.

Methods: A subsample of 1625 adult offspring from the Collaborative Perinatal Project were followed at mean age 39 years. Subjects were classified by recorded fetal growth and maternal smoking status during pregnancy. Clinical diagnosis of hypercholesterolemia was obtained in interviews.

Results: Compared with the appropriate-for-gestational-age subgroup without maternal smoking during pregnancy, only SGA subgroups with maternal smoking during pregnancy had higher risk of hypercholesterolemia: for heavy smoking, adjusted hazard ratio = 2.5 (95% confidence interval = 1.4-4.3); moderate smoking, 1.7 (1.0-2.8); nonsmoking, 1.1 (0.5-2.1).

Conclusion: Only SGA infants whose mothers smoked during pregnancy had elevated risk of hypercholesterolemia in adulthood.


From the aEpidemiology Section, Department of Community Health, Brown University, Providence, RI; bCenter for Population Health and Clinical Epidemiology, Department of Community Health, Brown University, Providence, RI; cCenter for Statistical Sciences, Department of Community Health, Brown University, Providence, RI; and dMaternal and Child Health Program, Department of Family Science, University of Maryland, College Park, MD.

Submitted 5 March 2010; accepted 17 June 2010; posted 26 August 2010.

Supported by National Institutes of Health (NIH) Transdisciplinary Tobacco Use Research Center (TTURC) Award (grant number P50 CA084719) by the National Cancer Institute, the National Institute on Drug Abuse, and the Robert Wood Johnson Foundation. A grant from Flight Attendants Medical Research Institute and by grant R40MC03600-01-00 from the Maternal and Child Health Bureau, Department of Health and Human Services (to E.D.S.).

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Correspondence: Xiaozhong Wen, Epidemiology Section, Department of Community Health, Brown University, 121 South Main St, 2nd Floor, Providence, RI 02912. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.