Associations of maternal prenatal smoking with umbilical cord blood hormones: the Project Viva cohort

Metabolism. 2017 Jul;72:18-26. doi: 10.1016/j.metabol.2017.04.001. Epub 2017 Apr 8.


Background: Maternal smoking during pregnancy is associated with low fetal growth and adverse cardiometabolic health in offspring. However, hormonal pathways underlying these associations are unclear. Therefore, we examined maternal smoking habits and umbilical cord blood hormone profiles in a large, prospective cohort.

Methods: We studied 978 mother/infant pairs in Project Viva, a Boston-area cohort recruited 1999-2002. We categorized mothers as early pregnancy smokers, former smokers, or never smokers. Outcomes were cord blood concentrations of IGF-1, IGF-2, IGFBP-3, leptin, adiponectin, insulin, and C-peptide. We used linear regression models adjusted for maternal pre-pregnancy body mass index (BMI), race/ethnicity, parity, education, and infant sex. We conducted analyses in the full cohort and stratified by infant sex.

Results: Thirteen percent of women were early pregnancy smokers, 20% former smokers, and 68% never smokers. Infants of early pregnancy smokers had lower IGF-1 adjusted for IGFBP-3 [-5.2ng/mL (95% CI: -8.6, -1.7)], with more pronounced associations in girls [-10.7ng/mL (95% CI: -18.5, -2.9) vs. -4.0ng/mL (95% CI: -8.4, 0.4) for boys]. Early pregnancy smoking was not associated with cord blood hormones other than IGF-1. Infants of former smokers had a cord blood hormone profile similar to infants of never smokers.

Conclusions: As compared to mothers who never smoked, early pregnancy smokers had infants with lower cord blood IGF-1 which could prime adverse metabolic outcomes. This provides further reason to support smoking cessation programs in women of reproductive age.

Keywords: Cord blood; Hormones; Insulin-like growth factor (IGF); Pregnancy; Smoking.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Fetal Blood / chemistry*
  • Hormones / blood*
  • Hormones / pharmacology
  • Humans
  • Infant, Newborn
  • Insulin-Like Growth Factor I / analysis
  • Insulin-Like Growth Factor I / pharmacology
  • Mothers
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / prevention & control
  • Smoking / adverse effects*
  • Young Adult


  • Hormones
  • Insulin-Like Growth Factor I