Maternal smoking is associated with worse lung function, children with poor lung function have an greater burden of disease explained by lead investigator Stacey-Ann Whittaker Brown, MD, from the Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Many children are exposed to secondhand smoke during pregnancy. Researchers analyzed the link between lung function and the type of secondhand smoke exposure in a representative sample of school-aged children aged 6 to 11 years. The sample consisted of 2,070 children who participated in the 2007-2012 National Health and Nutrition Examination Survey (NHANES).

NHANES is an annual cross-sectional survey conducted by the National Center for Health Statistics branch of the Centers for Disease Control and Prevention (CDC) on a representative sample of the US population of both children and adults. Detailed information about ongoing secondhand smoke exposure as well as parental self-reported exposure prior to birth was obtained. During the study period, lung function was measured using spirometry, and exposure to smoking was assessed through levels of cotinine in the blood, a marker of the extent of current secondhand smoke exposure.

Researchers were able to differentiate between exposure in pregnancy and ongoing secondhand smoke exposure. Current tobacco smoke exposure was independently associated with airflow obstruction in school-aged children, although the extent of the association was small.

However, prenatal tobacco smoke exposure was associated with a 2.5 times increase in odds of having airflow obstruction in children with asthma. This shows that maternal smoking in pregnancy as the period of secondhand exposure that is more strongly associated with worse lung function in asthmatic children. Maternal smoking in pregnancy may cause poor lung function in later childhood.
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