Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms.
Abstract
Introduction:Both prenatal smoke exposure and depression have been linked to lower
birth weight, a risk factor for morbidity and mortality. Few studies have looked at
the interaction between these risk factors and none have used a biomarker to objectively
measure prenatal smoke exposure. The current study sought to examine independent and
interactive effects of cotinine and depression on birth weight. The effect of race
was also explored. Method:Data were drawn from a prospective study of pregnant women
(N=568) in the southeastern U.S. Maternal demographic, health information, depressive
symptoms, and birth data were collected via self-report and medical record abstraction.
Prenatal blood samples were assayed for cotinine. Results:Controlling for covariates,
multiple regression analyses indicated that both cotinine and depressive symptoms
independently predicted lower birth weight and a significant interaction was also
observed. Upon probing the interaction, a negative association between cotinine levels
and birth weight was found in the context of higher depression but not lower depression
scores. Similarly, logistic regression analyses revealed a significant interaction
between cotinine and depression, such that cotinine predicted having a baby < 2500
g among women who fell above the indicated cut-off score. African American women had
the highest levels of cotinine and lowest weight babies; however, race was not a significant
moderator. Conclusions:Results suggest prenatal smoke exposure has a greater negative
effect on birth weight for women endorsing co-occurring depressive symptoms. Findings
can inform targeted interventions and assist medical providers with identifying women
at increased risk for poor perinatal outcomes. Implications:Despite the common occurrence
of smoking during pregnancy and prenatal depression, the interaction between these
risk factors on birth weight has rarely been examined. Further, the extant results
have been mixed, likely due in part to difficulties in measurement. The current study
was the first to use prenatal cotinine to assess bias-free, continuous levels of prenatal
smoke exposure. Results indicate that prenatal cotinine was a significant predictor
of birth weight only in the context of maternal depressive symptoms. These findings
have important implications for mitigating negative perinatal outcomes for pregnant
women and their children.
Type
Journal articlePermalink
https://hdl.handle.net/10161/18071Published Version (Please cite this version)
10.1093/ntr/nty267Publication Info
Schechter, Julia; Do, Elizabeth K; Zhang, Junfeng Jim; Hoyo, Cathrine; Murphy, Susan
K; Kollins, Scott H; & Fuemmeler, Bernard (2018). Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal
Depressive Symptoms. Nicotine & tobacco research : official journal of the Society for Research on Nicotine
and Tobacco. 10.1093/ntr/nty267. Retrieved from https://hdl.handle.net/10161/18071.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Scott Haden Kollins
Adjunct Professor in the Department of Psychiatry and Behavioral Sciences
Scott H. Kollins, PhD received his undergraduate degree in psychology from Duke and
his Master’s and Doctorate degrees in Clinical Psychology from Auburn University.
After completing his clinical internship at the University of Mississippi Medical
Center, where he served as Chief Intern, he joined the faculty of the Department of
Psychology at Western Michigan University for three years, before joining the Duke
faculty in 2000. Dr. Kollins has published more than 125 scientific pap
Susan Kay Murphy
Associate Professor in Obstetrics and Gynecology
Dr. Murphy is a tenured Associate Professor in the Department of Obstetrics and Gynecology
and serves as Chief of the Division of Reproductive Sciences. As a molecular biologist
with training in human epigenetics, her research interests are largely centered around
the role of epigenetic modifications in health and disease. Dr. Murphy has ongoing
projects on gynecologic malignancies, including approaches to eradicate ovarian cancer
cells that survive chemotherapy and later give r
Julia Corwin Schechter
Assistant Professor in Psychiatry and Behavioral Sciences
Junfeng Zhang
Professor of Global and Environmental Health
Dr. Zhang joined the Duke Faculty in fall 2013 from the University of Southern California
where he had been a professor of environmental and global health and the director
of Environmental and Biomarkers Analysis Laboratory since 2010. His prior positions
include professor, department chair, and associate dean at the Rutgers School of Public
Health. Dr. Zhang has more than 290 peer-reviewed publications. His work has been
featured in major international media such as the Time, the New York Ti
Alphabetical list of authors with Scholars@Duke profiles.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info