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Adverse effect of cigarette smoking on infant birth weight may be influenced by maternal metabolic genotypes

Boston University : 07 January, 2001  (Technical Article)
Low birth weight, defined as babies who weigh less than 2,500 grams or approximately five pounds, eight ounces at birth, is a significant clinical and public health challenge. Each year in the United States, over 300,000 babies are born with LBW. LBW is the single most important determinant of postnatal infant mortality, as well as morbidity during infancy and childhood. Sixty-five percent of all infant deaths occur among LBW infants.
The causes of LBW are not well understood, but both environmental factors and genetic factors may play a role. Researchers at Boston University School of Medicine and Boston Medical Center have shown that a subgroup of pregnant women with certain metabolic gene polymorphisms may be particularly susceptible to the adverse effects of cigarette smoke on their infants' birth weight. The findings, published in the January 9, 2002, issue of the Journal of the American Medical Association, suggests an interaction between metabolic genes and cigarette smoking.

This is one of the first studies to investigate how maternal genes can interact with environmental exposures to effect infant birth weight. Consistent with previous studies, the researchers found that maternal cigarette smoking was detrimental to infant birth weight. More importantly, they demonstrated that maternal cigarette smoking was even more harmful in a subset of women with certain metabolic genotypes. For example, without consideration of maternal genotype, mothers who smoked for the entirety of their pregnancy was associated with a mean reduction of 377 grams in birth weight. When CYP1A1 genotype was considered, the estimated reduction in birth weight was remarkably different by the genotype groups: 252 grams for the reference genotype group, as compared to 520 grams for the variant genotype groups. A similar pattern was found when GSTT1 genotypes were considered. There was a mean reduction of 1,285 grams (about 2 pounds, 12 ounces) in birth weight among smoking mothers with variant genotypes in both CYP1A1 and GSTT1 genes.

'Although there is little published data on genetic susceptibility to cigarette smoke in relation to birth weight or gestation, we believe this susceptibility is biologically possible,' said lead author Xiaobin Wang, MD, MPH, ScD, an associate professor of pediatrics at Boston University School of Medicine and an attending pediatrician at Boston Medical Center. 'LBW is a very complex entity and many environmental and genetic factors may be involved. This study is the first step to understand how genetic susceptibility interacts with environmental exposures to effect infant birth weight,' she added. The researchers stress that much more work remains to be done before any application can be made in the clinical setting. 'Our hope is that this study will open up new areas of research that will lead to better understanding of the causes of LBW and ultimately lead to reducing the tragedy of LBW and infant mortality.'
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