Maternal smoking during pregnancy and reproductive health of daughters: A follow-up study spanning two decades

A. Ernst, S. L. Kristensen, G. Toft, A. M. Thulstrup, L. B. Håkonsen, S. F. Olsen, C. H. Ramlau-Hansen

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


STUDY QUESTIONDoes in utero exposure to constituents of cigarette smoke have a programming effect on daughters' age of menarche and markers of long-term reproductive health? SUMMARY ANSWERIn utero exposure to constituents of cigarette smoke was associated with earlier age of menarche and-to a lesser extent-changes in the testosterone profile of the young women. WHAT IS KNOWN ALREADYStudies observe potential effects of in utero exposure to constituents of cigarette smoke on the intrauterine formation of female gonads, but the consequences on long-term reproductive health in daughters remain unclear. STUDY DESIGN, SIZE AND DURATIONA prospective cohort study was designed using data from 965 pregnant women enrolled prior to a routine 30th-week antenatal examination at a midwifery practice in Denmark from 1988 to 1989 and a follow-up of their 19-21-year-old daughters in 2008. Participants/materials, setting and methodsThe pregnant women provided information on lifestyle factors during pregnancy, including the exact number of cigarettes smoked per day during the first and the second trimesters. A total of 438 eligible daughters were asked to complete a web-based questionnaire on reproductive health and subsequently invited to participate in a clinical examination during 2008. Of the 367 daughters (84) who answered the questionnaire, 267 (61) agreed to further examination. Information on menstrual pattern was provided at examination, blood samples were drawn to be analyzed for serum levels of reproductive hormones [FSH, LH, estradiol (E2), sex hormone-binding globulin, anti-Müllerian hormone, dehydroepiandrosterone-sulphate (DHEAS), free testosterone and free E2] and number of follicles (2-9 mm) were examined by transvaginal ultrasound. The daughters were divided into three exposure groups according to the level of maternal smoking during first trimester [non-exposed (reference), low-exposed (mother smoking >0-9 cigarettes/day) and high-exposed (mother smoking 0-9 cigarettes/day debuted with -2. 7 [95 confidence interval (CI) -5. 2 to -0. 1] percentage earlier age of menarche, whereas daughters exposed to
Original languageEnglish
Pages (from-to)3593-3600
Number of pages8
JournalHuman reproduction (Oxford, England)
Issue number12
Publication statusPublished - 2012


  • cigarette smoking
  • female reproductive health
  • follow-up
  • prenatal exposure delayed effects
  • puberty


Dive into the research topics of 'Maternal smoking during pregnancy and reproductive health of daughters: A follow-up study spanning two decades'. Together they form a unique fingerprint.

Cite this