Background: Adverse health effects of prenatal exposure to maternal smoking may persist until adulthood. For example, Norwegian women exposed to tobacco smoke in utero were at higher risk of developing gestational diabetes (GDM), and whether this association is present elsewhere is an open question. AIMS: To study the risk of developing gestational diabetes in women who were exposed to tobacco smoke in utero. Secondary aims were to assess the risk of obesity and non-gestational diabetes. METHODS: Data were retrieved from the Medical Birth Register of Sweden for women who were born in 1982 (smoking data first registered) or later and who had given birth to at least one child; 80 189 pregnancies were included. The associations between in utero smoking exposure (three categories: non-smokers, 1-9 cig/day [moderately exposed], and ＞9 cig/day [heavily exposed]) and subsequent gestational diabetes (n=291), non-gestational diabetes (n=280) and obesity (n=7309) were assessed. RESULTS: The adjusted odds ratios (aOR) of gestational diabetes were increased among women who were moderately (aOR 1.63, 95% confidence interval (CI): 1.24-2.13) and heavily exposed (aOR 1.52, CI: 1.12-2.06). The corresponding odds ratios of obesity were (aOR 1.36, CI: 1.28-1.44) and (aOR 1.58, CI 1.48-1.68), respectively. A reduced odds ratio for non-gestational diabetes was seen in the offspring of heavy smokers (aOR=0.66, CI: 0.45-0.96). CONCLUSION: Women exposed to smoking during fetal life were at higher risk of developing gestational diabetes and obesity.
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