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Background  There are animal data that indicate that prenatal environmental exposures have sex-specific effects on subsequent generations. In humans, an increase in birthweight has been reported if the maternal grandmother had smoked in the pregnancy giving rise to the mother. Here we assess whether prenatal exposure of either parent to cigarette smoke has a sex-specific effect on the grandchild's birth measurements.    Methods  Information from 12707 maternal and 9677 paternal grandmothers of children in the Avon Longitudinal Study of Parents and Children (ALSPAC) concerned whether they had smoked while expecting the study parent. Study children were weighed and measured at birth. Analyses to test effects of grandmaternal prenatal smoking used multiple regression allowing for several potential confounders; analyses were restricted to births to non-smoking study mothers.    Findings  After adjustment, the average birthweight, birth length and BMI measurements of the grandsons (but not granddaughters) were greater if the maternal grandmother smoked prenatally: birthweight  = +61 [95% CI +30, +92] g; birth length  = +0·19 [95% CI +0·02, +0·35] cm; BMI  = +1·6 [95% CI +0·6, +2·6] g/m 2 . Similar effects were seen in births to primiparae and multiparae. Additional allowance for maternal birthweight resulted in an average increase in boys to +100 g [95% CI +61, +140] g. There were no fetal growth differences if the paternal grandmother had smoked prenatally.    Conclusions  The evidence from this study suggests that when the mother does not smoke in pregnancy the maternal grandmother's smoking habit in pregnancy has a positive association with her grandson's fetal growth.

Is the Growth of the Fetus of a Non-Smoking Mother Influenced by the Smoking of Either Grandmother while Pregnant?