{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:31:17Z","timestamp":1783042277059,"version":"3.54.6"},"reference-count":81,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CIBERESP","award":["PhD employment contract and fellowship for short stays abroad\u20142019"],"award-info":[{"award-number":["PhD employment contract and fellowship for short stays abroad\u20142019"]}]},{"name":"FIS-FEDER","award":["PI04\/2018"],"award-info":[{"award-number":["PI04\/2018"]}]},{"name":"FIS-FEDER","award":["PI09\/02311"],"award-info":[{"award-number":["PI09\/02311"]}]},{"name":"FIS-FEDER","award":["PI13\/02429"],"award-info":[{"award-number":["PI13\/02429"]}]},{"name":"FIS-FEDER","award":["PI18\/00909"],"award-info":[{"award-number":["PI18\/00909"]}]},{"name":"Obra Social Cajastur\/Fundaci\u00f3n Liberbank","award":["-"],"award-info":[{"award-number":["-"]}]},{"DOI":"10.13039\/501100006382","name":"Universidad de Oviedo","doi-asserted-by":"publisher","award":["-"],"award-info":[{"award-number":["-"]}],"id":[{"id":"10.13039\/501100006382","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Smoking by women is associated with adverse pregnancy outcomes such as spontaneous abortion, preterm delivery, low birth weight, infertility, and prolonged time to pregnancy. Anogenital distance (AGD) is a sensitive biomarker of prenatal androgen and antiandrogen exposure. We investigated the effect of smoking and passive smoke exposure during pregnancy on anogenital distance in offspring at 4 years in the INMA-Asturias cohort (Spain). Women were interviewed during pregnancy to collect information on tobacco consumption, and anogenital distance was measured in 381 children: Anoscrotal distance in boys and anofourchetal distance in girls. We also measured maternal urinary cotinine levels at 32 weeks of pregnancy. We constructed linear regression models to analyze the association between prenatal smoke exposure and anogenital distance and adjusted the models by relevant covariates. Reported prenatal smoke exposure was associated with statistically significant increased anogenital index (AGI), both at week 12 of pregnancy (\u03b2 = 0.31, 95% confidence interval: 0.00, 0.63) and at week 32 of pregnancy (\u03b2 = 0.31, 95% confidence interval: 0.00, 0.63) in male children, suggesting altered androgenic signaling.<\/jats:p>","DOI":"10.3390\/ijerph18094774","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T05:10:55Z","timestamp":1619759455000},"page":"4774","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0186-2804","authenticated-orcid":false,"given":"Miguel","family":"Garc\u00eda-Villarino","sequence":"first","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue 3-5, 28029 Madrid, Spain"},{"name":"Unit of Molecular Cancer Epidemiology, Department of Medicine, University Institute of Oncology of the Principality of Asturias (IUOPA)\u2014University of Oviedo, Juli\u00e1n Claver\u00eda Street s\/n., 33006 Oviedo, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7760-4994","authenticated-orcid":false,"given":"Roc\u00edo","family":"Fern\u00e1ndez-Iglesias","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue 3-5, 28029 Madrid, Spain"},{"name":"Unit of Molecular Cancer Epidemiology, Department of Medicine, University Institute of Oncology of the Principality of Asturias (IUOPA)\u2014University of Oviedo, Juli\u00e1n Claver\u00eda Street s\/n., 33006 Oviedo, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2125-5101","authenticated-orcid":false,"given":"Isolina","family":"Ria\u00f1o-Gal\u00e1n","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue 3-5, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"},{"name":"Servicio de Pediatr\u00eda, Endocrinolog\u00eda Pedi\u00e1trica, HUCA, Roma Avenue s\/n., 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rodr\u00edguez-Dehli","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"},{"name":"Servicio de Pediatr\u00eda, Hospital San Agust\u00edn, Heros Street, 4, 33410 Avil\u00e9s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3626-7036","authenticated-orcid":false,"given":"Izaro","family":"Babarro","sequence":"additional","affiliation":[{"name":"Faculty of Psychology, University of the Basque Country, 20018 Donostia\/San Sebastian, Spain"},{"name":"Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014 Donostia\/San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-9079","authenticated-orcid":false,"given":"Ana","family":"Fern\u00e1ndez-Somoano","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue 3-5, 28029 Madrid, Spain"},{"name":"Unit of Molecular Cancer Epidemiology, Department of Medicine, University Institute of Oncology of the Principality of Asturias (IUOPA)\u2014University of Oviedo, Juli\u00e1n Claver\u00eda Street s\/n., 33006 Oviedo, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5150-1209","authenticated-orcid":false,"given":"Adonina","family":"Tard\u00f3n","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue 3-5, 28029 Madrid, Spain"},{"name":"Unit of Molecular Cancer Epidemiology, Department of Medicine, University Institute of Oncology of the Principality of Asturias (IUOPA)\u2014University of Oviedo, Juli\u00e1n Claver\u00eda Street s\/n., 33006 Oviedo, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Roma Avenue s\/n., 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/bdrc.20119","article-title":"Tobacco and pregnancy: Overview of exposures and effects","volume":"84","author":"Rogers","year":"2008","journal-title":"Birth Defects Res. 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