Similar associations of parental prenatal smoking suggest child blood pressure is not influenced by intrauterine effects
Similar associations of parental prenatal smoking suggest child blood pressure is not influenced by intrauterine effects
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DOI：
10.1161/hypertensionaha.106.085316
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发表时间：
2007-06-01
期刊：
影响因子：
8.3
通讯作者：
Ness, Andy R.
中科院分区：
文献类型：
--
作者：
Brion, Marie-Jo A.;Leary, Sam D.;Ness, Andy R.
母亲在怀孕期间吸烟可能与后代血压升高有关;然而，以前的研究结果不一致，包括不同的混杂因素调整。我们在雅芳父母和子女纵向研究中研究了母亲在怀孕期间吸烟与子女7年血压之间的关系，考虑了重要的社会和环境混杂因素，并使用伴侣吸烟调查宫内影响。对6509名有母亲吸烟资料的儿童和7149名有伴侣吸烟资料的儿童进行了分析。在调整儿童年龄和性别的模型中，观察到母亲在怀孕期间吸烟和不吸烟的儿童之间收缩压存在适度差异（β = 0.64 mm Hg; 95% CI：0.09至1.20; P = 0.02）。调整所有混杂因素后，这种差异趋于零（β = 0.05 mm Hg; 95% CI：-0.59至0.68; P = 0.9），主要是因为调整了母乳喂养、母亲教育和家庭社会阶层。母亲和伴侣吸烟与后代收缩压之间的关系相似（对于伴侣吸烟：β = 0.62 mm Hg; 95% CI：0.17至1.07; P = 0.07，最小调整后β = 0.26 mm Hg; 95% CI：-0.36至0.87; P = 0.4完全校正），提供了进一步的证据表明，在最低限度调整模型中观察到的儿童血压差异不是因为母亲吸烟对宫内环境的生物学影响。
Maternal smoking in pregnancy may be associated with higher offspring blood pressure; however, results of previous studies have been inconsistent and included varying confounder adjustments. We studied the association between maternal smoking in pregnancy and offspring blood pressure at 7 years in the Avon Longitudinal Study of Parents and Children, accounting for important social and environmental confounders and using partner smoking to investigate intrauterine effects. Analysis was carried out in 6509 children with maternal smoking data and 7149 children with partner smoking data. In models adjusting for child age and sex, modest differences in systolic blood pressure were observed between children of mothers who did and did not smoke during pregnancy ( beta = 0.64 mm Hg; 95% CI: 0.09 to 1.20; P = 0.02). Adjusting for all of the confounders attenuated this difference toward the null ( beta = 0.05 mm Hg; 95% CI: -0.59 to 0.68; P = 0.9), mostly because of adjustment for breastfeeding, maternal education, and family social class. Associations were similar between maternal and partner smoking with offspring systolic blood pressure ( for partner smoking: beta = 0.62 mm Hg; 95% CI: 0.17 to 1.07; P = 0.07 minimally adjusted and beta = 0.26 mm Hg; 95% CI: -0.36 to 0.87; P = 0.4 fully adjusted), providing further evidence that differences in child blood pressure observed in minimally adjusted models are not because of a biological influence of maternal smoking on the intrauterine environment.