Placenta mediates the association between maternal second-hand smoke exposure during pregnancy and small for gestational age
Placenta mediates the association between maternal second-hand smoke exposure during pregnancy and small for gestational age
复制标题
胎盘介导母亲怀孕期间二手烟暴露与小于胎龄之间的关联。
DOI：
10.1016/j.placenta.2015.05.005
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发表时间：
2015-08-01
期刊：
影响因子：
3.8
通讯作者：
Chen, W. -Q.
中科院分区：
文献类型：
--
作者：
Niu, Z.;Xie, C.;Chen, W. -Q.
简介：母亲在怀孕期间接触二手烟（SHS）与小于胎龄儿（SGA）之间的因果关系已得到肯定，但其机制仍不清楚。先前的研究发现，胎盘显着影响胎儿宫内生长，并且怀孕期间暴露于SHS会损害胎盘生长并降低胎盘重量。因此，胎盘可能介导母体妊娠期间SHS暴露与SGA之间的关联。本研究探讨是否以及在何种程度上母亲的SHS暴露在怀孕期间和SGA之间的关联是由胎盘介导的。方法：我们调查了562例孕妇分娩SGA新生儿（病例）和1581例分娩适当的胎龄新生儿（对照）在这种情况下，对照研究。在中国广东省深圳市和佛山市的妇幼保健院收集了关于妊娠期间母亲SHS暴露、社会人口学特征和产科状况（包括胎盘重量）的信息。线性和分层逻辑回归模型拟合，以检查胎盘重量的中介作用之间的关联母亲在怀孕期间的SHS暴露和SGA。在控制了种族、母亲年龄、教育水平、家庭收入、孕前体重指数（BMI）、产次、胎龄和新生儿性别后，母亲在怀孕期间暴露于SHS与较高的SGA风险相关（调整的比值比（OR）= 1.26; 95%置信区间（CI）= 1.03-1.55）和较低的胎盘重量（标准差（SD）=-0.15，SE = 0.04）。回归模型表明，胎盘重量部分介导（49.6%; 95%CI = 35.9-633%）之间的关联SHS暴露在怀孕期间和SGA.Discussion：我们的研究结果表明，胎盘起着中介作用，母亲产前SHS暴露如何影响胎儿的生长。(C)2015爱思唯尔有限公司版权所有。
Introduction: The causal relationship between maternal second-hand smoke (SHS) exposure during pregnancy and small for gestational-age (SGA) has been affirmed, but the mechanism is still unclear. Previous studies have found that the placenta remarkably affects fetal intrauterine growth and that SHS exposure during pregnancy impairs placental growth and decreases placental weight. Therefore, the placenta may mediate the association between maternal SHS exposure during pregnancy and SGA. This study explores whether and to what extent the association between maternal SHS exposure during pregnancy and SGA is mediated by the placenta.Methods: We investigated 562 pregnant women delivering SGA newborns (cases) and 1581 delivering appropriate-for-gestational-age newborns (controls) in this case control study. Information on maternal SHS exposure during pregnancy, socio-demographic characteristics and obstetric conditions, including placental weight, were collected at the Maternity and Child Health Care Hospitals of Shenzhen and Foshan in Guangdong, China. Linear and hierarchical logistic regression models were fitted to examine the mediation effects of placental weight on the association between maternal SHS exposure during pregnancy and SGA.Results: After controlling for ethnicity, maternal age, educational level, family income, pre-pregnancy body mass index (BMI), parity, gestational age and newborn gender, maternal SHS exposure during pregnancy was associated with a higher SGA risk (adjusted odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.03-1.55) and lower placental weight (standard deviation (SD) = -0.15, SE = 0.04). Regression models illustrated that placental weight partially mediated (49.6%; 95% Cl = 35.9-633%) the association between SHS exposure during pregnancy and SGA.Discussion: Our findings suggest that the placenta plays an intermediary role in how maternal prenatal SHS exposure affects fetal growth. (C) 2015 Elsevier Ltd. All rights reserved.