The effect of maternal smoking during pregnancy on intellectual disabilities among 8-year-old children
The effect of maternal smoking during pregnancy on intellectual disabilities among 8-year-old children
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DOI：
10.1111/j.1365-3016.2009.01056.x
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发表时间：
2009-09-01
影响因子：
2.8
通讯作者：
Nicholas, Joyce S.
中科院分区：
文献类型：
--
作者：
Braun, Joe M.;Daniels, Julie L.;Nicholas, Joyce S.
产前烟草烟雾暴露被认为是儿童认知缺陷的一个危险因素。本研究的目的是调查生活在阿肯色州、格鲁吉亚、北卡罗来纳州和犹他州的8岁儿童产前烟草烟雾暴露与智力残疾（ID）诊断之间的关系。2002年和2004年，通过监测网络发现了965例ID病例儿童，并与同期监测地区出生的儿童人数（n = 104607）进行了比较。产前烟草烟雾暴露是从出生证明中确定的。我们估计了产前烟草烟雾暴露的影响一般来说，在母亲怀孕期间每天吸烟≥ 20支的儿童中，ID的风险轻度升高[RR 1.34;调整母亲教育、母亲种族、母亲年龄、婚姻状况、儿童性别、出生年份和研究中心后，95%（置信区间）CI 0.96，1.87]。然而，与女性[RR 0.81，95% CI 0.44，1.50]相比，男性[RR 1.77，95% CI 1.20，2.62]每天暴露于≥ 20支香烟的影响存在显著差异。补充分析显示，这种关系的社会经济指标的实质性混淆。烟草烟雾暴露对ID风险的不同影响，建议男性和女性，值得进一步研究;然而，解释是温和的潜在残留混杂。
Prenatal tobacco smoke exposure has been implicated as a risk factor for cognitive deficits in children. The purpose of this study is to examine the association between prenatal tobacco smoke exposure and diagnosis of intellectual disabilities (ID) among 8-year-old children living in Arkansas, Georgia, North Carolina and Utah. In 2002 and 2004, 965 ID case children were identified through a surveillance network and compared with the population of children born in the surveillance region during the same period (n = 104 607). Prenatal tobacco smoke exposure was determined from birth certificates. We estimated the effect of prenatal tobacco smoke exposure (none, < 10, 10-19 and >= 20 cigarettes per day) on ID using logistic regression.Generally, the risk of ID was mildly elevated among children whose mothers smoked >= 20 cigarettes per day during pregnancy [RR 1.34; 95% (confidence interval) CI 0.96, 1.87] after adjustment for maternal education, maternal race, maternal age, marital status, child sex, birth year and study site. However, the effect of exposure to >= 20 cigarettes per day significantly differed for males [RR 1.77, 95% CI 1.20, 2.62] compared with females [RR 0.81, 95% CI 0.44, 1.50]. Supplemental analyses reveal substantial confounding of this relationship by socio-economic indicators. A differential effect of tobacco smoke exposure on the risk of ID is suggested for males and females and deserves further investigation; however, the interpretation is tempered by the potential for residual confounding.