Revisiting the effect of maternal smoking during pregnancy on offspring birthweight: a quasi-experimental sibling analysis in Sweden.
Revisiting the effect of maternal smoking during pregnancy on offspring birthweight: a quasi-experimental sibling analysis in Sweden.
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DOI：
10.1371/journal.pone.0061734
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Merlo J
中科院分区：
文献类型：
--
作者：
Juárez SP;Merlo J
母亲在怀孕期间吸烟（SDP）似乎与后代出生体重下降有关。然而，这一观察结果是基于传统的流行病学分析，它可能会混淆与吸烟习惯和后代出生体重相关的未观察到的母体特征。因此，我们应用准实验的同胞分析，重新审视以前的研究结果。使用瑞典医学出生登记，我们确定了2002年至2010年期间出生的677，922名瑞典本地母亲的独生子女。从这个人群中，我们从28，768名具有不同SDP习惯的母亲中分离出62，941名兄弟姐妹。我们应用传统的和母亲特定的多水平线性回归模型来调查母亲SDP和后代出生体重之间的关联。根据母亲是轻度吸烟者还是重度吸烟者以及怀孕期间暴露的时间（即，第一或第三个三个月），吸烟对出生体重减少的影响在同胞分析中比传统分析低6 - 78 g。兄弟姐妹分析表明，与不吸烟的母亲相比，连续吸烟使轻度吸烟者（每天1至9支烟）的母亲的出生体重平均减少162克，而在整个怀孕期间吸烟量很大的母亲的出生体重平均减少226克。在怀孕期间戒烟部分抵消了吸烟相关的出生体重减少1至29克，随后在怀孕期间吸烟复发使出生体重减少77至83克。兄弟姐妹分析提供了强有力的证据表明，母亲SDP降低后代出生体重，虽然这种减少是不一样大，在传统的分析中观察到的。我们的研究结果支持旨在预防SDP的公共卫生干预措施，并说服那些已经吸烟的人戒烟，在整个怀孕期间不要复发。此外，还需要进一步分析，以解释吸烟降低出生体重的机制，并确定其他母亲的特征，这些特征是出生体重降低和母亲吸烟的共同原因。
Maternal smoking during pregnancy (SDP) seems associated with reduced birthweight in the offspring. This observation, however, is based on conventional epidemiological analyses, and it might be confounded by unobserved maternal characteristics related to both smoking habits and offspring birth weight. Therefore, we apply a quasi-experimental sibling analysis to revisit previous findings. Using the Swedish Medical Birth Register, we identified 677,922 singletons born between 2002 and 2010 from native Swedish mothers. From this population, we isolated 62,941 siblings from 28,768 mothers with discrepant habits of SDP. We applied conventional and mother-specific multilevel linear regression models to investigate the association between maternal SDP and offspring birthweight. Depending on the mother was light or heavy smoker and the timing of exposition during pregnancy (i.e., first or third trimester), the effect of smoking on birthweight reduction was between 6 and 78 g less marked in the sibling analysis than in the conventional analysis. Sibling analysis showed that continuous smoking reduces birthweight by 162 grams for mothers who were light smokers (1 to 9 cigarettes per day) and 226 g on average for those who were heavy smokers throughout the pregnancy in comparison to non-smoker mothers. Quitting smoking during pregnancy partly counteracted the smoking-related birthweight reduction by 1 to 29 g, and a subsequent smoking relapse during pregnancy reduced birthweight by 77 to 83 g. The sibling analysis provides strong evidence that maternal SDP reduces offspring birthweight, though this reduction was not as great as that observed in the conventional analysis. Our findings support public health interventions aimed to prevent SDP and to persuade those who already smoke to quit and not relapse throughout the pregnancy. Besides, further analyses are needed in order to explain the mechanisms through which smoking reduces birthweight and to identify other maternal characteristics that are common causes of both birthweight reduction and maternal smoking.
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DOI：
10.1111/1469-7610.00196
发表时间：
2003-11-01
期刊：
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES
影响因子：
--
作者：
D'Onofrio, BM;Turkheimer, EN;Emery, RE
通讯作者：
Emery, RE
影响因子：
5
作者：
Gilman, Stephen E.;Gardener, Hannah;Buka, Stephen L.
通讯作者：
Buka, Stephen L.
影响因子：
3.8
作者：
Carmines, Edward L.;Rajendran, Narayanan
通讯作者：
Rajendran, Narayanan
DOI：
10.1177/140349489001800209
发表时间：
1990-01-01
期刊：
SCANDINAVIAN JOURNAL OF SOCIAL MEDICINE
影响因子：
--
作者：
CNATTINGIUS, S;ERICSON, A;KALLEN, B
通讯作者：
KALLEN, B
DOI：
10.1067/s0002-9378(03)00661-6
发表时间：
2003-10-01
影响因子：
9.8
作者：
England, LJ;Levine, RJ;Cnattingius, S
通讯作者：
Cnattingius, S