Active and passive maternal smoking during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study
Active and passive maternal smoking during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study
复制标题
DOI：
10.1186/1471-2393-13-157
复制
发表时间：
2013-08-06
影响因子：
3.1
通讯作者：
Arakawa, Masashi
中科院分区：
文献类型：
--
作者：
Miyake, Yoshihiro;Tanaka, Keiko;Arakawa, Masashi
背景：在西方国家，孕期母亲主动吸烟被认为是不良分娩结局最重要的可预防危险因素。然而，母亲被动吸烟的影响尚不清楚，也没有得到广泛研究。在日本，只有一项流行病学研究调查了妊娠早期主动吸烟对出生结局的影响，但没有评估被动吸烟的影响。方法：研究对象是 1565 名单胎妊娠的母亲和这些妊娠所生的婴儿。通过自填问卷收集母亲在妊娠早期、中期和晚期的主动吸烟状况以及母亲在家庭和工作中的环境烟草烟雾（ETS）暴露情况的数据。结果：与怀孕期间从未吸烟的母亲所生的孩子相比，整个怀孕期间吸烟的母亲所生的孩子的小胎龄（SGA）风险显着增加（调整奇数比[OR] = 2.87；95%置信区间： 1.11-6.56）。然而，仅在妊娠早期吸烟的母亲和在妊娠中期和/或妊娠晚期但在整个妊娠期间不吸烟的母亲与 SGA 没有显着相关性。就早产风险而言，上述三类的调整后OR值均不显着；然而，正线性趋势显着（趋势 P = 0.048）。未发现母亲在怀孕期间吸烟与低出生体重风险之间存在显着关联。母亲在怀孕期间吸烟与出生体重之间存在显着的负相关关系；怀孕期间吸烟的母亲所生的新生儿，调整后的平均出生体重减少了 169.6 克。当按性别对婴儿进行分类时，仅在男性新生儿中发现母亲在整个怀孕期间主动吸烟与 SGA 风险之间存在显着正相关，但这种交互作用并不显着。母亲在家或工作中接触 ETS 与任何出生结果均无显着相关性。结论：这是日本第一项研究表明，母亲在整个怀孕期间（而非妊娠前三个月）主动吸烟与 SGA 风险增加和出生体重下降显着相关。因此，吸烟的女性在受孕后应尽快戒烟。
Background: In Western countries, active maternal smoking during pregnancy is recognized as the most important preventable risk factor for adverse birth outcomes. However, the effect of passive maternal smoking is less clear and has not been extensively studied. In Japan, there has been only one epidemiological study which examined the effects of active smoking during early pregnancy on birth outcomes although the effects of passive smoking were not assessed.Methods: Study subjects were 1565 mothers with singleton pregnancies and the babies born from these pregnancies. Data on active maternal smoking status in the first, second, and third trimesters and maternal environmental tobacco smoke (ETS) exposure at home and work were collected with self-administered questionnaires.Results: Compared with children born to mothers who had never smoked during pregnancy, children born to mothers who had smoked throughout their pregnancy had a significantly increased risk of small-for-gestational-age (SGA) (adjusted odd ratio [OR] = 2.87; 95% confidence interval: 1.11-6.56). However, active maternal smoking only in the first trimester and active maternal smoking in the second and/or third trimesters but not throughout pregnancy were not significantly associated with SGA. With regard to the risk of preterm birth, the adjusted ORs for the above-mentioned three categories were not significant; however, the positive linear trend was significant (P for trend = 0.048). No significant association was found between active maternal smoking during pregnancy and the risk of low birth weight. There was a significant inverse relationship between active maternal smoking during pregnancy and birth weight; newborns of mothers who had smoked throughout pregnancy had an adjusted mean birth weight reduction of 169.6 g. When classifying babies by gender, a significant positive association between active maternal smoking throughout pregnancy and the risk of SGA was found only in male newborns, however, the interaction was not significant. Maternal ETS exposure at home or work was not significantly associated with any birth outcomes.Conclusions: This is the first study in Japan to show that active maternal smoking throughout pregnancy, but not during the first trimester, is significantly associated with an increased risk of SGA and a decrease in birth weight. Thus, women who smoke should quit smoking as soon as possible after conception.