Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study
Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study
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DOI：
10.1111/j.1365-3016.2007.00916.x
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发表时间：
2008-03-01
影响因子：
2.8
通讯作者：
Witteman, Jacqueline C. M.
中科院分区：
文献类型：
--
作者：
Jaddoe, Vincent W. V.;Troe, Ernst-Jan W. M.;Witteman, Jacqueline C. M.
本研究的目的是检查在不同的怀孕期间主动和被动吸烟和改变吸烟习惯，与低出生体重和早产之间的关联。这项研究被纳入了R世代研究，这是一项在荷兰鹿特丹进行的基于人群的前瞻性队列研究，从胎儿早期开始。在妊娠早期、中期和晚期通过问卷调查评估主动吸烟和被动吸烟。分析基于7098名孕妇和她们的孩子，确定了怀孕前主动吸烟与低出生体重和早产无关。还记录了妊娠后持续主动吸烟，并与低出生体重（校正比值比1.75 [95% CI 1.20，2.56]）和早产（校正比值比1.36 [95% CI 1.04，1.78]）相关。最强的协会被发现积极的母亲吸烟在怀孕后期。妊娠晚期母亲被动吸烟与连续测量的出生体重相关（趋势P < 0.001）。对于怀孕早期的所有主动吸烟类别，戒烟与出生体重高于继续吸烟相关。在不完全戒烟的情况下，减少吸烟数量对平均出生体重的有益影响较小。这项研究表明，怀孕后期的主动和被动吸烟与出生时体重和胎龄的不良影响有关。仅在怀孕早期吸烟，似乎不会对胎儿生长产生不利影响。孕妇的保健策略应该是完全戒烟，而不是减少香烟的数量。
The objective of this study was to examine the associations between active and passive smoking in different periods of pregnancy and changing smoking habits during pregnancy, with low birthweight and preterm birth. The study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards in Rotterdam, The Netherlands. Active and passive smoking were assessed by questionnaires in early, mid- and late pregnancy. Analyses were based on 7098 pregnant women and their children.Active smoking until pregnancy was ascertained and was not associated with low birthweight and preterm birth. Continued active smoking after pregnancy was also recorded and was associated with low birthweight (adjusted odds ratio 1.75 [95% CI 1.20, 2.56]) and preterm birth (adjusted odds ratio 1.36 [95% CI 1.04, 1.78]). The strongest associations were found for active maternal smoking in late pregnancy. Passive maternal smoking in late pregnancy was associated with continuously measured birthweight (P for trend < 0.001). For all active smoking categories in early pregnancy, quitting smoking was associated with a higher birthweight than continuing to smoke. Tendencies towards smaller non-significant beneficial effects on mean birthweight were found for reducing the number of cigarettes without quitting completely. This study shows that active and passive smoking in late pregnancy are associated with adverse effects on weight and gestational age at birth. Smoking in early pregnancy only, seems not to affect fetal growth adversely. Health care strategies for pregnant women should be aimed at quitting smoking completely rather than reducing the number of cigarettes.