Influence of Smoking and Alcohol during Pregnancy on Outcome of VLBW Infants
Influence of Smoking and Alcohol during Pregnancy on Outcome of VLBW Infants
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怀孕期间吸烟和饮酒对极低出生体重婴儿结局的影响
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发表时间：
2013
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通讯作者：
Wolfgang Göpel
中科院分区：
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作者：
Juliane Spiegler;R. Jensen;H. Segerer;S. Ehlers;T. Kühn;A. Jenke;C. Gebauer;J. Möller;Thorsten Orlikowsky;F. Heitmann;K. Boeckenholt;E. Herting;Wolfgang Göpel
摘要背景：尼古丁和酒精的摄入与早产和不良新生儿结局有关。我们想分析自我报告的尼古丁和酒精摄入量对极低出生体重婴儿结局的影响。材料和方法：在一项正在进行的多中心研究中，2475名在2009年1月至2011年12月期间出生的前极低出生体重（VLBW）婴儿的父母回答了关于母亲在怀孕期间吸烟习惯和饮酒的问卷调查。2463人（99.5%）完成了饮酒问题，2462人（99.5%）完成了吸烟习惯问题。这些婴儿被分层报告母亲吸烟和饮酒在怀孕期间。我们比较了早产的原因，新生儿的结果和父母报告的支气管炎在生命的第一年，以及生长发育在2岁的怀孕暴露。结果如下：在尼古丁暴露的婴儿中，胎儿宫内生长受限（31%对21%，p<0.01）、出生体重低于第10百分位数（26%对17%，p<0.01）和胎盘脱垂（9.2%对5.8%，p<0.05）更常见。胎膜早破（24 vs. 30%，p<0.05）或HELLP综合征（6 vs. 11%，p<0.01）发生率较低。出生体重低于第三百分位数的情况在报告饮酒的母亲中更常见（13%对6%，p<0.05）。我们注意到，如果母亲在怀孕期间吸烟，BPD和ROP的发生率会增加（p<0.05）。2岁时婴儿发育的生长参数和Bayley S量表评分无差异。结论：妊娠期吸烟导致极低出生体重儿生长受限的发生率较高。产前暴露于尼古丁似乎会增加产后并发症，如BPD和ROP。
Abstract Background: Nicotine and alcohol consumption have been associated with premature delivery and adverse neonatal outcome. We wanted to analyze the influence of self-reported nicotine and alcohol consumption on outcome of VLBW infants. Material and Methods: In an ongoing multicenter study 2 475 parents of former very low birth weight (VLBW) infants born between January 2009 and December 2011 answered questionnaires about maternal smoking habits and alcohol consumption during pregnancy. 2 463 (99.5%) completed questions on alcohol consumption and 2 462 (99.5%) on smoking habits. These infants were stratified to reported maternal smoking and alcohol consumption during pregnancy. We compared the reasons for premature delivery, neonatal outcome and parental reports on bronchitis during the first year of life, as well as growth and development at age 2 years to pregnancy exposure. Results: In nicotine exposed infants intrauterine growth restriction (31 vs. 21%, p<0.01), a birth weight below the 10th percentile (26 vs. 17%, p<0.01) and placenta abruption (9.2 vs. 5.8%, p<0.05) was seen more often. Premature rupture of membranes (24 vs. 30%, p<0.05) or HELLP syndrome (6 vs. 11%, p<0.01) was less frequent. A birth weight below the 3rd percentile was seen more frequently in mothers with reported alcohol consumption (13 vs. 6%, p<0.05). We noted an increased rate of BPD and ROP if mothers reported smoking during pregnancy (p<0.05). Growth parameters and scores on Bayley Sscales of infant development at age 2 years did not differ. Conclusion: Smoking during pregnancy results in a high rate of growth restricted VLBW infants. Prenatal exposition to nicotine seems to increase postnatal complications such as BPD und ROP.