Maternal smoking during pregnancy and children's cognitive and physical development: A causal risk factor?
Maternal smoking during pregnancy and children's cognitive and physical development: A causal risk factor?
复制标题
DOI：
10.1093/aje/kwn175
复制
发表时间：
2008-09-01
影响因子：
5
通讯作者：
Buka, Stephen L.
中科院分区：
文献类型：
--
作者：
Gilman, Stephen E.;Gardener, Hannah;Buka, Stephen L.
关于母亲在怀孕期间吸烟对儿童生长发育的影响，仍有相当多的争论。怀孕期间母亲吸烟与许多不良后果有关的证据与研究相矛盾，研究表明这些关联是虚假的。作者使用围产期合作项目（1959-1974; n = 52，919）的数据，调查了母亲在怀孕期间吸烟与儿童从出生到7岁的14种发育结果之间的关系。除了调整与母亲吸烟同时测量的潜在混杂因素外，作者还在控制了未测量混杂因素的兄弟姐妹中拟合了条件固定效应模型。条件分析的结果表明，出生体重差异为-85.63 g，与怀孕期间每天吸烟≥ 20支有关（95%置信区间：-131.91，-39.34），7岁时超重的几率高出2.73倍（95%置信区间：1.30，5.71）。然而，母亲吸烟和其他12个研究结果（包括Apgar评分，智力，学业成绩，行为问题和哮喘）之间的关联在调整测量和未测量的混杂因素后完全消除。作者的结论是，假设的母亲在怀孕期间吸烟对这些结果的影响要么不存在，要么无法与更广泛的与母亲吸烟相关的家庭因素区分开来。
There remains considerable debate regarding the effects of maternal smoking during pregnancy on children's growth and development. Evidence that exposure to maternal smoking during pregnancy is associated with numerous adverse outcomes is contradicted by research suggesting that these associations are spurious. The authors investigated the relation between maternal smoking during pregnancy and 14 developmental outcomes of children from birth through age 7 years, using data from the Collaborative Perinatal Project (1959-1974; n = 52,919). In addition to adjusting for potential confounders measured contemporaneously with maternal smoking, the authors fitted conditional fixed-effects models among siblings that controlled for unmeasured confounders. Results from the conditional analyses indicated a birth weight difference of -85.63 g associated with smoking of >= 20 cigarettes daily during pregnancy (95% confidence interval: -131.91, -39.34) and 2.73 times' higher odds of being overweight at age 7 years (95% confidence interval: 1.30, 5.71). However, the associations between maternal smoking and 12 other outcomes studied (including Apgar score, intelligence, academic achievement, conduct problems, and asthma) were entirely eliminated after adjustment for measured and unmeasured confounders. The authors conclude that the hypothesized effects of maternal smoking during pregnancy on these outcomes either are not present or are not distinguishable from a broader range of familial factors associated with maternal smoking.