The association between prenatal exposure to environmental tobacco smoke and childhood obesity: a systematic review.
The association between prenatal exposure to environmental tobacco smoke and childhood obesity: a systematic review.
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DOI：
10.11124/jbisrir-2017-003558
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发表时间：
2018-08-01
期刊：
影响因子：
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通讯作者：
Watkins, Elizabeth Ann
中科院分区：
文献类型：
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作者：
Qureshi, Rubab;Jadotte, Yuri;Watkins, Elizabeth Ann
目的：探讨产前暴露于环境烟草烟雾(ETS)是否会增加儿童肥胖和超重的风险。这一点非常令人担忧，因为儿童肥胖与成人早期发病的慢性疾病有关，如冠状动脉疾病、II型糖尿病和高血压。广泛的研究表明，这是一种多因素的病因。这些因素包括遗传标记、个人生活方式、社会和环境因素，特别是这些因素之间的相互作用。在环境因素中，产前暴露于ETS与儿童时期肥胖和超重率的增加有关。结论标准：这篇综述考虑了关于非吸烟者和报告在怀孕期间暴露于ETS的妇女的孩子的研究。感兴趣的暴露是怀孕期间暴露于ETS或二手烟，由以下任一项确定：i)自我报告的母亲暴露；和/或ii)血清可替宁水平。观察性研究包括队列研究、病例对照研究、回顾研究和分析性横断面研究。感兴趣的结果是从出生到18岁的儿童的体重、身高和身体质量指数。方法：使用三步搜索策略搜索已发表和未发表的英文研究。未设置搜索范围(年)。两名审查员使用乔安娜·布里格斯信息统一管理、评估和审查研究所(JBI Sumari)标准化评估工具对研究的纳入情况和方法质量进行了评估。数据由两个人独立提取，并输入JBI提取工具。提取的数据被合并到基于随机效应模型的统计荟萃分析中。结果：纳入19项研究。其中8项研究进入了最终的荟萃分析。结果表明，产前暴露于ETS与儿童肥胖有关(优势比：1.905，CI：1.2 3~2.94)，而与超重无关(OR：1.5 1，CI：0.49~4.5 9)。I统计量确定的两项Meta分析中的高异质性比率(分别为97%和99%)支持对这些发现的解释和使用的谨慎。结论：根据证据，儿童肥胖与产前暴露于ETS有关，然而超重似乎与这种类型的暴露无关。
OBJECTIVE: The objective of the review was to determine if prenatal exposure to environmental tobacco smoke (ETS) increases the risk of obesity and overweight in children.INTRODUCTION: Childhood obesity has reached epidemic proportions in many developed countries. This is of great concern as childhood obesity is associated with early onset of chronic diseases such as coronary artery disease, type II diabetes and hypertension in adulthood. Extensive research suggests a multifactorial etiology. These factors include genetic markers, individual lifestyle, social and environmental factors, particularly the interaction between these factors. Among environmental factors, prenatal exposure to ETS has been linked to increased rates of obesity and overweight in childhood.INCLUSION CRITERIA: This review considered studies on children of women who were non-smokers and who reported exposure to ETS during pregnancy. The exposure of interest was exposure to ETS or second hand smoke during pregnancy, determined by either: i) self-reported maternal exposure; and/or ii) serum cotinine levels. Observational studies such as cohort studies, case control studies, retrospective studies and analytical cross-sectional studies were included. Outcomes of interest were weight, height and body mass index of children from birth up to 18 years.METHODS: A three-step search strategy was used to search for published and unpublished studies in the English language. No search range (years) was set. Two reviewers assessed the studies for inclusion and methodological quality using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) standardized appraisal instruments. Data was extracted by two people independently and entered into the JBI extraction tool. Extracted data was pooled in a statistical meta-analysis based on a random effects model.RESULTS: Nineteen studies were included in the review. Eight of the studies were included in the final meta-analysis. Findings suggest that there was an association between prenatal exposure to ETS and childhood obesity (odds ratio [OR]: 1.905, CI: 1.23-2.94), and no association between ETS exposure and overweight (OR: 1.51, CI: 0.49-4.59). The high rates of heterogeneity between studies in both of the meta-analyses determined by the I statistic (97% and 99%, respectively) sanction caution in the interpretation and use of these findings.CONCLUSIONS: Based on the evidence, childhood obesity is associated with exposure to prenatal ETS, however overweight does not appear to be associated with this type of exposure.