Effects of maternal smoking during pregnancy on offspring blood pressure in late adolescence.
Effects of maternal smoking during pregnancy on offspring blood pressure in late adolescence.
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DOI：
10.1097/hjh.0b013e32835168f4
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发表时间：
2012-04
影响因子：
4.9
通讯作者：
Iliadou AN
中科院分区：
文献类型：
--
作者：
Högberg L;Cnattingius S;Lundholm C;D'Onofrio BM;Långström N;Iliadou AN
先前的研究表明，母亲在怀孕期间吸烟与后代儿童期血压升高有关。我们的目的是调查这种关联是否在青春期后期仍然存在，如果是，是否可以归因于宫内效应或家庭混杂因素。我们对 1983 年至 1988 年间出生的 87 223 名瑞典年轻男性进行了全国队列研究，并提供了母亲怀孕期间吸烟情况和入伍时血压的信息。该队列包括 780 名在母亲吸烟方面不一致的亲兄弟。使用广义估计方程来估计具有 95% 置信区间 (95% CI) 的回归系数 (b)。我们发现，与不吸烟母亲的儿子相比，母亲在怀孕期间每天吸烟的年轻男性的收缩压和舒张压都有小幅但显着的升高：收缩压和舒张压分别为 0.26（95% CI 0.09 至 0.44）和 0.45mmHg（95% CI 0.31 至 0.59）。在一项比较母亲吸烟暴露情况不一致的亲兄弟的兄弟姐妹内分析中，点估计值相似，但不具有统计学显着性：舒张压为 0.85（95% CI _0.19 至 1.90），收缩压为 0.81（_0.56 至 2.19）。母亲在怀孕期间吸烟与青春期后期后代血压的小幅但具有统计学意义的升高有关。由于这种关联似乎不能用家族混杂因素来解释，因此我们的结果支持产前吸烟暴露对青春期后期血压的宫内影响。
Previous studies suggest that maternal smoking during pregnancy is associated with elevated offspring blood pressure during childhood. We aimed to investigate whether this association remained in late adolescence and, if so, whether it could be attributed to an intrauterine effect or to familial confounding. We used a national cohort of 87 223 young Swedish men born between 1983 and 1988 with information on both maternal smoking during pregnancy and blood pressure at military conscription. The cohort included 780 full brothers discordant for maternal smoking. Generalized estimation equations were used to estimate regression coefficients (b) with 95% confidence intervals (95% CIs). We found a small but significant increase in both SBP and DBP for young men whose mothers had been daily smokers during pregnancy compared with sons of nonsmoking mothers: 0.26 (95% CI 0.09 to 0.44) and 0.45mmHg (95% CI 0.31 to 0.59) for SBP and DBP, respectively. In a within-sibling analysis comparing full brothers discordant for maternal smoking exposure, point estimates were similar but not statistically significant: 0.85 (95% CI _0.19 to 1.90) for DBP and 0.81 (_0.56 to 2.19) for SBP. Maternal smoking during pregnancy is associated with a small but statistically significant increase in offspring blood pressure in late adolescence. Because the association does not appear to be explained by familial confounding, our results support an intrauterine effect of prenatal smoking exposure on blood pressure in late adolescence.