Prenatal and Childhood Tobacco Smoke Exposure Are Associated With Sleep-Disordered Breathing Throughout Early Childhood.
Prenatal and Childhood Tobacco Smoke Exposure Are Associated With Sleep-Disordered Breathing Throughout Early Childhood.
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DOI：
10.1016/j.acap.2020.11.003
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发表时间：
2021-05
影响因子：
3.1
通讯作者：
Abuabara K
中科院分区：
文献类型：
--
作者：
Ramirez FD;Groner JA;Ramirez JL;McEvoy CT;Owens JA;McCulloch CE;Cabana MD;Abuabara K
为确定产前和儿童期烟草烟雾暴露（TSE）是否各自独立地与整个幼儿期的轻度睡眠呼吸障碍（SDB）症状相关，以及儿童期TSE与SDB之间的关联是否因产前暴露水平而异。
纵向队列研究，使用来自英国基于人群的出生队列——雅芳父母与儿童纵向研究的数据。主要暴露因素是母亲报告的直至7岁的产前和儿童期TSE的重复测量值。结果是母亲报告的轻度SDB症状的测量值，包括打鼾、张口呼吸和目击的呼吸暂停，每年重复测量直至7岁。
对12030名儿童进行了中位时长为7年的随访。24.2%的儿童有产前烟草烟雾暴露，46.2%的儿童在儿童期至少暴露过一次，20.6%的儿童在两个时期都有暴露。产前和儿童期TSE都与整个幼儿期的SDB症状相关（任何产前TSE的调整后比值比[aOR]为1.23；95%置信区间为1.08 - 1.40；任何儿童期TSE的aOR为1.17；95%置信区间为1.06 - 1.29）。我们观察到TSE与SBD症状之间存在剂量 - 反应效应，并发现两个时期都暴露的儿童存在效应修正的证据[产前和儿童期都有高水平暴露：打鼾的aOR为2.43（95%置信区间为1.50 - 3.93），呼吸暂停的aOR为2.65（95%置信区间为1.46 - 4.82）]。
产前和儿童期TSE都以剂量依赖的方式独立地与整个幼儿期的轻度SDB症状相关，进一步支持了在整个孕期和儿童期保持无烟环境至关重要。
To determine whether prenatal and childhood tobacco smoke exposure (TSE) are each independently associated with mild sleep-disordered breathing (SDB) symptoms throughout early childhood, and whether the association between childhood TSE and SDB differs according to the level of prenatal exposure. Longitudinal cohort study, using data from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort from the United Kingdom. Primary exposures were repeated measures of mother-reported prenatal and childhood TSE through age 7 years. Outcomes were mother-reported measures of mild SDB symptoms, including snoring, mouth breathing, and witnessed apnea, repeated annually through age 7 years. 12,030 children were followed for a median duration of 7 years. 24.2% were exposed to prenatal tobacco smoke, 46.2% were exposed at least once in childhood, and 20.6% were exposed during both periods. Both prenatal and childhood TSE were associated with SDB symptoms throughout early childhood (adjusted OR [aOR] for any prenatal TSE 1.23; 95% CI 1.08, 1.40; aOR for any childhood TSE 1.17; 95% CI 1.06, 1.29). We observed a dose-response effect between TSE and SBD symptoms, and found evidence of effect modification for those exposed during both time periods [combined high level exposure both prenatally and during childhood: aOR snoring 2.43 (95% CI 1.50, 3.93), aOR apnea 2.65 (95% CI 1.46, 4.82)]. Prenatal and childhood TSE were both independently associated with mild SDB symptoms throughout early childhood in a dose-dependent manner, further supporting the critical importance of maintaining a tobacco-free environment throughout gestation and childhood.
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影响因子：
2.3
作者：
Hafström, A;Milerad, J;Sundell, HW
通讯作者：
Sundell, HW
影响因子：
12.7
作者：
KENDRICK, JS;ZAHNISER, SC;DALMAT, ME
通讯作者：
DALMAT, ME
DOI：
10.1038/s41370-018-0051-z
发表时间：
2018-11-01
影响因子：
4.5
作者：
Groner, Judith A.;Rule, Ana M.;Wilson, Karen
通讯作者：
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影响因子：
5.8
作者：
McEvoy CT;Spindel ER
通讯作者：
Spindel ER
影响因子：
5.2
作者：
Avila-Tang E;Al-Delaimy WK;Ashley DL;Benowitz N;Bernert JT;Kim S;Samet JM;Hecht SS
通讯作者：
Hecht SS