Pre- and Postnatal Smoking Exposure and Risk of Atopic Eczema in Young Japanese Children: A Prospective Prebirth Cohort Study
Pre- and Postnatal Smoking Exposure and Risk of Atopic Eczema in Young Japanese Children: A Prospective Prebirth Cohort Study
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日本幼儿产前和产后吸烟暴露与特应性湿疹风险：一项前瞻性产前队列研究
DOI：
10.1093/ntr/ntw299
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发表时间：
2017
影响因子：
4.7
通讯作者：
Arakawa Masashi
中科院分区：
文献类型：
--
作者：
Tanaka Keiko;Miyake Yoshihiro;Furukawa Shinya;Arakawa Masashi
关于围产期吸烟暴露对儿童特应性湿疹影响的流行病学证据仍不确定。这一前瞻性的出生前队列研究的目的是探讨产前吸烟暴露和产后生活与家庭吸烟者和特应性湿疹的风险，在日本儿童年龄23至29 months.MethodsStudy受试者之间的关联1354日本母子对。研究中的变量信息是通过母亲填写的问卷获得的，首先在分娩前，然后在分娩后不久，随后在分娩后4个月、12个月和24个月左右填写。根据儿童哮喘和过敏国际研究的标准定义过去12个月内的过敏。医生诊断的特应性湿疹被认为是目前，如果报告的mothers.ResultsCompared没有围产期吸烟暴露，产前吸烟暴露仅与医生诊断的特应性湿疹的风险增加（调整后的比值比= 7.11，95%置信区间：1.43至27.8）。出生后与至少一个家庭吸烟者生活在一起与医生诊断的特应性湿疹的风险无关;产前吸烟暴露和出生后与至少一个家庭吸烟者生活在一起也不相关。根据国际研究哮喘和过敏症在儿童criteria.ConclusionsOur findings suggest that maternal smoking may increase the risk of atopic eczema in young children.ImplicationIn the present prebirth cohort study，我们评估了出生前和出生后暴露于吸烟对儿童特应性湿疹的独立和累加效应。与无围产期吸烟暴露相比，仅产前吸烟暴露与特应性湿疹风险增加显著相关。仅出生后吸烟暴露与特应性湿疹的风险无关;出生前和出生后吸烟暴露的组合也不相关。这是第一个流行病学研究表明，产前吸烟暴露与特应性湿疹的风险呈正相关。
IntroductionEpidemiological evidence regarding the effect of perinatal smoking exposure on atopic eczema in children continues to be inconclusive. The aim of this prospective prebirth cohort study was to investigate the association between prenatal smoking exposure and postnatal living with household smokers and the risk of atopic eczema in Japanese children aged 23 to 29 months.MethodsStudy subjects were 1354 Japanese mother–child pairs. Information on the variables under study was obtained through questionnaires which were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, and 24 months after delivery. Eczema in the last 12 months was defined according to the criteria of the International Study of Asthma and Allergies in Childhood. Physician-diagnosed atopic eczema was considered present if reported by mothers.ResultsCompared with no perinatal smoking exposure, prenatal smoking exposure only was associated with an increased risk of physician-diagnosed atopic eczema (adjusted odds ratio = 7.11, 95% confidence interval: 1.43 to 27.8). Postnatal living with at least one household smoker only was not associated with the risk of physician-diagnosed atopic eczema; neither was the combination of both prenatal smoking exposure and postnatal living with at least one household smoker. No association was observed between perinatal smoking exposure status and the risk of eczema as defined according to the International Study of Asthma and Allergies in Childhood criteria.ConclusionsOur findings suggest that maternal smoking during pregnancy may increase the risk of atopic eczema in young children.ImplicationIn the present prebirth cohort study, we assessed the independent and additive effects of pre- and postnatal exposure to tobacco smoking on atopic eczema in children. Compared with no perinatal smoking exposure, prenatal smoking exposure only was significantly associated with an increased risk of atopic eczema. Postnatal smoking exposure only was not associated with the risk of atopic eczema; neither was the combination of both pre- and postnatal smoking exposure. This is the first epidemiological study to show a positive association between prenatal smoking exposure only and the risk of atopic eczema.