Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure
Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure
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DOI：
10.1136/tc.2005.015065
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发表时间：
2006-08-01
期刊：
影响因子：
5.2
通讯作者：
Fletcher, Tony
中科院分区：
文献类型：
--
作者：
Pattenden, Sam;Antova, Temenuga;Fletcher, Tony
目的：据报道，产前和/或产后被动暴露于吸烟对儿童健康的不良影响。关于吸烟在孩子一生中不同时期的相对重要性，人们还没有定论。我们调查这一汇总分析，对53 879名儿童从12个横断面研究的组成部分的PATY研究（污染和年轻的）。方法：估计的影响，在每个研究中，三个曝光：母亲在怀孕期间吸烟，父母吸烟在头两年，目前的父母吸烟。结果是：喘息、哮喘、“被喘息吵醒”、支气管炎、夜间咳嗽、早晨咳嗽、“对吸入性过敏原敏感”和花粉热。使用Logistic回归，控制个体风险因素和研究区域。研究特定结果和平均效应之间的异方差性结果：有强有力的证据表明父母吸烟与喘息、哮喘、支气管炎和夜间咳嗽有关，平均优势比均在1.15左右，产前和产后暴露对大多数相关性具有独立影响。产前和产后父母吸烟对儿童呼吸系统健康的不良影响得到证实。哮喘与母亲在怀孕期间吸烟的关系最密切，但产后暴露与一系列其他呼吸道症状有独立的联系。所有烟草烟雾暴露都对儿童的呼吸系统健康造成严重后果，迫切需要减少。
Objectives: Adverse effects have been reported of prenatal and/or postnatal passive exposure to smoking on children's health. Uncertainties remain about the relative importance of smoking at different periods in the child's life. We investigate this in a pooled analysis, on 53 879 children from 12 cross-sectional studies-components of the PATY study (Pollution And The Young).Methods: Effects were estimated, within each study, of three exposures: mother smoked during pregnancy, parental smoking in the first two years, current parental smoking. Outcomes were: wheeze, asthma, "woken by wheeze'', bronchitis, nocturnal cough, morning cough, "sensitivity to inhaled allergens'' and hay fever. Logistic regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results, and mean effects (allowing for heterogeneity) were estimated using meta-analytical tools.Results: There was strong evidence linking parental smoking to wheeze, asthma, bronchitis and nocturnal cough, with mean odds ratios all around 1.15, with independent effects of prenatal and postnatal exposures for most associations.Conclusions: Adverse effects of both pre- and postnatal parental smoking on children's respiratory health were confirmed. Asthma was most strongly associated with maternal smoking during pregnancy, but postnatal exposure showed independent associations with a range of other respiratory symptoms. All tobacco smoke exposure has serious consequences for children's respiratory health and needs to be reduced urgently.