Environmental tobacco smoke and risk of spontaneous abortion
Environmental tobacco smoke and risk of spontaneous abortion
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DOI：
10.1097/01.ede.0000229984.53726.33
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发表时间：
2006-09-01
期刊：
影响因子：
5.4
通讯作者：
Cnattingius, Sven
中科院分区：
文献类型：
--
作者：
George, Lena;Granath, Fredrik;Cnattingius, Sven
背景资料：暴露于环境烟草烟雾（ETS）和自然流产风险的研究仅限于少数自我报告暴露的研究，结果不一致。本研究的目的是调查早期自然流产的风险与ETS和主动吸烟定义的血浆可替宁levels.Methods：我们进行了一项以人口为基础的病例对照研究，在乌普萨拉县，瑞典，1996年1月至1998年12月。方法选择妊娠6 ~ 12周自然流产妇女463例为研究对象，按孕周配对864例为对照组。暴露状态由血浆可替宁浓度定义：未暴露，< 0.1 ng/mL; ETS暴露，0.1-15 ng/mL;暴露于主动吸烟，> 15 ng/mL。多变量分析被用来估计与暴露于ETS和主动smoking.Results：19%的控制和24%的情况下，自然流产的相对风险被归类为已暴露于ETS。与非暴露妇女相比，暴露于ETS的妇女（调整后的比值比= 1.67; 95%置信区间= 1.17-2.38）和主动吸烟者（2.11; 1.36-3.27）的自然流产风险增加。我们不能显示正常和异常的胎儿核型abnormality. Conclusions胎儿核型abnormality.Conclusions：暴露于ETS或主动吸烟的差异效应：非吸烟孕妇可能会增加自然流产的风险。鉴于ETS暴露的高流行率，被动吸烟对早期胎儿丢失的公共卫生后果可能是巨大的。
Background: Studies of exposure to environmental tobacco smoke (ETS) and risk of spontaneous abortion are limited to a few studies of self-reported exposure, and the results have been inconsistent. The aim of this study was to investigate risk of early spontaneous abortion related to ETS and active smoking as defined by plasma cotinine levels.Methods: We conducted a population-based case-control study in Uppsala County, Sweden, between January 1996 and December 1998. Cases were 463 women with spontaneous abortion at 6 to 12 completed weeks of gestation, and controls were 864 pregnant women matched to cases according to the week of gestation. Exposure status was defined by plasma cotinine concentrations: nonexposed, < 0.1 ng/mL; ETS-exposed, 0.1-15 ng/mL; and exposed to active smoking, > 15 ng/mL. Multivariable analysis was used to estimate the relative risk of spontaneous abortion associated with exposure to ETS and active smoking.Results: Nineteen percent of controls and 24% of cases were classified as having been exposed to ETS. Compared with nonexposed women, risk of spontaneous abortion was increased among both ETS-exposed women (adjusted odds ratio = 1.67; 95% confidence interval = 1.17-2.38) and active smokers (2.11; 1.36-3.27). We could not show a differential effect of exposure to ETS or active smoking between normal and abnormal fetal karyotype abortions.Conclusions: Nonsmoking pregnant women exposed to ETS may be at increased risk of spontaneous abortion. Given the high prevalence of ETS exposure, the public health consequences of passive smoking regarding early fetal loss may be substantial.