Maternal and grandmaternal smoking patterns are associated with early childhood asthma
Maternal and grandmaternal smoking patterns are associated with early childhood asthma
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DOI：
10.1378/chest.127.4.1232
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发表时间：
2005-04-01
期刊：
影响因子：
9.6
通讯作者：
Gilliland, FD
中科院分区：
文献类型：
--
作者：
Li, YF;Langholz, B;Gilliland, FD
目的：调查母亲和外祖母在怀孕前、怀孕期间和怀孕后吸烟与儿童哮喘的关联。
设计、环境和参与者：我们在南加州的儿童健康研究中进行了一项巢式病例对照研究。病例组包括338名在生命最初5年被诊断患有哮喘的儿童，570名对照组在宫内暴露于母亲吸烟情况、年级、性别和居住社区方面进行了匹配。
测量：通过电话访谈获取详细的母亲和家庭吸烟史以及其他哮喘危险因素信息。
结果：对照组和病例组的参与率分别为72.3%和82.5%。宫内暴露于母亲吸烟与生命最初5年被诊断为哮喘的风险增加相关（优势比[OR]，1.5；95%置信区间[CI] 1.0 - 2.3），以及与持续性哮喘相关（OR，1.5；95% CI，1.0 - 2.3）。早期短暂性哮喘儿童与早期持续性哮喘儿童相比，这种关联没有差异。相对于从不吸烟者，母亲在整个孕期吸烟的儿童在生命最初5年患哮喘的风险升高（OR，1.6；95% CI，1.0 - 2.6）。母亲在怀孕前戒烟的儿童没有显示风险增加（OR，0.9；95% CI，0.5 - 1.5）。我们无法评估孕期戒烟的关联，因为据报道很少有母亲这样做（15%）。哮喘风险并没有随着孕期吸烟强度呈单调模式增加。产后二手烟暴露与哮喘没有独立关联。母亲胎儿期外祖母吸烟与其孙辈患哮喘风险增加相关（OR，2.1；95% CI，1.4 - 3.2）。
结论：母亲和外祖母在孕期吸烟可能增加儿童患哮喘的风险。
Objective: To investigate the associations of maternal and grandmaternal smoking before, during, and after pregnancy with childhood asthma.Design, setting, and participants: We conducted a case-control study nested within the Children's Health Study in southern California. The case patients consisted of 338 children with asthma that had been diagnosed in the first 5 years of life, and 570 control subjects were countermatched on in utero exposure to maternal smoking within grade, sex, and community of residence.Measurements: Detailed maternal and household smoking histories and other asthma risk factor information was obtained by telephone interview.Results: The participation rates were 72.3% and S2.5%, respectively, for control subjects and case patients. In utero exposure to maternal smoking was associated with increased risk for asthma diagnosed in the first 5 years of life (odds ratio [OR], 1.5; 95% confidence interval [CI] 1.0 to 2.3), and for persistent asthma (OR, 1.5; 95% CI, 1.0 to 2.3). The associations did not differ in children with early transient asthma compared to those with early persistent asthma. Relative to never-smokers, children whose mothers smoked throughout the pregnancy had an elevated risk of asthma in the first 5 years of life (OR, 1.6; 95% CI, 1.0 to 2.6). Children of mothers who quit smoking prior to the pregnancy showed no increased risk (OR, 0.9; 95% CI, 0.5 to 1.5). We were unable to assess the association of smoking cessation during pregnancy because very few mothers were reported to have done so (15%). Asthma risk did not increase in a monotonic pattern with smoking intensity during pregnancy. Postnatal secondhand smoke exposure was not independently associated with asthma. Grandmaternal smoking during the mother's fetal period was associated with increased asthma risk in her grandchildren (OR, 2.1; 95% CI, 1.4 to 3.2).Conclusions: Maternal and grandmaternal smoking during pregnancy may increase the risk of childhood asthma.