Effects of early onset asthma and in utero exposure to maternal smoking on childhood lung function
Effects of early onset asthma and in utero exposure to maternal smoking on childhood lung function
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DOI：
10.1164/rccm.200206-616oc
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发表时间：
2003-03-15
影响因子：
24.7
通讯作者：
Peters, JM
中科院分区：
文献类型：
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作者：
Gilliland, FD;Berhane, K;Peters, JM
子宫内暴露于母亲吸烟和哮喘都与肺功能的慢性缺陷有关。我们假设子宫内暴露影响非哮喘儿童的肺功能，并协同影响早发性哮喘儿童。为了研究宫内暴露和哮喘诊断年龄对肺功能的影响，我们检查了儿童健康研究中5,933名参与者的纵向病史、烟草烟雾暴露和肺功能数据。我们发现，在子宫内暴露的儿童，但没有哮喘，表现出减少FEV 1/FVC，FEF 25 -75，和FEF 25 -75/FVC的比例。在没有宫内暴露的儿童中，早期哮喘诊断与此相关。与后来诊断的哮喘相比，FEV 1、FEF 25 -75和FEV 1/FVC比值下降幅度较大。仅宫内暴露和早发哮喘的儿童显示FEV 1不足（-13.6%; 95%置信区间[CI]，-18.9至-8.2）和FEF 25 -75（-29.7%; 95% CI，-37.8至-20.5）;女孩FEF 25 -75（-26.6%; 95% CI，-36.4至-15.1）和FEV 1/FVC（-9.3%; 95% CI，-12.9至-5.4）。在早发性哮喘儿童中，与宫内暴露相关的FEF 25 -75的绝对差异随年龄增加而增加。我们几乎没有发现环境烟草烟雾暴露单独影响的证据。总之，肺功能的缺陷是最大的儿童在。子宫暴露和早发性哮喘。
Both in utero exposures to maternal smoking and asthma are associated with chronic deficits in lung function. We hypothesized that in utero exposure affects lung function in children without asthma and synergistically affects children with early onset asthma. To investigate ate effects of in utero exposure and age at asthma diagnosis on lung function, we examined longitudinal medical history, tobacco smoke exposure, and lung function data from 5,933 participants in the Children's Health Study. We found that children exposed in utero, but without asthma, showed decreased FEV1/FVC, FEF25-75, and FEF25-75/FVC ratio. Among children without in utero exposure, early asthma diagnosis was associated. with larger decreases in FEV1, FEF25-75, and FEV1/FVC ratio compared with later diagnosed asthma. Children with in utero exposure alone and early onset asthma showed deficits in FEV1 (-13.6%; 95% confidence interval [CI], -18.9 to -8.2) and FEF25-75 (-29.7%; 95% Cl, -37.8 to -20.5) among boys; and FEF25-75 (-26.6%; 95% Cl, -36.4 to -15.1) and FEV1/FVC (-9.3%; 95% Cl, -12.9 to -5.4) among girls. The absolute differences in FEF25-75 associated with in utero exposure increased with age in children with early onset asthma. We found little evidence for effects from environmental tobacco smoke exposure alone. In summary, deficits in lung function were largest among children with in. utero exposure and early onset asthma.