AJRCCM：怀孕母亲吸烟增加儿童患喘息和哮喘的风险

根据一项新研究，在怀孕期间，母亲吸烟与学龄前儿童患上喘息和哮喘相关联，即便是对接触怀孕前期母亲吸烟但在怀孕后期或出生后没有吸烟的儿童而言，也是如此。

研究第一作者、瑞典卡洛林斯卡学院环境医学研究所成员Åsa Neuman博士说，“流行病学证据提示着在胎儿早期生命期间，接触母亲吸烟能够增加儿童患上喘息和哮喘的风险，但是较早之前的研究不能区分胎儿出生前和出生后接触母亲吸烟之间的影响。我们的研究是对21000多名儿童的8项出生群体研究进行汇聚分析，其中就包括735名只在怀孕期间接触母亲吸烟的儿童。”研究结果表明这735名儿童有更高的风险在学龄前患上喘息和哮喘。再者，患上喘息和哮喘的几率以一种显著性的与怀孕头三个月母亲吸烟相关的剂量反应模式发生增加。这些研究发现在线发表在American Journal of Respiratory and Critical Care Medicine期刊上。

在对分析结果进行性别、父母教育、父母是否患有哮喘、出生体重和出生儿童兄弟姐妹数量进行校正之后，母亲只在怀孕期间吸烟与4到6岁儿童患有喘息(比值比为1.39，95%置信区间为1.08-1.77)和哮喘((比值比为1.65，95%置信区间为1.18-2.31)的风险相关联。再者，在怀孕头3个月母亲吸烟，而不是在怀孕9个月期间或者出生后第一年吸烟，与增加儿童患上喘息和哮喘的风险相关联。

Neuman博士说，“这些结果表明在母亲吸烟对胎儿呼吸系统的有害影响在怀孕早期发生，而且可能是在妇女意识到她们怀孕之间就已发生。”

本文编译自Smoking during pregnancy increases the risk of wheeze and asthma in preschool children

American Journal of Respiratory and Critical Care Medicine, 2012
PMC:
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Maternal Smoking in Pregnancy and Asthma in Preschool Children: a Pooled Analysis of 8 Birth Cohorts

Neuman et al.

The eight European birth cohorts included in the study included a total of 21,600 children. Exposure information and information on symptoms of wheeze and asthma were derived from parental questionnaires. In analyses adjusted for sex, parental education, parental asthma, birth weight and siblings, maternal smoking only during pregnancy was associated with increased risks for wheeze (odd ratio 1.39, 95 % CI 1.08-1.77) and asthma (odds ratio 1.65, 1.18-2.31) at age four to six years. Moreover, maternal smoking during the first trimester of pregnancy, but not during the third trimester or the first year following birth, was associated with increased risks for subsequent wheeze