哮喘联盟

   摘要
   背景：已有研究提出产前吸烟暴露对哮喘发生具有隔代遗传效应，但证据仍然不足。
   方法：我们调查“挪威母亲与儿童的队列研究”（the Norwegian Mother and Child Cohort Study ，MoBa），评估外祖母在怀母亲时吸烟与外孙36个月时患哮喘的儿童（总人数=53 169，病例数=3013），7岁时患哮喘的儿童（总人数=25 394，病例数=1265），在7岁时使用过挪威处方药数据库中分发的哮喘药物的儿童（总数=45 607，例数=1718））患哮喘是否具有相关性。
   结果：共有23.5%的母亲们报道她们的母亲在怀她们时吸烟。外祖母在怀母亲时吸烟与36个月时患哮喘儿童（RR 1.15（95% CI 1.06-1.24）），7岁时患哮喘儿童（RR 1.21（95% CI 1.07-1.37）），7岁时曾使用分发的哮喘药物的儿童（RR 1.15 （95% CI 1.04-1.26））患哮喘呈正相关关系。这种正相关关系并未明显受到母亲怀孕时吸烟状况的影响（多重交互时的P>0.1）。
   结论：外祖母在怀母亲时吸烟增加了外孙患哮喘的风险，并独立于母亲的吸烟状态。然而，由于外祖母的社会经济学状态、哮喘状态与其他因素等有限信息，可能存在一些难以测量的混杂因素。
 

(马利  张红萍 王刚  四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（Thorax; 2015;70:237-243.）

Grandmother’s smoking when pregnant with the mother and asthma in the grandchild: the Norwegian Mother and Child Cohort Study
 

Magnus MC, Håberg SE, Karlstad Ø, Nafstad P, London SJ, Nystad W.
Thorax; 2015;70:237-243.

ABSTRACT
BACKGROUND: A trans-generational influence of prenatal tobacco smoke exposure on asthma development has been proposed but the evidence remains sparse.
METHODS: We examined the grandmother’s smoking when pregnant with the mother in relation to asthma outcomes in the grandchild (current asthma at 36 months (N=53 169, cases=3013), current asthma at 7 years (N=25 394, cases=1265) and dispensed asthma medications at 7 years in the Norwegian Prescription Database (N=45 607, cases=1787)) within the Norwegian Mother and Child Cohort Study (MoBa). We calculated adjusted RR (adj. RR) and 95% CIs using log binomial regression.
RESULTS: A total of 23.5% of mothers reported that their mother smoked when pregnant with them. The grandmother’s smoking when pregnant with the mother was positively associated with asthma at 36 months (adj. RR 1.15 (95% CI 1.06 to 1.24)), asthma at 7 years (adj. RR 1.21 (95% CI 1.07 to 1.37)) and dispensed asthma medications at 7 years (adj. RR 1.15 (95% CI 1.04 to 1.26)). This positive association did not differ significantly by the mother’s smoking status when pregnant with the child (p values for multiplicative interaction >0.1).
CONCLUSIONS: The grandmother’s smoking when pregnant with the mother increased the risk of asthma in the grandchild independent of the mother’s smoking status. However, given limited information on the grandmother’s socioeconomic status, asthma status and other factors, unmeasured confounding may be present.