妊娠妇女被动暴露于环境烟草烟雾与儿童哮喘症状的相关性
2009/10/15
环境烟草烟雾（ETS）是导致儿童哮喘或过敏相关性症状发生及恶化的重要危险因素。孕期吸烟是引发儿童期哮喘的不利影响因素。但对于孕期被动暴露于EST是否也会导致其子女出现哮喘尚不得而知。本试验旨在研究孕期被动暴露于ETS与学龄前儿童中发生哮喘和/或过敏相关性症状间的相关性。横断面数据来自于对2374名学龄前儿童的问卷调查结果。这些儿童来自于公立、私立幼儿园及托儿所。双亲吸烟与其子女发生喘息症状具有显著相关性。母亲孕期主动吸烟可显著增加其后代发生哮喘症状和/或诊断为学龄前哮喘的危险，且呈剂量依赖性模式。校正了相关的混杂因素后的多变量分析结果显示，被动暴露于ETS（主要是在妊娠末三月）与其子女发生哮喘和过敏相关性症状显著相关（现时喘息: 优势比(OR)= 1.42, 95%CI 1.06～1.91, 瘙痒性皮疹: OR= 1.45, 95% CI 1.01～2.08）。妊娠末三月被动暴露于ETS与其子女在学龄前发生哮喘和过敏相关性症状呈正相关。公共健康政策不仅要重视戒烟，也要加大降低孕妇暴露于ETS的力度。
（苏楠 审校）
Xepapadaki P, et al. Pediatr Allergy Immunol. 2009 Aug;20(5):423-429.
Association of passive exposure of pregnant women to environmental tobacco smoke with asthma symptoms in children.
Xepapadaki P, Manios Y, Liarigkovinos T, Grammatikaki E, Douladiris N, Kortsalioudaki C, Papadopoulos NG.
Environmental tobacco smoke (ETS) is a significant risk factor for the presence and increased severity of asthma- and allergy-related symptoms in children. Smoking during pregnancy has detrimental effects on asthma-associated outcomes in childhood. Whether passive exposure of pregnant women to ETS may also lead to asthma in their offspring, is not known. The aim of this study was to investigate the association of passive exposure of pregnant women to ETS and asthma- and/or allergy-related symptoms in Preschool children. Cross-sectional data were collected with questionnaires from 2374 Preschool children, recruited from public and private nurseries and day-care centers. Parental smoking was significantly associated with wheezing symptoms in their children. Mother’s active smoking during pregnancy significantly increased the risk for occurrence of asthma symptoms and/or medically diagnosed asthma in Preschool children in a dose-dependent manner. Passive exposure to ETS, mainly during the third trimester of pregnancy, was significantly associated with asthma- and allergy-related symptoms after adjusting for several confounders in a multivariate analysis (current wheeze: OR = 1.42, 95% CI = 1.06-1.91, pruritic rash ever: OR= 1.45, 95% CI = 1.01-2.08). Passive exposure of pregnant women to ETS during the third trimester is positively associated with asthma- and allergy-related symptoms in their Preschool age children. Public health policies should be oriented not only towards smoking cessation, but also reinforce elimination of ETS exposure of pregnant women.
