哮喘联盟

   摘要
   背景：儿童哮喘的发生与妊娠期母体主动吸烟有关，但其与孕期二手烟暴露之间的关系需要进一步评估。
   目的：调查了妊娠期孕妇烟雾暴露与儿童哮喘发生的垂直关系。
   方法：在5619名多伦多7岁儿童队列人群中，父母报告了诊断为哮喘的年龄，孕期吸烟情况，7岁前家庭二手烟暴露情况，人口统计数据和家族过敏史。通过使用Cox比例和离散时间风险生存分析，我们评估了哮喘与孕期吸烟或家庭二手烟暴露之间的关系。
   结果：妊娠期间，5.0%的孕妇吸烟，6.2%的孕妇不吸烟，但暴露于家庭二手烟雾中，15.5%的儿童发展为哮喘。母亲吸烟或妊娠期暴露于家庭二手烟雾中的儿童更易患哮喘（校正风险比[HR]1.30[95%置信区间，1.06-1.60]）。儿童母亲不吸烟但孕期存在家庭二手烟暴露（校正HR1.34[95%置信区间1.01-1.76]），在过去一年中儿童有哮喘症状（校正HR1.36[95%置信区间1.03-1.79]），且校正从1岁到7岁家庭二手烟暴露后，这种相关性持续着。
   结论：即使母亲妊娠期没有主动吸烟，孕期家庭二手烟暴露与诊断的儿童期哮喘事件相关。儿童哮喘预防方案应包括生活在吸烟和不吸烟的孕妇家庭中的吸烟者戒烟，以及吸烟孕妇戒烟。
 

（林江涛 审校）
JAllergyClinImmunolPract.2014Mar-Apr;2(2):201-207.e3.doi:10.1016/j.jaip.2013.11.014.

 

Maternal second-hand smoke exposure in pregnancy is associated with childhood asthma development.
 

Simons E1, To T2, Moineddin R3, Stieb D4, Dell SD5.
 

ABSTRACT
BACKGROUND: Childhood asthma development has been associated with active maternal smoking during pregnancy, but its association with maternal second-hand smoke exposure in pregnancy needs to be evaluated.
OBJECTIVE: We investigated longitudinal associations between maternal smoke exposure in pregnancy and childhood asthma development.
METHODS: In a population-based cohort of 5619 seven-year-old Toronto children, parents reported age of physician-diagnosed asthma development, maternal smoking during pregnancy, home second-hand smoke exposure from pregnancy until 7 years, demographics, and family history of atopy. By using Cox proportional and discrete-time hazard survival analyses, we evaluated associations between asthma and maternal smoking or home second-hand smoke exposure in pregnancy.
RESULTS: During pregnancy, 5.0% of mothers smoked and 6.2% were nonsmokers and exposed to home second-hand smoke; 15.5% of children developed asthma. Children whose mothers smoked or were exposed to home second-hand smoke during pregnancy were more likely to develop asthma (adjusted hazard ratio [HR] 1.30 [95% CI, 1.06-1.60]). The association persisted for children of nonsmoking mothers with home second-hand smoke exposure during pregnancy (adjusted HR 1.34 [95% CI, 1.01-1.76]), children with asthma symptoms in the past year (adjusted HR 1.36 [95% CI, 1.03-1.79]), and after adjusting for home second-hand smoke exposure from birth to age 7 years.
CONCLUSIONS: Maternal home second-hand smoke exposure during pregnancy is associated with incident physician-diagnosed childhood asthma, even if the mother does not smoke actively during pregnancy. Childhood asthma prevention programs should include smoking cessation strategies targeted toward smokers who live in the homes of smoking and nonsmoking pregnant women as well as pregnant women who smoke.
 

JAllergyClinImmunolPract.2014Mar-Apr;2(2):201-207.e3.doi:10.1016/j.jaip.2013.11.014.