Kelmanson I A, Erman L V, Litvina S V
St. Petersburg State Paediatric Medical Academy, Litovskaya 2, St. Petersburg, 194 100, Russia.
Klin Padiatr. 2002 Nov-Dec;214(6):359-64. doi: 10.1055/s-2002-35369.
The study aimed to assess potential relationship between maternal smoking during pregnancy and behavioural characteristics in 2 - 4-month-old infants. It covered period from 1999 to 2000 and comprised 250 randomly selected, apparently healthy singleton born infants from community setting (129 boys, 121 girls). The mothers were asked to complete the questionnaires addressing infant, maternal, demographic major characteristics with particular emphasis on maternal smoking during pregnancy. To objectively assess behavioural peculiarities of the infants, the mothers were requested to complete the Early Infancy Temperament Questionnaire. Of 250 mothers, 64. women (25.6 %) smoked during pregnancy. The infants of smoking mothers were more often born low birth weight and were also lighter at study; more frequently they were born at earlier gestational age, had lower Apgar score at 5 th minute, were less frequently breast fed at birth and at the time of study. Mothers who smoked during pregnancy were younger, had lower educational level, and less frequently were married. The infants born to smoking mothers had more frequent fussy periods occurring at about the same time of the day, protesting behaviour at face washing and washing in bath, indifferent attitude to the mother when held by new person, extreme reactions (either indifference or much feeling) during diapering and bowel movement, less attention to the parents during parent-infant play activity, and more sensitivity to the wet diaper. They were also characterised by more intensive reactions (displayed more amount of energy regardless of positive or negative behaviour) compared with the babies from the non-smoking group. This association remained after adjustment has been made for major potential confounders, and had a significant "dose-response" effect. Maternal smoking during pregnancy may serve as a risk factor for infant's behavioural deviations.
该研究旨在评估孕期母亲吸烟与2至4个月大婴儿行为特征之间的潜在关系。研究涵盖1999年至2000年期间,包括250名从社区环境中随机选取的、看似健康的单胎出生婴儿(129名男孩,121名女孩)。研究要求母亲们填写问卷,内容涉及婴儿、母亲的主要人口统计学特征,尤其着重于孕期母亲吸烟情况。为客观评估婴儿的行为特点,要求母亲们填写《早期婴儿气质问卷》。在250名母亲中,有64名女性(25.6%)在孕期吸烟。吸烟母亲所生的婴儿出生时低体重的情况更为常见,且在研究时体重也更轻;他们更频繁地在较早孕周出生,出生后第5分钟的阿氏评分较低,出生时及研究时母乳喂养的频率较低。孕期吸烟的母亲更年轻,教育水平较低,结婚的频率也较低。吸烟母亲所生的婴儿在一天中大致相同的时间更容易出现烦躁期,洗脸和洗澡时会有抗议行为,被陌生人抱时对母亲态度冷漠,换尿布和排便时有极端反应(要么冷漠要么反应强烈),在母婴互动游戏活动中对父母的关注较少,对湿尿布更敏感。与非吸烟组的婴儿相比,他们的反应也更强烈(无论积极或消极行为都表现出更多的能量)。在对主要潜在混杂因素进行调整后,这种关联仍然存在,并且有显著的“剂量反应”效应。孕期母亲吸烟可能是婴儿行为偏差的一个风险因素。