Leslie G B, Fave A
ARIA 2 Ivel Gardens Biggleswade (Beds), SG 18 OAN (Royaume Uni), Paris, France.
J Toxicol Clin Exp. 1992 Aug;12(3):155-77.
For near thirty years, epidemiological studies have coped with the search of possible noxious consequences of an involuntary exposure of pregnant women to environmental tobacco smoke on the gestation and the intrauterine development of embryo and foetus. These studies were mainly retrospectives; a careful study of the methods used (questionnaires, evaluation of exposure, and so on ...) gives evidence that they can rarely avoid serious criticism. As possible effects of intrauterine exposure to environmental tobacco smoke, low birth weight and impairing of other body parameters, perinatal mortality, frequency of abnormalities have been reviewed. As a potential cause, the role of the father tobacco smoking has been especially examined. As a whole, the consequences of a prenatal exposure to environmental tobacco smoke are an extremely controversial subject and no obvious effect has yet been universally recognized. The critical analysis of the studies has shown that, frequently, the epidemiological studies have been interpreted in order to find links between and involuntary exposure to tobacco smoke and some troubles of reproduction, particularly in offspring. As a matter of facts, fundamentally, the noted actually correlations, even if they are statistically significant, are not able to move such links. They are only able to indicate the existence of an association and only, if the eventual role of confounding factors has been properly treated. An interesting case is the potential effects of the father's tobacco smoking. The hypotheses emerging from these examined inquiries remain to be more precisely defined and thoroughly by new studies, preferentially prospective, and, when necessary, completed by animal experiments. It is suggested that a special effort shall be applied to the measurement of the exposure of pregnant women to define toxic compounds originating from environmental tobacco smoke. Presently, it is not possible to draw a conclusion on the noxious or innoxious influence of the involuntary exposure of pregnant women to environmental tobacco smoke, particularly as far as potential risks for foetus are concerned.
近三十年来，流行病学研究一直在探寻孕妇非自愿接触环境烟草烟雾对妊娠以及胚胎和胎儿宫内发育可能产生的有害后果。这些研究主要是回顾性的；仔细研究其使用的方法（问卷调查、接触评估等）会发现，它们很难避免受到严厉批评。关于宫内接触环境烟草烟雾可能产生的影响，已对低出生体重、其他身体参数受损、围产期死亡率、异常发生率等进行了综述。作为一个潜在原因，尤其对父亲吸烟的作用进行了研究。总体而言，产前接触环境烟草烟雾的后果是一个极具争议的话题，尚未有任何明显影响得到普遍认可。对这些研究的批判性分析表明，流行病学研究常常为了找出非自愿接触烟草烟雾与某些生殖问题（尤其是后代的问题）之间的联系而进行解读。事实上，从根本上说，即便所指出的实际相关性在统计学上具有显著性，也无法确立这种联系。它们只能表明存在一种关联，而且只有在对混杂因素的潜在作用进行恰当处理的情况下才行。一个有趣的例子是父亲吸烟的潜在影响。从这些研究中得出的假设仍有待通过新的研究（最好是前瞻性研究，必要时辅以动物实验）更精确地界定和深入探究。建议应特别致力于测量孕妇接触源自环境烟草烟雾的有毒化合物的情况。目前，对于孕妇非自愿接触环境烟草烟雾的有害或无害影响，尤其就对胎儿的潜在风险而言，尚无法得出结论。
