Brooks Daniel R, Mucci Lorelei A, Hatch Elizabeth E, Cnattingius Sven
Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA.
Cancer Causes Control. 2004 Dec;15(10):997-1005. doi: 10.1007/s10552-004-1123-z.
Studies of the effect of maternal smoking during pregnancy on development of brain tumors in the offspring generally have found no increase in risk but most have mainly relied on retrospective exposure assessment. We conducted a prospective study on a large birth cohort in Sweden.
Women giving birth during 1983-1997 were classified as smokers or non-smokers based on information ascertained at the first prenatal visit and recorded in the Swedish Birth Register. Follow-up of brain tumor incidence among offspring through 1997 was achieved by linkage with the Swedish Cancer Register. Hazard ratios were estimated using Cox proportional hazard regression, adjusting for demographic characteristics available in the Birth Register.
Brain tumors (n=480) occurred at a rate of 4.5 cases per 100,000 person-years. Children of women who smoked during pregnancy had an increased incidence of brain tumors (hazard ratio = 1.24; 95% confidence interval: 1.01-1.53). The increase in risk was similar for benign and malignant tumors, and was most apparent for astrocytoma. The effect of smoking on the occurrence of brain tumors was seen most strongly among 2-4 year-old children.
These results support a role for maternal smoking during pregnancy in the etiology of childhood brain tumors. Our findings should be confirmed in other prospective studies.
关于孕期母亲吸烟对后代脑肿瘤发生影响的研究通常未发现风险增加，但大多数主要依赖回顾性暴露评估。我们在瑞典的一个大型出生队列中进行了一项前瞻性研究。
根据首次产前检查确定并记录在瑞典出生登记册中的信息，将1983年至1997年期间分娩的妇女分为吸烟者或非吸烟者。通过与瑞典癌症登记册联动，对后代至1997年的脑肿瘤发病率进行随访。使用Cox比例风险回归估计风险比，并根据出生登记册中可用的人口统计学特征进行调整。
脑肿瘤（n = 480）的发生率为每10万人年4.5例。孕期吸烟妇女的子女患脑肿瘤的发病率增加（风险比 = 1.24；95%置信区间：1.01 - 1.53）。良性和恶性肿瘤的风险增加相似，星形细胞瘤最为明显。吸烟对脑肿瘤发生的影响在2至4岁儿童中最为显著。
这些结果支持孕期母亲吸烟在儿童脑肿瘤病因学中的作用。我们的发现应在其他前瞻性研究中得到证实。
