Julvez Jordi, Ribas-Fitó Núria, Torrent Maties, Forns Maria, Garcia-Esteban Raquel, Sunyer Jordi
Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica. Barcelona, Spain.
Int J Epidemiol. 2007 Aug;36(4):825-32. doi: 10.1093/ije/dym107. Epub 2007 Jun 5.
Active maternal smoking during pregnancy has been associated with a higher risk of behavioural disorders in children, but a few cohort studies measuring smoking data prospectively have studied its specific effects on the cognitive abilities of pre-schoolers.
A birth cohort was set up in Menorca Island in 1997 within the Asthma Multicenter Infants Cohort Study. A total of 420 (87% of those eligible) children had complete data for final analyses at age 4 years. Interviewer-administered questionnaires were completed by mothers during the third trimester of pregnancy and then every year up to age 4 years of their child. A standardized version of the McCarthy Scales of Children's Abilities (MCSA) was used to evaluate the child's motor and cognitive capabilities. Multivariable regressions were used with MCSA's assessed outcomes adjusting for: home location, maternal alcohol consumption, mother's social class and level of education during pregnancy, parity, marital status, father's education level, child's gender, birth weight and height, breastfeeding duration, passive smoking, school season, age during test administration and evaluator (psychologist).
A high global consistency in maternal smoking habits was found (total agreement = 88.7%). Maternal social class and education level were inversely associated with maternal smoking behaviour. Maternal smoking during pregnancy (in cig./day) was associated with a decrease (in points) of children's global cognitive score [beta = -0.60, (95% CI: -1.10; -0.09)]; as well as global cognitive sub-areas like verbal score [beta = -0.59, (95% CI: -1.11; -0.07)]; quantitative score [beta = -0.57, (95% CI: -1.08; -0.06)]; executive function score [beta = -0.71, (95% CI: -1.23; -0.20)]; and working memory score [beta = -0.46, (95% CI: -0.92; -0.01)].
Our findings suggest an association with maternal smoking during pregnancy and lowered cognitive development in children at age 4 years.
孕期母亲主动吸烟与儿童行为障碍风险较高有关，但少数前瞻性测量吸烟数据的队列研究探讨了其对学龄前儿童认知能力的具体影响。
1997年在梅诺卡岛建立了一个出生队列，纳入哮喘多中心婴儿队列研究。共有420名儿童（占符合条件者的87%）在4岁时拥有完整数据用于最终分析。母亲在孕期第三个月及之后每年孩子4岁前完成由访员管理的问卷。使用儿童能力麦卡锡量表（MCSA）的标准化版本评估儿童的运动和认知能力。多变量回归用于根据MCSA评估结果进行调整，调整因素包括：家庭住址、母亲饮酒情况、母亲社会阶层和孕期教育水平、产次、婚姻状况、父亲教育水平、孩子性别、出生体重和身高、母乳喂养时长、被动吸烟、上学季节、测试时年龄以及评估者（心理学家）。
发现母亲吸烟习惯具有高度的总体一致性（总体一致性 = 88.7%）。母亲社会阶层和教育水平与母亲吸烟行为呈负相关。孕期母亲吸烟（每天吸烟支数）与儿童总体认知得分降低（点数）相关[β = -0.60，（95%置信区间：-1.10；-0.09）]；以及言语得分[β = -0.59，（95%置信区间：-1.11；-0.07）]、定量得分[β = -0.57，（95%置信区间：-1.08；-0.06）]、执行功能得分[β = -0.71，（95%置信区间：-1.23；-0.20）]和工作记忆得分[β = -0.46，（95%置信区间：-0.92；-0.01）]等总体认知子领域。
我们的研究结果表明孕期母亲吸烟与4岁儿童认知发育降低有关。
