Cornelius Marie D, Goldschmidt Lidush, DeGenna Natacha, Day Nancy L
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Nicotine Tob Res. 2007 Jul;9(7):739-50. doi: 10.1080/14622200701416971.
We prospectively examined the relationship between prenatal tobacco exposure (PTE) and child behavior in a birth cohort of 357 offspring of teenage mothers. PTE was defined as any exposure across pregnancy and, in separate analyses, exposure within each trimester. Outcomes included measures of behavior problems, activity, and attention. On average, the children were 6.4 years of age, 48% were females, and 69% were Black. Data on maternal tobacco and other substance use were collected prenatally and postnatally: 46% of the mothers smoked in the first trimester and 58% smoked 6 years later. Child urinary cotinine measured exposure to environmental tobacco smoke (ETS). Stepwise multiple regressions were run. PTE predicted significantly increased offspring activity; impulsivity; and aggression, externalizing, and total behavior problems in step 1. PTE remained a significant predictor of increased activity when maternal psychological characteristics, home environment, and ETS were added. The results were similar when PTE was examined by trimesters, although later pregnancy tobacco exposure predicted the most behavioral outcomes. In the final model, PTE (all three trimesters) and PTE (second trimester) were significant predictors of increased activity and attention problems, respectively. Other predictors of child behavior included maternal anxiety, depression, hostility, and home environment. ETS was not a significant predictor of child behavior when PTE was considered. Smoking during pregnancy among adolescents is a significant predictor of increased activity and attention problems in their offspring after controlling for covariates in the prenatal and current environments. Smoking cessation interventions are recommended for this population to avoid the effects of PTE on the offspring of pregnant adolescents. This is particularly important because these mothers will likely become pregnant again and many will increase their level of tobacco use as they mature.
我们前瞻性地研究了357名青少年母亲的后代出生队列中，产前烟草暴露（PTE）与儿童行为之间的关系。PTE被定义为整个孕期的任何暴露，在单独分析中，还包括各孕期内的暴露。结果包括行为问题、活动和注意力的测量指标。这些孩子平均年龄为6.4岁，48%为女性，69%为黑人。在产前和产后收集了母亲烟草及其他物质使用的数据：46%的母亲在孕早期吸烟，6年后这一比例为58%。通过检测儿童尿可替宁来衡量环境烟草烟雾（ETS）暴露情况。进行了逐步多元回归分析。在第一步中，PTE可显著预测后代活动增加、冲动性增强、攻击性增加、外化行为问题及总体行为问题。当加入母亲心理特征、家庭环境和ETS后，PTE仍然是活动增加的显著预测因素。按孕期对PTE进行分析时结果相似，尽管孕晚期烟草暴露预测的行为结果最多。在最终模型中，PTE（三个孕期均有暴露）和PTE（孕中期暴露）分别是活动增加和注意力问题增加的显著预测因素。儿童行为的其他预测因素包括母亲焦虑、抑郁、敌意及家庭环境。在考虑PTE时，ETS不是儿童行为的显著预测因素。在控制产前和当前环境中的协变量后，青少年孕期吸烟是其后代活动增加和注意力问题增加的显著预测因素。建议对这一人群进行戒烟干预，以避免PTE对怀孕青少年后代的影响。这一点尤为重要，因为这些母亲可能会再次怀孕，而且许多人随着年龄增长会增加烟草使用量。
