Delpisheh A, Kelly Y, Rizwan S, Attia E, Drammond S, Brabin B J
Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Public Health. 2007 Nov;121(11):861-8. doi: 10.1016/j.puhe.2007.03.015. Epub 2007 Jul 2.
Little is known about how population-attributable risks (PAR) for adverse birth outcomes due to smoking differ in adolescent and adult pregnancies.
An analysis of community and hospital-based cross-sectional studies in Liverpool was undertaken to estimate the PAR values of low birthweight (LBW), preterm birth, and small for gestational age (SGA) births resulting from pregnancy smoking covering the period between 1983 and 2003. Maternal smoking status and pregnancy outcomes were available for a sample of 12631 women.
The prevalence of maternal pregnancy smoking was 40% in the community sample and 33% in adults and 40% among adolescent pregnancies in the hospital sample. The PAR values (95% CI) associated with LBW, preterm birth and SGA outcomes due to maternal pregnancy smoking in the community sample were 27% (25-30), 13% (11-15) and 25% (23-27), respectively. The PAR values in adults in the hospital sample were 29% (27-31) for LBW, 16% (14-19) for preterm birth and 28% (26-31) for SGA. The corresponding PAR values in adolescents were 39% (34-43), 12% (7-18) and 31% (23-40). The LBW risk attributed to pregnancy smoking in adolescents was significantly higher than for adults (P=0.05).
About one-third of LBW, one-quarter of SGA and one-sixth of preterm births could be attributed to maternal smoking during pregnancy. The magnitude of the problem was greater among adolescent pregnancies, among whom a sub-group of mothers with very high risk for adverse birth outcomes due to pregnancy smoking was identified.
关于吸烟导致不良出生结局的人群归因风险（PAR）在青少年和成年妊娠中有何差异，目前所知甚少。
对利物浦社区和医院的横断面研究进行分析，以估计1983年至2003年期间妊娠吸烟导致的低出生体重（LBW）、早产和小于胎龄（SGA）出生的PAR值。有12631名女性样本的孕产妇吸烟状况和妊娠结局数据。
社区样本中孕产妇妊娠吸烟的患病率为40%，医院样本中成年人的患病率为33%，青少年妊娠中的患病率为40%。社区样本中因孕产妇妊娠吸烟导致的LBW、早产和SGA结局的PAR值（95%CI）分别为27%（25 - 30）、13%（11 - 15）和25%（23 - 27）。医院样本中成年人因LBW的PAR值为29%（27 - 31），早产为16%（14 - 19），SGA为28%（26 - 31）。青少年中的相应PAR值分别为39%（34 - 43）、12%（7 - 18）和31%（23 - 40）。青少年中因妊娠吸烟导致的LBW风险显著高于成年人（P = 0.05）。
约三分之一的LBW、四分之一的SGA和六分之一的早产可归因于孕期母亲吸烟。该问题在青少年妊娠中更为严重，其中识别出了因妊娠吸烟导致不良出生结局风险极高的母亲亚组。
