Department of Pathology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Proc Am Thorac Soc. 2009 Dec;6(8):660-2. doi: 10.1513/pats.200907-065DP.
One third of women continue to smoke during early pregnancy, although evidence for detrimental effects of in utero smoke exposure on fetal growth and development are rising. A number of epidemiologic studies have shown that prenatal exposure to environmental smoke is an independent risk factor for poor lung function, wheezing, and the development of (possibly nonatopic) asthma. Epidemiologic data on the effect on development of allergic sensitization are inconclusive, since in most studies no clear separation is made between pre- and postnatal exposure. However, studies that included prenatal smoke exposure showed no effect on sensitization. Aberrant development of the fetal lung structure, as shown in experimental models, may underlie the increased risk for poor lung function and asthma development. Recently, we showed that maternal smoking during pregnancy decreased expression of genes that are involved in lung development in lungs of neonatal mice. In addition, maternal smoking during pregnancy increased airway remodeling in adult mice offspring. Future experimental studies may reveal whether lung developmental changes may additionally underlie susceptibility to the apparent adult-onset disease chronic obstructive pulmonary disease.
尽管越来越多的证据表明子宫内暴露于烟雾会对胎儿的生长和发育造成有害影响，但仍有三分之一的女性在孕早期继续吸烟。一些流行病学研究表明，产前暴露于环境烟雾是肺功能不佳、喘息和（可能非特应性）哮喘发展的独立危险因素。关于对过敏致敏发展影响的流行病学数据尚无定论，因为在大多数研究中，无法明确区分产前和产后暴露。然而，包括产前烟雾暴露的研究并未显示对致敏有影响。正如实验模型所示，胎儿肺部结构的异常发育可能是肺功能不佳和哮喘发展风险增加的基础。最近，我们发现，母亲在怀孕期间吸烟会降低参与新生小鼠肺部发育的基因的表达。此外，母亲在怀孕期间吸烟会增加成年小鼠后代的气道重塑。未来的实验研究可能会揭示肺部发育变化是否可能使机体更容易受到明显的成人发病的慢性阻塞性肺疾病的影响。
