Department of Health Sciences, McMaster University, Hamilton, Ontario, Canada L8N 3Z5.
Department of Health Research Methodology, McMaster University, 1200 Main St. West, Hamilton, Ontario, Canada L8N 3Z5.
Acta Obstet Gynecol Scand. 2010;89(4):423-441. doi: 10.3109/00016340903505748.
While active maternal tobacco smoking has well established adverse perinatal outcomes, the effects of passive maternal smoking, also called environmental tobacco exposure (ETS), are less well studied and less consistent.
To determine to the effect of ETS on perinatal outcomes.
Medline, EMBASE and reference lists were searched.
Studies comparing ETS-exposed pregnant women with those unexposed which adequately addressed active maternal smoking.
Two reviewers independently assessed titles, abstracts, full studies, extracted data and assessed quality. Dichotomous data were pooled using odds ratios (OR) and continuous data with weighted mean differences (WMD) using a random effects model.
Seventy-six articles were included with a total of 48,439 ETS-exposed women and 90,918 unexposed women. ETS-exposed infants weighed less [WMD -60 g, 95% confidence interval (CI) -80 to -39 g], with a trend towards increased low birthweight (LBW, < 2,500 g; RR 1.16; 95% CI 0.99-1.36), although the duration of gestation and preterm delivery were similar (WMD 0.02 weeks, 95% CI -0.09 to 0.12 weeks and RR 1.07; 95% CI 0.93-1.22). ETS-exposed infants had longer infant lengths (1.75 cm; 95% CI 1.37-2.12 cm), increased risks of congenital anomalies (OR 1.17; 95% CI 1.03-1.34) and a trend towards smaller head circumferences (-0.11 cm; 95% CI -0.22 to 0.01 cm).
ETS-exposed women have increased risks of infants with lower birthweight, congenital anomalies, longer lengths, and trends towards smaller head circumferences and LBW.
虽然母亲主动吸烟对围产期有明确的不良影响，但母亲被动吸烟（也称为环境烟草暴露，ETS）的影响研究较少，且结果不一致。
确定 ETS 对围产期结局的影响。
检索了 Medline、EMBASE 和参考文献列表。
比较 ETS 暴露孕妇与未暴露孕妇的研究，且要充分解决主动吸烟的问题。
两名评审员独立评估标题、摘要、全文、提取数据和评估质量。使用随机效应模型，对二分类数据进行汇总，使用优势比（OR）；对连续数据进行汇总，使用加权均数差（WMD）。
共纳入 76 篇文章，共有 48439 名 ETS 暴露孕妇和 90918 名未暴露孕妇。ETS 暴露婴儿的体重较轻[WMD-60g，95%置信区间（CI）-80 至-39g]，低出生体重（<2500g）的趋势增加（RR 1.16；95%CI 0.99-1.36），但妊娠期和早产的持续时间相似[WMD 0.02 周，95%CI-0.09 至 0.12 周和 RR 1.07；95%CI 0.93-1.22]。ETS 暴露婴儿的身长较长（1.75cm；95%CI 1.37-2.12cm），先天性畸形的风险增加（OR 1.17；95%CI 1.03-1.34），头围较小的趋势（-0.11cm；95%CI-0.22 至 0.01cm）。
ETS 暴露的孕妇所生婴儿的出生体重较低、先天性畸形、身长较长、头围较小和早产的风险增加。
