Department of Paediatrics, Division of Neonatology, Neuropaediatrics and Metabolic Disorders, Innsbruck Medical University, Innsbruck, Austria.
Acta Paediatr. 2010 Jul;99(7):1016-9. doi: 10.1111/j.1651-2227.2010.01749.x. Epub 2010 Feb 23.
To assess whether smoking in pregnancy influences neurodevelopmental outcome at 2-years of age in preterm infants with a gestational age <32 weeks.
Between January 2003 and December 2005 we prospectively enrolled 181 infants born alive between 23 and 32 weeks of gestation; 142 infants (78.5%) completed the follow-up visit. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis.
Low maternal age, smoking in pregnancy, low gestational age, low birth weight, small for gestational age, chronic lung disease, intracerebral haemorrhage, periventricular leucomalacia, and retinopathy of prematurity (stages 3 and 4) all were associated with an increased risk for delayed development (p < 0.05, each). Smoking in pregnancy, small for gestational age and chronic lung disease maintained significance in a multivariable analysis.
Smoking in pregnancy emerged as a risk predictor for adverse neurodevelopmental outcome in our study. Strategies to reduce smoking in pregnancy should be further endorsed.
评估孕期吸烟是否会影响妊娠 32 周以下早产儿 2 岁时的神经发育结局。
2003 年 1 月至 2005 年 12 月，我们前瞻性地纳入了 181 名胎龄为 23 至 32 周的活产婴儿；其中 142 名婴儿（78.5%）完成了随访。采用逻辑回归分析，分析候选危险因素与运动或智力发育延迟（贝利婴幼儿发展量表 II；精神运动或智力发育指数 <85）之间的关系。
母亲年龄低、孕期吸烟、胎龄低、出生体重低、小于胎龄儿、慢性肺部疾病、颅内出血、脑室周围白质软化、早产儿视网膜病变（3 期和 4 期）均与发育延迟的风险增加相关（p < 0.05，每项）。多变量分析显示，孕期吸烟、小于胎龄儿和慢性肺部疾病仍然具有统计学意义。
在本研究中，孕期吸烟成为不良神经发育结局的风险预测因素。应进一步支持减少孕期吸烟的策略。
