Ekblad Mikael, Gissler Mika, Lehtonen Liisa, Korkeila Jyrki
Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
Arch Gen Psychiatry. 2010 Aug;67(8):841-9. doi: 10.1001/archgenpsychiatry.2010.92.
Prenatal smoking exposure modulates brain development, which may deviate mental development of the offspring.
To study the effects of prenatal smoking exposure on psychiatric morbidity and mortality among Finnish young adults by means of population-based longitudinal register data.
Information on maternal smoking as reported by the mothers (0, <10, or >10 cigarettes a day) and other background factors (maternal age and parity and child's sex, gestational age, birth weight, and 5-minute Apgar score) was derived from the Finnish Medical Birth Register. Information on children's psychiatric diagnoses related to outpatient visits (1998-2007), children's inpatient care (1987-2007), and mothers' psychiatric inpatient care (1969-1989) was derived from the Finnish Hospital Discharge Register. Information on deaths and their causes for the children (1987-2007) was received from the Cause-of-Death Register.
Population-based study of all singletons born in Finland from 1987 to 1989 with information on prenatal smoking exposure. Patients The source population included all singleton births in Finland from January 1, 1987, through December 31, 1989 (n = 175 869), excluding children with major congenital anomalies (3.1%) and children who died during the first week of life (0.3%).
Psychiatric morbidity and mortality.
The prevalence of maternal smoking was 15.3%. The risk of psychiatric morbidity was significantly higher in the exposed children than in the unexposed children. Among the offspring of mothers who smoked fewer than 10 cigarettes a day, 21.0% had any psychiatric diagnoses (adjusted odds ratio [OR], 1.53 [95% confidence interval (CI), 1.47-1.60]) compared with 24.7% among those of mothers who smoked more than 10 cigarettes a day (1.85 [1.74-1.96]) and 13.7% in the unexposed children (the reference group). The risk was significantly increased for most of the psychiatric diagnoses. The strongest effects were in psychiatric disorders due to psychoactive substance use and in behavioral and emotional disorders. The risk of mortality was significantly higher in children exposed to more than 10 cigarettes a day (OR, 1.69 [95% CI, 1.31-2.19]) compared with unexposed children.
Prenatal smoking exposure is associated with an increased risk of psychiatric morbidity, whereas prenatal exposure to more than 10 cigarettes a day increases the risk of mortality in childhood, adolescence, and young adulthood.
产前暴露于吸烟环境会影响大脑发育，这可能会使后代的智力发育出现偏差。
通过基于人群的纵向登记数据，研究产前暴露于吸烟环境对芬兰年轻人精神疾病发病率和死亡率的影响。
母亲报告的孕期吸烟情况（每天0支、少于10支或多于10支）以及其他背景因素（母亲年龄、产次、孩子性别、孕周、出生体重和5分钟阿氏评分）来自芬兰医疗出生登记处。与门诊就诊（1998 - 2007年）、儿童住院治疗（1987 - 2007年）以及母亲住院治疗（1969 - 1989年）相关的儿童精神疾病诊断信息来自芬兰医院出院登记处。儿童死亡及其原因的信息（1987 - 2007年）来自死因登记处。
对1987年至1989年在芬兰出生的所有单胎进行基于人群的研究，这些单胎有产前吸烟暴露信息。患者来源人群包括1987年1月1日至1989年12月31日在芬兰出生的所有单胎（n = 175 869），不包括患有严重先天性异常的儿童（3.1%）和出生后第一周内死亡的儿童（0.3%）。
精神疾病发病率和死亡率。
母亲吸烟的患病率为15.3%。暴露组儿童患精神疾病的风险显著高于未暴露组儿童。在每天吸烟少于10支的母亲的后代中，21.0%有任何精神疾病诊断（调整优势比[OR]，1.53[95%置信区间（CI），1.47 - 1.60]），而在每天吸烟多于10支的母亲的后代中这一比例为24.7%（1.85[1.74 - 1.96]），未暴露组儿童为13.7%（参照组）。大多数精神疾病诊断的风险显著增加。最强的影响出现在使用精神活性物质所致精神障碍以及行为和情绪障碍中。每天暴露于多于10支香烟的儿童的死亡风险显著高于未暴露儿童（OR，1.69[95%CI，1.31 - 2.19]）。
产前暴露于吸烟环境与精神疾病发病率增加相关，而产前每天暴露于多于10支香烟会增加儿童期、青少年期和青年期的死亡风险。
