UK Centre for Tobacco Control Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
Pediatrics. 2011 Apr;127(4):734-41. doi: 10.1542/peds.2010-3041. Epub 2011 Mar 7.
To determine the risk of adverse fetal outcomes of secondhand smoke exposure in nonsmoking pregnant women.
This was a systematic review and meta-analysis in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We searched Medline and Embase (to March 2009) and reference lists for eligible studies; no language restrictions were imposed. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using random-effect models. Our search was for epidemiologic studies of maternal exposure to secondhand smoke during pregnancy in nonsmoking pregnant women. The main outcome measures were spontaneous abortion, perinatal and neonatal death, stillbirth, and congenital malformations.
We identified 19 studies that assessed the effects of secondhand smoke exposure in nonsmoking pregnant women. We found no evidence of a statistically significant effect of secondhand smoke exposure on the risk of spontaneous abortion (OR: 1.17 [95% CI: 0.88-1.54]; 6 studies). However, secondhand smoke exposure significantly increased the risk of stillbirth (OR: 1.23 [95% CI: 1.09-1.38]; 4 studies) and congenital malformation (OR: 1.13 [95% CI: 1.01-1.26]; 7 studies), although none of the associations with specific congenital abnormalities were individually significant. Secondhand smoke exposure had no significant effect on perinatal or neonatal death.
Pregnant women who are exposed to secondhand smoke are estimated to be 23% more likely to experience stillbirth and 13% more likely give birth to a child with a congenital malformation. Because the timing and mechanism of this effect is not clear, it is important to prevent secondhand smoke exposure in women before and during pregnancy.
确定二手烟暴露对不吸烟孕妇不良胎儿结局的风险。
这是一项系统评价和荟萃分析，符合观察性研究荟萃分析（MOOSE）指南。我们检索了 Medline 和 Embase（截至 2009 年 3 月）和参考文献列表中的合格研究；没有对语言进行限制。使用随机效应模型估计合并的比值比（OR）及其 95％置信区间（CI）。我们的搜索是针对非吸烟孕妇在怀孕期间接触二手烟的流行病学研究。主要结局指标为自然流产、围产儿和新生儿死亡、死产和先天性畸形。
我们确定了 19 项评估二手烟暴露对非吸烟孕妇影响的研究。我们没有发现二手烟暴露对自然流产风险有统计学意义的影响（OR：1.17[95％CI：0.88-1.54]；6 项研究）。然而，二手烟暴露显著增加了死产的风险（OR：1.23[95％CI：1.09-1.38]；4 项研究）和先天性畸形的风险（OR：1.13[95％CI：1.01-1.26]；7 项研究），尽管与特定先天性异常的关联均无统计学意义。二手烟暴露对围产儿或新生儿死亡没有显著影响。
估计接触二手烟的孕妇发生死产的可能性增加 23％，发生先天性畸形的可能性增加 13％。由于这种影响的时间和机制尚不清楚，因此在怀孕前和怀孕期间预防妇女接触二手烟非常重要。
