Department of Obstetrics and Gynaecology, Eastern Health, St John's, NL, Canada.
BJOG. 2011 Jun;118(7):865-71. doi: 10.1111/j.1471-0528.2011.02941.x. Epub 2011 Mar 23.
To evaluate the effects of environmental tobacco smoke (ETS) on perinatal outcomes.
Retrospective cohort study.
Newfoundland and Labrador, Canada.
Nonsmoking women with singleton gestations who delivered 1 April 2001-31 March 2009, identified through the Newfoundland and Labrador Provincial Perinatal Database.
Women who self-reported exposure to ETS were compared with those who reported no exposure. Univariate analyses and multivariate linear and logistic regression analyses (adjusting for maternal age, parity, partnered status, work status, level of education, body mass index, alcohol use, illicit drug use and gestational age) were performed and odds ratios(OR; or adjusted differences) with 95% confidence intervals were calculated.
Birthweight, birth length, head circumference and stillbirth. Secondary outcomes included gestational age at delivery, preterm birth <37 and <34 weeks of gestation, prelabour rupture of membranes, Apgar score, endotracheal intubation for resuscitation, neonatal intensive care unit admission, congenital anomalies, respiratory distress syndrome, intraventricular haemorrhage, neonatal bacterial sepsis, jaundice and neonatal metabolic abnormalities.
A total of 11,852 women were included: 1202(11.1%) exposed to ETS and 10,650 (89.9%) not exposed. Exposure to ETS was an independent risk factor for lower mean birthweight (-53.7 g, 95% CI -98.4 to -8.9 g), smaller head circumference (-0.24 cm, 95% CI -0.39 to -0.08 cm), shorter birth length (-0.29 cm, 95% CI -0.51 to -0.07 cm), stillbirth (OR 3.35, 95% CI 1.16-9.72, P = 0.026), and trends towards preterm birth <34 weeks (OR 1.87, 95% CI 1.00-3.53, P = 0.05) and neonatal sepsis (OR 2.96, 95% CI 0.99-8.86).
Exposure of nonsmoking pregnant women to ETS is associated with a number of adverse perinatal outcomes including lower birthweight, smaller head circumference and stillbirth, as well as shorter birth length. This information is important for women, their families and healthcare providers, and reinforces the continued need for increased public policy and education on prevention of exposure to ETS.
评估环境烟草烟雾（ETS）对围产期结局的影响。
回顾性队列研究。
加拿大纽芬兰和拉布拉多省。
通过纽芬兰和拉布拉多省围产期数据库确定的 2001 年 4 月 1 日至 2009 年 3 月 31 日期间分娩的单胎妊娠、不吸烟的女性。
将自我报告接触 ETS 的女性与未报告接触 ETS 的女性进行比较。进行单变量分析和多变量线性和逻辑回归分析（调整母亲年龄、产次、伴侣状况、工作状况、受教育程度、体重指数、酒精使用、非法药物使用和胎龄），并计算比值比（OR；或调整差异）及其 95%置信区间。
出生体重、出生体长、头围和死产。次要结局包括分娩时的胎龄、早产 <37 周和 <34 周、胎膜早破、阿普加评分、气管插管复苏、新生儿重症监护病房入院、先天性异常、呼吸窘迫综合征、脑室内出血、新生儿细菌性败血症、黄疸和新生儿代谢异常。
共纳入 11852 名女性：1202 名（11.1%）接触 ETS，10650 名（89.9%）未接触 ETS。接触 ETS 是出生体重降低（-53.7g，95%CI-98.4 至-8.9g）、头围减小（-0.24cm，95%CI-0.39 至-0.08cm）、出生体长缩短（-0.29cm，95%CI-0.51 至-0.07cm）、死产（OR3.35，95%CI1.16-9.72，P=0.026）以及早产 <34 周（OR1.87，95%CI1.00-3.53，P=0.05）和新生儿败血症（OR2.96，95%CI0.99-8.86）的独立危险因素。
不吸烟孕妇接触 ETS 与多种不良围产期结局相关，包括出生体重降低、头围和死产较小以及出生体长缩短。这些信息对女性、她们的家人和医疗保健提供者很重要，并再次强调需要加强公共政策和教育，以防止接触 ETS。
