Institut Municipal d'Investigacions Mèdiques, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
BMC Pregnancy Childbirth. 2012 Apr 5;12:26. doi: 10.1186/1471-2393-12-26.
Over the last few years a decreasing trend in smoking has occurred not only in the general population but also during pregnancy. Several countries have implemented laws requiring all enclosed workplace and public places to be free of second hand smoke (SHS). In Spain, legislation to reduce SHS was implemented in 2005. The present study examines the possible effect of this legislation on prenatal SHS exposure.
Mothers and newborns were recruited from 3 independent studies performed in Hospital del Mar (Barcelona) and approved by the local Ethics Committee: 415 participated in a study in 1996-1998, 283 in 2002-2004 and 207 in 2008. A standard questionnaire, including neonatal and sociodemographic variables,tobacco use and exposure during pregnancy, was completed at delivery for all the participants in the three study groups. Fetal exposure to tobacco was studied by measuring cotinine in cord blood by radioimmunoassay (RIA).
32.8% of the pregnant women reported to smoke during pregnancy in 1996-1998, 25.9% in 2002-2004 and 34.1% in 2008. In the most recent group, the percentage of no prenatal SHS exposure (cord blood cotinine 0.2-1 ng/mL) showed an increase compared to the previous groups while the percentages of both: low (1.1-14 ng/mL) and very high (> 100 ng/mL) prenatal SHS exposure showed a decrease.
The results of the three study periods (1996-2008) demonstrated a significant increase in the percentage of newborns free from SHS exposure and a decrease in the percentage of newborns exposed to SHS during pregnancy, especially at the very high levels of exposure. A significant maternal smoking habit was noted in this geographical area with particular emphasis on immigrant pregnant smoking women.
Our study indicates that there is a significant maternal smoking habit in this geographical area. Our recommendation is that campaigns against smoking should be directed more specifically towards pregnant women with particular emphasis on non-native pregnant smokers due to the highest prevalence of tobacco consumption in the immigrant women.
过去几年中，不仅普通人群，而且孕妇人群的吸烟率都呈下降趋势。一些国家已制定法律，要求所有封闭的工作场所和公共场所内禁止二手烟（SHS）。在西班牙，减少 SHS 的立法于 2005 年生效。本研究旨在探讨该立法对产前 SHS 暴露的可能影响。
本研究招募了来自巴塞罗那德尔玛医院（Hospital del Mar）进行的 3 项独立研究的母亲和新生儿，这些研究均获得了当地伦理委员会的批准：1996-1998 年有 415 名参与者参加了一项研究，2002-2004 年有 283 名，2008 年有 207 名。所有参加这 3 项研究的参与者在分娩时都完成了一份标准问卷，其中包括新生儿和社会人口统计学变量、怀孕期间的吸烟和暴露情况。通过放射免疫分析（RIA）测量脐带血中的可替宁来研究胎儿对烟草的暴露情况。
1996-1998 年，32.8%的孕妇报告在怀孕期间吸烟，2002-2004 年为 25.9%，2008 年为 34.1%。在最近的一组中，与前两组相比，脐带血可替宁浓度在 0.2-1ng/ml 之间的无产前 SHS 暴露的比例有所增加，而低浓度（1.1-14ng/ml）和高浓度（>100ng/ml）产前 SHS 暴露的比例均有所下降。
这三个研究阶段（1996-2008 年）的结果表明，无 SHS 暴露的新生儿比例显著增加，而怀孕期间暴露于 SHS 的新生儿比例下降，尤其是在极高暴露水平下。在这一地理区域，孕妇吸烟的习惯显著，特别是对移民孕妇吸烟的问题。
我们的研究表明，在这一地理区域存在显著的孕妇吸烟习惯。我们的建议是，针对孕妇的禁烟运动应更有针对性，特别是针对非本地孕妇吸烟者，因为移民女性的烟草消费率最高。
