Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98104-2499 , USA.
Pediatr Infect Dis J. 2013 Jan;32(1):e1-7. doi: 10.1097/INF.0b013e3182704bb5.
Maternal smoking is associated with infant respiratory infections and with increased risk of low birth weight infants and preterm birth. This study assesses the association of maternal smoking during pregnancy with both respiratory and nonrespiratory infectious disease (ID) morbidity and mortality in infants.
We conducted 2 retrospective case-control analyses of infants born in Washington State from 1987 to 2004 using linked birth certificate, death certificate and hospital discharge records. One assessed morbidity--infants hospitalized due to IDs within 1 year of birth (47,404 cases/48,233 controls). The second assessed mortality--infants who died within 1 year due to IDs (627 cases/2730 controls).
Maternal smoking was associated with both hospitalization (adjusted odds ratio [AOR] = 1.52; 95% confidence interval [CI]: 1.46, 1.58) and mortality (AOR = 1.51; 95% CI: 1.17, 1.96) due to any ID. In subgroup analyses, maternal smoking was associated with hospitalization due to a broad range of IDs including both respiratory (AOR = 1.69; 95% CI: 1.63, 1.76) and nonrespiratory IDs (AOR = 1.27; 95% CI: 1.20, 1.34). Further stratification by birth weight and gestational age did not appreciably change these estimates. In contrast, there was no association of maternal smoking with ID infant mortality when only low birth weight infants were considered.
Maternal smoking was associated with a broad range of both respiratory and nonrespiratory ID outcomes. Despite attenuation of the mortality association among low birth weight infants, ID hospitalization was found to be independent of both birth weight and gestational age. These findings suggest that full-term infants of normal weight whose mothers smoked may suffer an increased risk of serious ID morbidity and mortality.
母亲吸烟与婴儿呼吸道感染以及低出生体重儿和早产的风险增加有关。本研究评估了母亲在怀孕期间吸烟与婴儿呼吸道和非呼吸道传染病（ID）发病率和死亡率之间的关系。
我们使用链接的出生证明、死亡证明和住院记录，对 1987 年至 2004 年在华盛顿州出生的婴儿进行了 2 项回顾性病例对照分析。一项评估了发病率-出生后 1 年内因 ID 住院的婴儿（47404 例/48233 例对照）。第二项评估了死亡率-1 年内因 ID 死亡的婴儿（627 例/2730 例对照）。
母亲吸烟与因任何 ID 导致的住院（校正优势比[OR] = 1.52；95%置信区间[CI]：1.46，1.58）和死亡（OR = 1.51；95% CI：1.17，1.96）均相关。在亚组分析中，母亲吸烟与广泛的 ID 住院相关，包括呼吸道（OR = 1.69；95% CI：1.63，1.76）和非呼吸道 ID（OR = 1.27；95% CI：1.20，1.34）。按出生体重和胎龄进一步分层并没有显著改变这些估计值。相比之下，当仅考虑低出生体重儿时，母亲吸烟与 ID 婴儿死亡率之间没有关联。
母亲吸烟与广泛的呼吸道和非呼吸道 ID 结局有关。尽管在低出生体重儿中，与死亡率的关联减弱，但 ID 住院与出生体重和胎龄无关。这些发现表明，母亲吸烟的正常体重足月婴儿可能面临严重 ID 发病率和死亡率增加的风险。
