Weitzman M, Gortmaker S, Walker D K, Sobol A
Department of Pediatrics, Boston City Hospital, MA 02118.
Pediatrics. 1990 Apr;85(4):505-11.
According to a substantial literature, passive smoking by children is associated with an increased incidence of lower respiratory illness and diminished pulmonary function. The relationship between passive smoking and childhood asthma, however, is not clear. Data from the Child Health Supplement to the 1981 National Health Interview Survey were analyzed with information about 4331 children aged 0 to 5 years to study the relationship between maternal smoking and (1) the prevalence of childhood asthma, (1) the likelihood of taking asthma medication, (3) the age of onset of children's asthma, and (4) the number of hospitalizations among children with and without asthma. An odds ratio for asthma of 2.1 was shown by multivariate logistic regressions among children whose mothers smoke 0.5 packs of cigarettes or more per day compared with children of nonsmokers (P = .001). In similar analyses maternal smoking of 0.5 packs per day was identified as an independent risk for children's use of asthma medications (odds ratio 4.6, P = .0006) and for asthma developing in the first year of life (odds ratio 2.6, P = .0006). Maternal smoking is also associated with increased numbers of hospitalizations by its association with an increased risk of asthma as well as by contributing to hospitalizations independently of a child having asthma. Among children with asthma, however, maternal smoking is not associated with increased numbers of hospitalizations. It was concluded that maternal smoking is associated with higher rates of asthma, an increased likelihood of using asthma medications, and an earlier onset of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)
大量文献表明,儿童被动吸烟与下呼吸道疾病发病率增加及肺功能下降有关。然而,被动吸烟与儿童哮喘之间的关系尚不清楚。对1981年全国健康访谈调查儿童健康补充资料中的数据进行了分析,这些数据涉及4331名0至5岁儿童,以研究母亲吸烟与以下方面的关系:(1)儿童哮喘患病率;(2)使用哮喘药物的可能性;(3)儿童哮喘发病年龄;(4)有哮喘和无哮喘儿童的住院次数。多因素逻辑回归显示,与不吸烟母亲的孩子相比,母亲每天吸烟半包或更多的孩子患哮喘的比值比为2.1(P = .001)。在类似分析中,母亲每天吸烟半包被确定为儿童使用哮喘药物的独立危险因素(比值比4.6,P = .0006)以及儿童在出生第一年患哮喘的独立危险因素(比值比2.6,P = .0006)。母亲吸烟还与住院次数增加有关,这既与哮喘风险增加有关,也与独立于孩子是否患有哮喘导致住院有关。然而,在患有哮喘的儿童中,母亲吸烟与住院次数增加无关。研究得出结论,母亲吸烟与哮喘发病率较高、使用哮喘药物的可能性增加以及疾病发病较早有关。(摘要截选至250字)