Dior Uri P, Lawrence Gabriella M, Sitlani Colleen, Enquobahrie Daniel, Manor Orly, Siscovick David S, Friedlander Yechiel, Hochner Hagit
Department of Obstetrics and Gynecology, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel; Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
Braun School of Public Health, The Hebrew University-Hadassah Medical Center, P.O.B. 12272, Jerusalem 91120, Israel.
Atherosclerosis. 2014 Aug;235(2):430-7. doi: 10.1016/j.atherosclerosis.2014.05.937. Epub 2014 Jun 3.
To examine the association of maternal and/or paternal smoking during pregnancy with offspring cardio-metabolic risk (CMR) factors at adolescence and early adulthood, taking into account socio-demographic, medical and lifestyle characteristics of parents and offspring, as well as offspring common genetic variation.
We used a population-based cohort of all 17 003 births in Jerusalem during 1974-76, with available archival data on parental and birth characteristics. Measurements at age 17 were assessed at military induction examinations for 11 530 offspring. 1440 offspring from the original 1974-1976 birth cohort were sampled using a stratified sampling approach, and were interviewed and examined at age 32. Parental smoking during pregnancy (i.e. maternal, paternal and any parent) was primarily defined dichotomously (any number of cigarettes smoked daily by mother or father during pregnancy vs. non-smokers). Additionally, smoking was assessed by quantity of cigarettes smoked daily. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with various offspring CMR factors, after controlling for potential confounders and for genetic variation in candidate genes.
Prevalence of exposure to parental smoking in-utero (i.e. smoking of any parent) was 53.2% and 48.4% among the 17 years old and 32 years old samples, respectively. At age 17, smoking of at least one parent during pregnancy was significantly associated with weight (B = 1.39), height (B = 0.59), BMI (B = 0.32) and pulse rate (B = -0.78) (p-values < 0.001). At age 32, parental smoking, adjusted for covariates, was associated with 2.22 kg higher mean offspring weight, 0.95 cm higher mean offspring height, 0.57 kg/m(2) higher BMI, and 1.46 cm higher waist-circumference (p-values ≤ 0.02). Similar results, reflecting a dose response, were observed when maternal and paternal smokings were assessed by number of cigarettes smoked daily.
This prospective study demonstrates a potential long-term adverse effect of parental smoking during pregnancy on offspring health and calls for increasing efforts to promote smoking cessation of both parents before pregnancy.
考虑父母及子代的社会人口学、医学和生活方式特征以及子代常见基因变异，研究孕期母亲和/或父亲吸烟与子代青春期和成年早期心脏代谢风险（CMR）因素之间的关联。
我们使用了一个基于人群的队列，该队列涵盖了1974 - 1976年在耶路撒冷出生的所有17003例婴儿，并拥有关于父母和出生特征的存档数据。对11530名子代在17岁时进行军事入伍体检时进行测量评估。采用分层抽样方法从1974 - 1976年出生队列的原始样本中抽取1440名子代，并在他们32岁时进行访谈和检查。孕期父母吸烟情况（即母亲、父亲及任何一方父母吸烟）主要采用二分法定义（孕期母亲或父亲每天吸烟的数量与不吸烟者）。此外，根据每日吸烟量评估吸烟情况。在控制潜在混杂因素和候选基因的基因变异后，使用线性回归模型评估孕期父母吸烟与子代各种CMR因素之间的关联。
在17岁和32岁的样本中，子宫内暴露于父母吸烟（即任何一方父母吸烟）的患病率分别为53.2%和48.4%。在17岁时，孕期至少有一方父母吸烟与体重（B = 1.39）、身高（B = 0.59）、体重指数（BMI）（B = 0.32）和脉搏率（B = -0.78）显著相关（p值<0.001）。在子代32岁时，经协变量调整后，父母吸烟与子代平均体重高2.22千克、平均身高高0.95厘米、BMI高0.57千克/平方米以及腰围高1.46厘米相关（p值≤0.02）。当根据每日吸烟量评估母亲和父亲吸烟情况时，观察到了反映剂量反应的类似结果。
这项前瞻性研究表明孕期父母吸烟对后代健康具有潜在的长期不良影响，并呼吁加大力度促进父母在怀孕前戒烟。
