Werhmeister F C, Nunes B P, Loret de Mola C, Gómez-Cofré N, de Oliveira P D, Marco P L, Assunção M C F, Gonçalves H, Horta B L, Menezes A M B
Post-Graduate Program in Epidemiology,Federal University of Pelotas,Pelotas,Brazil.
J Dev Orig Health Dis. 2015 Jun;6(3):217-24. doi: 10.1017/S2040174414000555. Epub 2014 Nov 18.
Previous studies have suggested an association between maternal smoking during pregnancy and asthma symptoms such as wheezing during childhood. However, few have evaluated this association in adolescence, especially in populations with high prevalence of wheezing as in Brazil. Using the 1993 Pelotas birth cohort, a longitudinal study set in southern Brazil of 5249 urban live births, we aimed to evaluate the association between maternal and the partner's smoking during pregnancy and wheezing at 11 and 15 years of age. We evaluated smoking during pregnancy using number of cigarettes/day, and our main outcomes were as follows: wheezing in the last year and number of wheezing crises, at both 11 and 15 years of age, as well as persistent wheezing (having crises at 11 and 15 years of age) and medical asthma diagnosis at age 15. In addition, other socio-demographic variables were included as possible confounders and mediators of this association. We used Poisson regression models to evaluate crude and adjusted associations. Of the 5249 live births in 1993, 87.5% and 85.7% were followed-up to 11 and 15 years of age, respectively. Maternal smoking during pregnancy showed a dose-response association with number of wheezing crises at age 15 (P = 0.023), presence of persistent wheezing (P = 0.034) and asthma diagnosis (P = 0.023). Partner's smoking was not associated with any wheezing variables. Maternal smoking during pregnancy appears to exert an effect on respiratory morbidity of adolescents, evaluated by wheezing symptoms.
以往的研究表明，孕期母亲吸烟与儿童期哮喘症状（如喘息）之间存在关联。然而，很少有研究评估这种关联在青少年期的情况，尤其是在像巴西这样喘息患病率较高的人群中。利用1993年佩洛塔斯出生队列研究，这是一项在巴西南部对5249例城市活产儿进行的纵向研究，我们旨在评估孕期母亲及伴侣吸烟与11岁和15岁时喘息之间的关联。我们根据每日吸烟量评估孕期吸烟情况，我们的主要结局如下：11岁和15岁时过去一年的喘息情况、喘息发作次数、持续性喘息（11岁和15岁时均有发作）以及15岁时的医学哮喘诊断。此外，还纳入了其他社会人口学变量作为这种关联可能的混杂因素和中介因素。我们使用泊松回归模型评估粗关联和调整关联。在1993年的5249例活产儿中，分别有87.5%和85.7%随访至11岁和15岁。孕期母亲吸烟与15岁时的喘息发作次数（P = 0.023）、持续性喘息的存在（P = 0.034）和哮喘诊断（P = 0.023）呈剂量反应关联。伴侣吸烟与任何喘息变量均无关联。孕期母亲吸烟似乎对青少年的呼吸道发病率有影响，这通过喘息症状来评估。
