Tanaka Keiko, Miyake Yoshihiro, Furukawa Shinya, Arakawa Masashi
Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
Nicotine Tob Res. 2017 Jul 1;19(7):804-809. doi: 10.1093/ntr/ntw299.
Epidemiological evidence regarding the effect of perinatal smoking exposure on atopic eczema in children continues to be inconclusive. The aim of this prospective prebirth cohort study was to investigate the association between prenatal smoking exposure and postnatal living with household smokers and the risk of atopic eczema in Japanese children aged 23 to 29 months.
Study subjects were 1354 Japanese mother-child pairs. Information on the variables under study was obtained through questionnaires which were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, and 24 months after delivery. Eczema in the last 12 months was defined according to the criteria of the International Study of Asthma and Allergies in Childhood. Physician-diagnosed atopic eczema was considered present if reported by mothers.
Compared with no perinatal smoking exposure, prenatal smoking exposure only was associated with an increased risk of physician-diagnosed atopic eczema (adjusted odds ratio = 7.11, 95% confidence interval: 1.43 to 27.8). Postnatal living with at least one household smoker only was not associated with the risk of physician-diagnosed atopic eczema; neither was the combination of both prenatal smoking exposure and postnatal living with at least one household smoker. No association was observed between perinatal smoking exposure status and the risk of eczema as defined according to the International Study of Asthma and Allergies in Childhood criteria.
Our findings suggest that maternal smoking during pregnancy may increase the risk of atopic eczema in young children.
In the present prebirth cohort study, we assessed the independent and additive effects of pre- and postnatal exposure to tobacco smoking on atopic eczema in children. Compared with no perinatal smoking exposure, prenatal smoking exposure only was significantly associated with an increased risk of atopic eczema. Postnatal smoking exposure only was not associated with the risk of atopic eczema; neither was the combination of both pre- and postnatal smoking exposure. This is the first epidemiological study to show a positive association between prenatal smoking exposure only and the risk of atopic eczema.
关于围产期吸烟暴露对儿童特应性皮炎影响的流行病学证据尚无定论。这项前瞻性出生前队列研究的目的是调查日本23至29个月大儿童的产前吸烟暴露、产后与家庭吸烟者共同生活情况与患特应性皮炎风险之间的关联。
研究对象为1354对日本母婴。通过母亲填写的问卷获取研究变量信息，问卷分别在分娩前、出生后不久以及分娩后约4、12和24个月填写。过去12个月内的湿疹情况根据儿童哮喘和过敏国际研究标准定义。若母亲报告医生诊断为特应性皮炎，则视为存在。
与无围产期吸烟暴露相比，仅产前吸烟暴露与医生诊断的特应性皮炎风险增加相关（调整后的优势比=7.11，95%置信区间：1.43至27.8）。仅产后与至少一名家庭吸烟者共同生活与医生诊断的特应性皮炎风险无关；产前吸烟暴露与产后与至少一名家庭吸烟者共同生活这两者的组合也与该风险无关。根据儿童哮喘和过敏国际研究标准定义的湿疹风险与围产期吸烟暴露状况之间未观察到关联。
我们的研究结果表明，孕期母亲吸烟可能会增加幼儿患特应性皮炎的风险。
在本出生前队列研究中，我们评估了产前和产后吸烟暴露对儿童特应性皮炎的独立和累加效应。与无围产期吸烟暴露相比，仅产前吸烟暴露与特应性皮炎风险增加显著相关。仅产后吸烟暴露与特应性皮炎风险无关；产前和产后吸烟暴露两者的组合也与该风险无关。这是第一项显示仅产前吸烟暴露与特应性皮炎风险呈正相关的流行病学研究。
