Määttä Anni-Julia, Paananen Markus, Marttila Riikka, Auvinen Juha, Miettunen Jouko, Karppinen Jaro
Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Nicotine Tob Res. 2017 Jul 1;19(7):797-803. doi: 10.1093/ntr/ntw325.
Smoking and behavioral problems are related to musculoskeletal (MS) pain in adolescence. Maternal smoking during pregnancy (MSDP) is associated with offspring's behavioral problems but its relation to MS pain in adolescence is unknown. Our purpose was to investigate whether there is an association between MSDP, the number of pain sites in adolescence, and the factors that potentially mediate this relationship.
We evaluated the association of MSDP with offspring's MS pain at 16 years among participants of the Northern Finland Birth Cohort 1986 (n = 6436, 3360 girls, 68% of all births) using Chi-square test and independent samples t test. We used structural equation modeling to assess the mediating factors stratified by gender.
MSDP was frequent (22%) associating with paternal smoking (p < .001), externalization problems at 8 years (p = .009 boys, p = .002 girls), offspring's smoking at 16 years (p < .001), externalizing problems at 16 years (p < .001), family's social class (p < .001) and intactness of the family status (p < .001). The mean number of offspring's MS pain sites was higher among adolescents whose mothers had smoked during pregnancy than among those whose mothers were nonsmokers (p = .002 boys, p = .012 girls). The association between MSDP and MS pain at 16 years was mediated by externalizing problems at 8 years (p < .001) and 16 years (p < 0.001).
MSDP increased the risk of offspring's MS pain in adolescence, and the association was mediated by offspring's externalizing problems during childhood and early adolescence.
This study indicates that MSDP increases the risk of MS pain in adolescence and the effect is mediated by externalizing problems. Our results add to the evidence on harmfulness of MSDP for offspring, and can be used as additional information in interventions aiming to influence MSDP.
吸烟和行为问题与青少年的肌肉骨骼疼痛有关。孕期母亲吸烟（MSDP）与后代的行为问题有关，但其与青少年肌肉骨骼疼痛的关系尚不清楚。我们的目的是研究MSDP、青少年疼痛部位数量以及可能介导这种关系的因素之间是否存在关联。
我们使用卡方检验和独立样本t检验，评估了1986年芬兰北部出生队列（n = 6436，3360名女孩，占所有出生人数的68%）参与者中MSDP与后代16岁时肌肉骨骼疼痛的关联。我们使用结构方程模型按性别分层评估中介因素。
MSDP很常见（22%），与父亲吸烟（p <.001）、8岁时的外化问题（男孩p =.009，女孩p =.002）、16岁时后代吸烟（p <.001）、16岁时的外化问题（p <.001）、家庭社会阶层（p <.001）和家庭状况完整性（p <.001）有关。母亲在孕期吸烟的青少年的后代肌肉骨骼疼痛部位的平均数量高于母亲不吸烟的青少年（男孩p =.002，女孩p =.012）。MSDP与16岁时肌肉骨骼疼痛之间的关联由8岁（p <.001）和16岁（p < 0.001）时的外化问题介导。
MSDP增加了青少年后代肌肉骨骼疼痛的风险，这种关联由儿童期和青春期早期后代的外化问题介导。
本研究表明，MSDP增加了青少年肌肉骨骼疼痛的风险，且这种影响由外化问题介导。我们的结果补充了MSDP对后代有害性的证据，并可作为旨在影响MSDP的干预措施中的额外信息。
