Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health and.
Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Clin J Am Soc Nephrol. 2017 Feb 7;12(2):253-260. doi: 10.2215/CJN.05980616. Epub 2016 Dec 22.
Smoking is a well known risk factor of proteinuria in adults; however, clinical studies in children are limited. The purpose of this study is to clarify the associations of maternal smoking during pregnancy and household smoking after the child's birth with the risk of proteinuria at age 3 years old.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a population-based retrospective cohort study on 44,595 children using data on prenatal health checkups, home visit neonatal health checkups, and health checkups at 4, 9, and 18 months and 3 years of age in Kobe City, Japan. Maternal smoking status (nonsmoker, past smoker, or current smoker) was collected with standardized questionnaires. The outcome of interest was the presence of proteinuria at 3 years of age defined as urinary protein ≥1+. To evaluate the association between child proteinuria and smoking status, we performed multivariate logistic regression model analyses adjusted for confounding factors.
The prevalence rates of children in the maternal smoking groups (none, past, and current) were 78.9%, 4.4%, and 16.7%, respectively. The frequencies of child proteinuria defined as ≥1+ urinary protein were 1.7% in the current smoking group, 1.6% in the past smoking group, and 1.3% in the nonsmoking group. Maternal smoking during pregnancy was associated with child proteinuria (odds ratio, 1.24; 95% confidence interval, 1.00 to 1.52; P=0.05) in the multiple logistic regression model, although nonmaternal family smoking during pregnancy was not significantly associated with child proteinuria (odds ratio, 0.97; 95% confidence interval, 0.79 to 1.19; P=0.77). We also found a similar association with household smoking after the child's birth (odds ratio, 1.23; 95% confidence interval, 0.99 to 1.54; P=0.06), although this observation was not significant.
Maternal smoking during pregnancy was one of the risk factors of childhood proteinuria. We also found a similar association with household smoking after the child's birth, although this observation was not significant.
吸烟是成人蛋白尿的一个已知危险因素；然而，儿童的临床研究有限。本研究的目的是阐明母亲怀孕期间吸烟和孩子出生后家庭吸烟与 3 岁时蛋白尿风险之间的关系。
设计、地点、参与者和测量方法：我们使用日本神户市产前健康检查、家庭访视新生儿健康检查以及 4、9、18 个月和 3 岁健康检查的数据，对 44595 名儿童进行了一项基于人群的回顾性队列研究。母亲吸烟状况（不吸烟者、过去吸烟者或当前吸烟者）通过标准化问卷收集。研究的结局是 3 岁时蛋白尿的存在，定义为尿蛋白≥1+。为了评估儿童蛋白尿与吸烟状况之间的关系，我们进行了多变量逻辑回归模型分析，并调整了混杂因素。
在母亲吸烟组（不吸烟、过去吸烟和当前吸烟）中，儿童的患病率分别为 78.9%、4.4%和 16.7%。在当前吸烟组、过去吸烟组和不吸烟组中，定义为≥1+尿蛋白的儿童蛋白尿频率分别为 1.7%、1.6%和 1.3%。在多变量逻辑回归模型中，母亲怀孕期间吸烟与儿童蛋白尿相关（比值比，1.24；95%置信区间，1.00 至 1.52；P=0.05），而怀孕期间非母亲家庭吸烟与儿童蛋白尿无显著相关性（比值比，0.97；95%置信区间，0.79 至 1.19；P=0.77）。我们还发现了与儿童出生后家庭吸烟类似的关联（比值比，1.23；95%置信区间，0.99 至 1.54；P=0.06），尽管这一观察结果并不显著。
母亲怀孕期间吸烟是儿童蛋白尿的危险因素之一。我们还发现了与儿童出生后家庭吸烟类似的关联，尽管这一观察结果并不显著。
