Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China.
Jinan Military Area CDC, Jinan, Shandong, China.
Tob Control. 2017 Nov;26(6):697-702. doi: 10.1136/tobaccocontrol-2016-053239. Epub 2016 Dec 23.
Studies of secondhand smoke (SHS) exposure especially childhood SHS exposure and pregnancy loss are limited. We used baseline data of the Guangzhou Biobank Cohort Study (GBCS) to examine the association of childhood SHS exposure with a history of pregnancy loss.
Never smoking women aged 50 years or above in GBCS from 2003 to 2008 were included. Propensity score matching (PSM) was used to control for confounding. Negative binomial regression and logistic regression were used to examine the association of childhood SHS, assessed by number of smokers in childhood household and frequency of exposure, with past pregnancy loss.
Of 19 562 women, 56.7% (11 096) had SHS exposure during childhood. In negative binomial regression, after adjusting for age, education, past occupational dust exposure, past home fuel exposure, oral contraceptive, adulthood SHS exposure, age at first pregnancy and age at first menarche, compared to non-exposure, the incidence rate ratio of one more pregnancy loss was 1.20 (95% CI1.05 to 1.37) in those who lived with ≥2 smokers in the same household, and 1.14 (95% CI 1.04 to 1.25) in those exposed ≥5 times/week. After similar adjustment, logistic regression showed that the OR of pregnancy loss ≥2 times (versus 0 to 1 time) was 1.25 (95% CI 1.00 to 1.57) and 1.20 (95% CI 1.03 to 1.40) for high density (≥2 smokers in the same household) and frequency (≥5 times/week) of childhood exposure, respectively.
Childhood SHS exposure was associated with higher risks of pregnancy loss in middle-aged and older Chinese women.
二手烟(SHS)暴露,尤其是儿童时期 SHS 暴露与妊娠丢失的研究有限。本研究利用广州生物银行队列研究(GBCS)的基线数据,探讨儿童时期 SHS 暴露与妊娠丢失史的关系。
纳入 2003 年至 2008 年 GBCS 中从未吸烟且年龄在 50 岁及以上的女性。采用倾向评分匹配(PSM)控制混杂因素。采用负二项回归和逻辑回归分析儿童时期 SHS 暴露(通过家庭中吸烟人数和暴露频率评估)与既往妊娠丢失的关系。
在 19562 名女性中,56.7%(11096 人)有儿童时期 SHS 暴露。在负二项回归中,在校正年龄、教育程度、既往职业性粉尘暴露、既往家庭燃料暴露、口服避孕药、成人时期 SHS 暴露、首次妊娠年龄和首次月经年龄后,与无暴露相比,与同住≥2 名吸烟者的女性相比,每多一次妊娠丢失的发生率比为 1.20(95%CI1.05-1.37),每周暴露≥5 次的女性为 1.14(95%CI 1.04-1.25)。在类似的调整后,逻辑回归显示,与 0 至 1 次妊娠丢失相比,≥2 次(≥2 次)和≥5 次/周(≥5 次/周)的妊娠丢失的 OR 分别为 1.25(95%CI 1.00-1.57)和 1.20(95%CI 1.03-1.40)。
儿童时期 SHS 暴露与中国中老年女性更高的妊娠丢失风险相关。