EPIUnit, Institute of Public Health, University of Porto, Portugal.
Nicotine Tob Res. 2018 May 3;20(6):674-680. doi: 10.1093/ntr/ntx117.
Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children.
We evaluated 4295 of Generation XXI children, recruited at birth in 2005-2006 and reevaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records. At 4-year follow-up, interviews were performed and children's BP measured. Linear regression models were fitted to estimate the association between maternal smoking and children's BP.
Children of smoking mothers presented significantly higher BP levels. After adjustment for maternal education, gestational hypertensive disorders, and child's body mass index, children exposed during pregnancy to maternal smoking presented a higher systolic BP (SBP) z-score (β = 0.08, 95% confidence interval [CI] 0.04 to 0.14). In crude models, maternal smoking was associated with higher SBP z-score at every assessed period. However, after adjustment, an attenuation of the association estimates occurred (β = 0.08, 95% CI 0.03 to 0.13 before conception; β = 0.07, 95%CI 0.02 to 0.12; β = 0.04, 95%CI -0.02 to 0.10; and β = 0.06, 95%CI 0.00 to 0.13 for the first, second, and third pregnancy trimesters, respectively; and β = 0.07, 95%CI 0.02 to 0.12 for current maternal smoking). No significant association was observed for diastolic BP z-score levels.
Maternal smoking before, during, and after pregnancy was independently associated with systolic BP z-score in preschool children. This study provides additional evidence to the public health relevance of maternal smoking cessation programs if early cardiovascular health of children is envisaged.
Using observational longitudinal data from the birth cohort Generation XXI, this study showed that exposure to maternal smoking-before pregnancy, during pregnancy, and 4 years after delivery-was associated with a systolic BP-raising effect in children at the age of 4. The findings of this study add an important insight into the need to support maternal smoke-free environments in order to provide long-term cardiovascular benefit, starting as early as possible in life.
生命早期接触母体吸烟可能会影响血压（BP）控制机制。我们研究了母体吸烟（受孕前、怀孕期间和分娩后 4 年）与学龄前儿童 BP 之间的关系。
我们评估了 2005-2006 年出生的 4295 名 XXI 世代儿童，并在 4 岁时进行了重新评估。在出生时，通过面对面访谈收集信息，并从临床记录中补充信息。在 4 年的随访中，进行了访谈并测量了儿童的 BP。拟合线性回归模型来估计母亲吸烟与儿童 BP 之间的关联。
母亲吸烟的儿童的 BP 水平明显较高。在校正母亲教育、妊娠期高血压疾病和儿童体重指数后，怀孕期间暴露于母亲吸烟的儿童的收缩压（SBP）Z 评分升高（β=0.08，95%置信区间[CI]0.04 至 0.14）。在原始模型中，母亲吸烟与每个评估期的 SBPZ 评分升高相关。然而，在调整后，关联估计值减弱（受孕前β=0.08，95%CI0.03 至 0.13；β=0.07，95%CI0.02 至 0.12；β=0.04，95%CI-0.02 至 0.10；β=0.06，95%CI0.00 至 0.13 分别为第一、第二和第三个妊娠三个月；当前母亲吸烟β=0.07，95%CI0.02 至 0.12）。舒张压 Z 评分水平无显著相关性。
受孕前、怀孕期间和分娩后母亲吸烟与学龄前儿童的 SBPZ 评分独立相关。本研究提供了额外的证据，表明如果考虑儿童的早期心血管健康，那么停止母亲吸烟的公共卫生相关计划是有意义的。
利用 XXI 世代出生队列的观察性纵向数据，本研究表明，暴露于母体吸烟（受孕前、怀孕期间和分娩后 4 年）与儿童 4 岁时的 SBP 升高有关。本研究的发现为需要支持母亲无烟环境提供了一个重要的见解，以便尽早开始为生命提供长期心血管益处。
