Department of Public Health, School of Health Sciences, University of Eastern Africa, Baraton, Eldoret 30100, Kenya.
International Ph.D. Program in Environmental Science and Technology, Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan.
Int J Environ Res Public Health. 2018 Jul 4;15(7):1409. doi: 10.3390/ijerph15071409.
The adverse health effects of exposure to environmental tobacco smoke (ETS) on children are well-documented, and yet, gender difference in low birthweight among newborns whose mothers were exposed to ETS during pregnancy still remains contentious. We therefore explored the association between ETS exposure and risk of low birthweight, and further determined the gender difference in the association between exposure to ETS during pregnancy and birth weight in Africa. The Demographic Health Surveys of 23 African countries with information on 208,027 newborns were used. The associations between exposure to ETS and birth weight was estimated using multiple logistic regression models. Exposure to ETS increased the risk of low birthweight in Africa (adjusted odds ratio (OR) = 1.06; 95% Confidence Interval (CI): 1.02⁻1.10). A stratified analysis, by gender, revealed that male newborns whose mothers were exposed to ETS were 1.08 (95% CI: 1.02⁻1.14) times more likely to be low in birthweight than those whose mothers were not exposed, with those exposed weekly (adjusted OR = 1.17; 95% CI: 1.01⁻1.35) and daily (adjusted OR = 1.06; 95% CI: 1.01⁻1.12) being more likely to have low birthweight. Exposure to ETS is significantly associated with low birthweight in Africa, mainly among male newborns. Gender could possibly be a modifier, and hence, research on biological plausibility is necessary. Moreover, a public health promotion on behavioral changes is likely to have a positive impact on newborns’ health.
环境烟草烟雾（ETS）暴露对儿童健康的不良影响已有充分记录，但母亲在怀孕期间暴露于 ETS 的新生儿中低出生体重的性别差异仍存在争议。因此，我们探讨了 ETS 暴露与低出生体重风险之间的关联，并进一步确定了在非洲，怀孕期间暴露于 ETS 与出生体重之间的关联存在性别差异。本研究使用了 23 个非洲国家的人口健康调查数据，这些国家的信息涵盖了 208027 名新生儿。使用多因素逻辑回归模型来估计 ETS 暴露与出生体重之间的关联。结果显示，在非洲，暴露于 ETS 会增加低出生体重的风险（调整后的优势比（OR）=1.06；95%置信区间（CI）：1.02-1.10）。按性别分层分析显示，母亲暴露于 ETS 的男婴比母亲未暴露于 ETS 的男婴低出生体重的可能性高 1.08 倍（95%CI：1.02-1.14），每周暴露（调整后的 OR=1.17；95%CI：1.01-1.35）和每天暴露（调整后的 OR=1.06；95%CI：1.01-1.12）的男婴更有可能低出生体重。在非洲，ETS 暴露与低出生体重显著相关，主要是在男婴中。性别可能是一个修饰因素，因此需要进行生物学合理性的研究。此外，开展关于行为改变的公共卫生宣传可能会对新生儿的健康产生积极影响。
