Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee.
Department of Biological Sciences, University of Memphis, Memphis, Tennessee.
Clin Exp Allergy. 2018 Dec;48(12):1688-1697. doi: 10.1111/cea.13294.
Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema.
Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence.
We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements.
If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation.
Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
香烟烟雾中含有与煤焦油类似的化合物，煤焦油是古代治疗湿疹的药物。一些研究报告了母亲妊娠期吸烟对后代湿疹的保护作用；然而，其他研究则表明没有保护作用或增加了风险。同样，将母乳喂养持续时间与湿疹联系起来的研究也得出了相互矛盾的结论。目前尚无研究调查这两个因素的综合作用对湿疹的影响。
由于烟草化合物可以通过母乳传递给后代，我们研究了它们在儿童期到青春期对湿疹发展的综合影响。
我们从英国怀特岛（IOW）出生队列中获得了 1 岁或 2 岁、4 岁、10 岁和 18 岁时的妊娠期吸烟、纯母乳喂养持续时间和湿疹信息。使用广义估计方程，我们在校正混杂因素后，评估了妊娠期吸烟和剩余纯母乳喂养持续时间（通过回归后者获得）随时间对湿疹的交互作用。对于 1 岁或 2 岁至 4 岁、4 岁至 10 岁和 10 岁至 18 岁的三个过渡阶段，我们使用重复测量来估计与交互作用相关的持续性、新发和缓解性湿疹的风险。
如果母亲在妊娠期吸烟，与不吸烟相比，剩余纯母乳喂养时间较长与湿疹风险较低相关。如果母亲在妊娠期吸烟且至少纯母乳喂养 3、9、15、21 周，那么风险比（95%CI）分别为 0.7（0.6，1.7）、0.6（0.4，0.9）、0.5（0.3，0.8）和 0.4（0.2，0.8）。此外，在所有三个过渡阶段，如果母亲在妊娠期吸烟，那么剩余纯母乳喂养时间较长与持续性湿疹的风险较低相关。
结果表明，妊娠期吸烟与纯母乳喂养持续时间较长相结合对早期持续性湿疹有保护作用。未来的研究应探讨潜在的生物学机制。即使母亲在妊娠期吸烟，也应鼓励延长母乳喂养时间。
