Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan.
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Sci Total Environ. 2019 Mar 10;655:141-146. doi: 10.1016/j.scitotenv.2018.11.194. Epub 2018 Nov 14.
Kawasaki disease is the leading cause of acquired childhood heart disease in most developed countries, but the etiology of the disease is unknown. An aberrant immune response to some environmental triggers may play a role and involuntary exposure to tobacco smoke can alter immune functions. We thus prospectively examined the association between early childhood exposure to maternal smoking and the incidence of Kawasaki disease. We used a large, nationwide population-based longitudinal survey ongoing since 2010 and restricted participants to a total of 38,444 children for whom information on maternal smoking was available. Maternal smoking status was ascertained at 6months of age, and responses to questions about hospital admission for Kawasaki disease between the ages of 6 and 30months were used as outcome. We conducted binomial log-linear regression analyses adjusting for children's, parental, and residential factors with children of non-smoking mothers as our reference group. Maternal smoking increased the risk of admission, in particular for the period between 6 and 18months of age, in a dose-dependent manner. Compared with children of non-smoking mothers, the children of mothers who smoked had a risk ratio of 1.83 (95% confidence interval: 1.06, 3.35) for hospital admissions between 6 and 30months of age and a risk ratio of 2.69 (95% confidence interval: 1.56, 4.64) for hospital admissions between 6 and 18months of age. Early childhood exposure to maternal smoking may increase the risk of Kawasaki disease hospitalizations in childhood.
川崎病是大多数发达国家儿童获得性心脏病的主要病因，但病因不明。对某些环境诱因的异常免疫反应可能起作用，而被动接触烟草烟雾会改变免疫功能。因此，我们前瞻性地研究了儿童早期暴露于母亲吸烟与川崎病发病之间的关系。我们使用了一个自 2010 年以来持续进行的大型全国性基于人群的纵向调查，并将参与者限制在总共 38444 名有母亲吸烟信息的儿童中。母亲吸烟状况在 6 个月大时确定，6 至 30 个月大时因川崎病住院的信息作为结果。我们进行了二项对数线性回归分析，调整了儿童、父母和居住因素，以不吸烟母亲的孩子为参照组。母亲吸烟以剂量依赖的方式增加了住院的风险，特别是在 6 至 18 个月期间。与不吸烟母亲的孩子相比，母亲吸烟的孩子在 6 至 30 个月大期间住院的风险比为 1.83（95%置信区间：1.06，3.35），在 6 至 18 个月大期间住院的风险比为 2.69（95%置信区间：1.56，4.64）。儿童早期暴露于母亲吸烟可能会增加儿童川崎病住院的风险。
