School of Advanced Agricultural Sciences, Peking University, Beijing 100871, China.
The college of Economics and Business administration, Jiangxi Agricultural University, Nanchang 330029, China.
Int J Environ Res Public Health. 2018 Dec 14;15(12):2866. doi: 10.3390/ijerph15122866.
There is a substantial body of evidence supporting the association between maternal active smoking during pregnancy and child development, but the association between prenatal exposure to environmental tobacco smoke (ETS) and early child development has not been well documented. This cross-sectional study examines the association between prenatal exposure to ETS and the development of children in their first two years of life.
We interviewed the primary caregivers of 446 children under two years old in rural Guizhou Province, China. Based on self-reported assessments about whether the mother was exposed to ETS during pregnancy, we divided the children into the ETS-exposed group or the non-exposed group. Sociodemographic information was collected through a questionnaire. The cognitive, language, motor, and socioemotional abilities of children were assessed using the Bayley Scales of Infant Development III (BSID-III). A multivariate linear regression model adjusting for confounding variables was used to estimate the association of interest.
About 60% of mothers experienced ETS exposure during pregnancy. Cognitive and language scores were lower among children in the ETS-exposed group. When adjusting for characteristics of the child, the mother, the household, and village fixed effects, prenatal exposure to ETS was associated with lower cognition scores (-3.41; 95% confidence interval (CI): -6.39 to -0.42; = 0.03) and language scores (-3.01; 95% CI: -5.39 to -0.09; = 0.04). Frequency of prenatal exposure to ETS was also negatively associated with language development (-0.48; 95% CI: -0.87 to -0.09; = 0.02) before children reached two years old.
Prenatal exposure to ETS is negatively associated with the cognitive and language development of rural young children within their first two years of life. The government should take action to raise public awareness about the negative effects of tobacco use, with an emphasis on the protection of pregnant women and their children, in order to carry through comprehensive smoke-free laws in rural areas, while also increasing tobacco taxation.
有大量证据表明，母亲在怀孕期间吸烟与儿童发育之间存在关联，但产前接触环境烟草烟雾（ETS）与儿童早期发育之间的关联尚未得到充分记录。本横断面研究旨在探讨产前接触 ETS 与儿童生命头两年发育之间的关系。
我们对中国贵州省农村地区 446 名两岁以下儿童的主要照顾者进行了访谈。根据母亲在怀孕期间是否接触 ETS 的自我报告评估，我们将儿童分为 ETS 暴露组或非暴露组。通过问卷收集社会人口学信息。使用贝利婴幼儿发展量表第三版（BSID-III）评估儿童的认知、语言、运动和社会情感能力。采用多元线性回归模型调整混杂因素，估计感兴趣的关联。
约 60%的母亲在怀孕期间接触过 ETS。暴露于 ETS 的儿童认知和语言得分较低。在调整儿童、母亲、家庭和村庄固定效应的特征后，产前接触 ETS 与认知得分较低（-3.41；95%置信区间（CI）：-6.39 至-0.42； = 0.03）和语言得分较低（-3.01；95% CI：-5.39 至-0.09； = 0.04）相关。产前接触 ETS 的频率也与儿童在两岁前的语言发展呈负相关（-0.48；95% CI：-0.87 至-0.09； = 0.02）。
产前接触 ETS 与农村幼儿生命头两年的认知和语言发育呈负相关。政府应采取行动，提高公众对烟草使用负面影响的认识，重点保护孕妇及其子女，以在农村地区实施全面禁烟法律，同时增加烟草税。
