Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands.
PLoS One. 2019 Jun 20;14(6):e0218577. doi: 10.1371/journal.pone.0218577. eCollection 2019.
There is limited evidence on the effect of exposure to second hand smoke (SHS) in non-smoking pregnant mothers and infant health. We assessed the effects of maternal antenatal exposure to SHS on infant growth rate, and secondarily, on birth weight, birth length and head circumference at birth.
In this prospective cohort, 305 mother-infant pairs were studied. Mothers filled out questionnaires about exposure to SHS in pregnancy at the 3rd trimester of pregnancy. Infant anthropometry was performed at birth, day 7, and months 1, 2, 4, and 6, postnatally. Linear mixed modeling and linear regression were used to calculate growth rates over the first 6 months. The association between SHS-exposure with growth rate and birth sizes was assessed using multivariate linear regression adjusted for confounders, with SHS as both number of cigarettes and as groups (no exposure, SHS < 23 cigarettes, SHS ≥ 23 cigarettes).
Seventy-three mothers were not exposed and 232 were exposed. SHS exposure (per cigarette) was not related to gain in weight, length, head circumference, and weight for length. However, infants born to mothers exposed to ≥ 23 cigarettes/d had lower head circumference gain (-0.32 mm/m, 95% CI -0.60, -0.03) than those born to non-exposed mothers. SHS exposure (per cigarette) was not related to birth weight, length, and head circumference, but exposure to ≥ 23 cigarettes was related to lower head circumference at birth (-11.09 mm, -20.03, -2.16).
Heavy antenatal exposure to SHS in non-smoking mothers results in reduced neonatal head circumference at birth and head circumference gain over the first 6 months of life. Our findings show no clear relations between exposure to SHS during pregnancy and other markers of neonatal growth and birth size.
关于二手烟（SHS）暴露对非吸烟孕妇及其婴儿健康的影响，目前仅有有限的证据。本研究评估了母亲产前接触 SHS 对婴儿生长速度的影响，其次还评估了其对出生体重、出生长度和头围的影响。
本前瞻性队列研究纳入了 305 对母婴。母亲在妊娠 3 期时填写了关于孕期接触 SHS 的问卷。在产后第 1、2、4 和 6 个月，对婴儿进行了体格测量。使用线性混合模型和线性回归来计算出生后前 6 个月的生长速度。使用多元线性回归，根据混杂因素调整，将 SHS 作为香烟数量和分组（无暴露、暴露于 SHS<23 支/天、暴露于 SHS≥23 支/天），评估 SHS 暴露与生长速度和出生大小的关系。
73 名母亲未暴露，232 名母亲暴露。与未暴露组相比，每支烟 SHS 暴露（per cigarette）与体重、长度、头围和体重-长度比值的增长均无关。但是，与未暴露母亲相比，母亲暴露于≥23 支/天的婴儿头围增长较慢（-0.32mm/月，95%CI-0.60，-0.03）。每支烟 SHS 暴露与出生体重、长度和头围无关，但暴露于≥23 支/天与出生时头围较小有关（-11.09mm，-20.03，-2.16）。
非吸烟母亲产前大量接触 SHS 会导致新生儿出生时头围较小，出生后前 6 个月头围增长较慢。本研究结果表明，孕妇在孕期接触 SHS 与其他新生儿生长和出生大小的标志物之间没有明确的关系。
