Dan Nadav, Sheiner Eyal, Wainstock Tamar, Marks Kyla, Kessous Roy
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Perinatol. 2021 Jan;38(2):166-170. doi: 10.1055/s-0039-1695773. Epub 2019 Sep 6.
Infectious diseases account for up to 43% of childhood hospitalizations. Given the magnitude of infection-related hospitalizations, we aimed to evaluate the effect of maternal smoking during pregnancy on the risk for long-term childhood infectious morbidity.
This is a population-based cohort analysis comparing the long-term risk for infectious diseases, in children born to mothers who smoked during pregnancy versus those who did not. Infectious diseases were predefined based on International Classification of Diseases, Ninth Revision codes. Deliveries occurred between the years 1991 and 2014.
A total of 246,854 newborns met the inclusion criteria; 2,986 (1.2%) were born to mothers who smoked during pregnancy. Offspring of smokers had significantly higher risk for several infectious diseases during childhood (upper respiratory tract, otitis, viral infections, and bronchitis) as well as increased risk for total infection-related hospitalizations (odds ratio = 1.5, 95% confidence interval [CI]: 1.3-1.7; = 0.001). Cumulative incidence of infection-related hospitalizations was significantly higher in offspring of smokers (log-rank test, = 0.001). Controlling for maternal age, diabetes, hypertensive disorders, and gestational age at index delivery, smoking remained an independent risk factor for infectious diseases during childhood (adjusted hazard ratio = 1.5, 95% CI: 1.3-1.6; = 0.001).
Intrauterine exposure to maternal smoking may create an environment leading to an increased future risk for long-term pediatric infectious morbidity of the offspring.
传染病占儿童住院病例的比例高达43%。鉴于与感染相关的住院病例数量众多，我们旨在评估孕期母亲吸烟对儿童长期感染性疾病发病风险的影响。
这是一项基于人群的队列分析，比较孕期吸烟母亲所生儿童与非吸烟母亲所生儿童患传染病的长期风险。传染病根据《国际疾病分类》第九版编码预先定义。分娩发生在1991年至2014年之间。
共有246,854名新生儿符合纳入标准；2,986名（1.2%）为孕期吸烟母亲所生。吸烟者的后代在儿童期患几种传染病（上呼吸道感染、中耳炎、病毒感染和支气管炎）的风险显著更高，且与感染相关的住院总风险也增加（优势比=1.5，95%置信区间[CI]：1.3 - 1.7；P = 0.001）。吸烟者后代与感染相关的住院累积发病率显著更高（对数秩检验，P = 0.001）。在控制母亲年龄、糖尿病、高血压疾病以及本次分娩时的孕周后，吸烟仍然是儿童期传染病的独立风险因素（调整后的风险比=1.5，95% CI：1.3 - 1.6；P = 0.001）。
子宫内暴露于母亲吸烟可能会营造一种环境，导致后代未来患儿童长期感染性疾病的风险增加。
