Shenoy Rathika Damodara, Sindgikar Seema Pavaman, Shenoy Vijaya, Uppoor Raghuraja, Rao Raghavendra, Singh Shalini
Department of Paediatrics, KS Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India.
Department of Radiodiagnosis, KS Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India.
Indian J Community Med. 2020 Jan-Mar;45(1):54-59. doi: 10.4103/ijcm.IJCM_195_19.
Women constitute a significant labor pool in the Indian tobacco industry as bidi (hand-rolled cigarette) rollers. On an average, they roll around 600 bidis/day and are exposed to 120 g of tobacco and 3 g of nicotine. Bidis do not have chemical preservatives or stabilizing agents, and therefore, the rollers are exposed only to nicotine by handling and inhalation. The study objective was to assess pregnancy outcome in these women with occupational tobacco exposure.
A prospective cohort study of bidi-rollers ( = 177) and women with no tobacco exposure ( = 354), followed up for pregnancy outcome, neonatal anthropometry, and nicotine absorption by cotinine assays. Adjusted risk and adjusted mean differences with a 95% confidence interval were derived.
Outcomes included increased adjusted risk for gestational hypertension (3.54 [1.21, 10.31]; = 0.021) and fetal growth restriction (2.71 [1.39, 5.29]; = 0.004). Risk for prematurity was not statistically significant (1.81 [0.74, 4.45]; = 0.194). Lower adjusted mean difference of birth weight (-104 g [-177, -31]; = 0.005), length (-0.4 cm [-0.8, -0.1]; = 0.006), and head circumference (-0.4 cm [-0.6, -0.1]; = 0.002) were seen with increased risk for small for gestational age (1.75 [1.12, 2.73]; = 0.015). Nicotine absorption was evident in one-third of maternal and cord blood estimations.
Occupational passive tobacco exposure results in adverse pregnancy outcome.
在印度烟草行业，妇女作为比迪烟（手工卷烟）卷制工人构成了重要的劳动力群体。她们平均每天卷制约600支比迪烟，接触120克烟草和3克尼古丁。比迪烟没有化学防腐剂或稳定剂，因此，卷制工人仅通过处理和吸入接触尼古丁。本研究的目的是评估这些职业性接触烟草的妇女的妊娠结局。
一项对比迪烟卷制工人（n = 177）和无烟草接触的妇女（n = 354）的前瞻性队列研究，随访妊娠结局、新生儿人体测量指标，并通过可替宁测定评估尼古丁吸收情况。得出调整风险和调整平均差异及95%置信区间。
结局包括妊娠高血压调整风险增加（3.54 [1.21, 10.31]；P = 0.021）和胎儿生长受限（2.71 [1.39, 5.29]；P = 0.004）。早产风险无统计学意义（1.81 [0.74, 4.45]；P = 0.194）。出生体重（-104克 [-177, -31]；P = 0.005）、身长（-0.4厘米 [-0.8, -0.1]；P = 0.006）和头围（-0.4厘米 [-0.6, -0.1]；P = 0.002）的调整平均差异较低，同时小于胎龄儿风险增加（1.75 [1.12, 2.73]；P = 0.015）。三分之一的母体和脐带血检测中可见尼古丁吸收。
职业性被动接触烟草会导致不良妊娠结局。
