母亲吸烟是极早产儿重度早产儿视网膜病变发生的独立危险因素。
Maternal smoking as an independent risk factor for the development of severe retinopathy of prematurity in very preterm infants.
机构信息
Department of Neonatology, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany.
出版信息
Eye (Lond). 2021 Mar;35(3):799-804. doi: 10.1038/s41433-020-0963-4. Epub 2020 May 12.
BACKGROUND/OBJECTIVES: Retinopathy of prematurity (ROP) is a severe neonatal complication potentially leading to visual impairment and blindness. Known risk factors include preterm birth, low birth weight and respiratory support. Limited and contradictory data exist on the risk of maternal smoking during pregnancy on the development of ROP. This study aims to investigate smoking as an independent risk factor for the development of severe ROP (≥stage 3).
SUBJECTS/METHODS: This is a single centre retrospective case-control study of prospectively collected clinical data of infants born before 32 weeks of gestation between 2001 and 2012 at a tertiary care university hospital. The association between maternal smoking during pregnancy and the development of severe ROP was analyzed by multivariate logistic regression.
RESULTS
In total, n = 751 infants born < 32 weeks of gestation were included in this study. In total, 52.9% (n = 397) were diagnosed with ROP and 10.8% (n = 81) developed ROP ≥ stage 3. In total, 8.4% (n = 63) mothers presented with a history of smoking during pregnancy, which was associated to a higher rate of ROP (OR 2.59, 95% CI 1.10-6.12). Low gestational age, low birth weight and prolonged respiratory support were confirmed as independent risk factors for the development of severe ROP.
CONCLUSIONS
To date, this is the largest study evaluating the effect of maternal smoking on the development of ROP. Maternal smoking during pregnancy is identified as an independent risk factor for the development of severe ROP in preterm infants born < 32 weeks of gestation.
背景/目的：早产儿视网膜病变（ROP）是一种严重的新生儿并发症，可能导致视力损害和失明。已知的危险因素包括早产、低出生体重和呼吸支持。关于母亲在怀孕期间吸烟对 ROP 发展的风险，存在有限且相互矛盾的数据。本研究旨在调查吸烟是否是严重 ROP（≥3 期）发展的独立危险因素。
受试者/方法：这是一项单中心回顾性病例对照研究，对 2001 年至 2012 年间在一家三级保健大学医院出生的妊娠 32 周前早产儿前瞻性收集的临床数据进行了研究。通过多变量逻辑回归分析母亲在怀孕期间吸烟与严重 ROP 发展之间的关联。
结果
本研究共纳入了 751 名出生胎龄<32 周的婴儿。共有 52.9%（n=397）被诊断为 ROP，10.8%（n=81）发展为 ROP≥3 期。共有 8.4%（n=63）的母亲有怀孕期间吸烟史，这与 ROP 发生率较高相关（OR 2.59，95% CI 1.10-6.12）。低胎龄、低出生体重和延长的呼吸支持被确认为严重 ROP 发展的独立危险因素。
结论
迄今为止，这是评估母亲吸烟对 ROP 发展影响的最大研究。母亲在怀孕期间吸烟是 32 周前早产儿发生严重 ROP 的独立危险因素。
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