Li J, Du Y J, Wang H L, Du J Y, Qu P F, Zhang R, Guo L Q, Yan H, Dang S N
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an Jiaotong University, Xi'an 710003, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jun 10;41(6):884-889. doi: 10.3760/cma.j.cn112338-20190710-00509.
To explore the association between maternal passive smoking during perinatal period and congenital heart disease (CHD) in their offspring. A case-control study was designed. Data being used was based on a case-control study of congenital heart disease collected in Shaanxi province from January 2014 to December 2016. Cases under this study were perinatal infants diagnosed as CHD from 28 weeks of gestation to 7 days after birth, and fetus less than 28 weeks of gestation but diagnosed as CHD by ultrasonography. The controls would include newborn infants without any birth defects, born at the same period of the cases. Logistic regression model with confounding factors adjusted was established to analyze the association between maternal passive smoking status during perinatal period and CHD in their offspring. Subgroup analysis was carried out to explore its stability. A total of 2 259 subjects, consisting 695 cases and 1 564 controls were included in this study. Passive smokers accounted for 26.76 in the case group while only 6.01 in the control group. After adjusting for related confounding factors, the risk of CHD in the offspring of passive smokers was 3.32 times higher than that of the non-passive smokers (=3.32, 95: 2.41-4.56), during the perinatal period. Results also showed that related risk accumulated with the increase of exposure frequency to passive smoking. For mothers who smoked passively for 1-3 days per week, the risk of CHD in their offspring was 2.75 times higher than that of those non-passive smokers (=2.75, 95: 1.62-4.66). For mothers who smoked passively for more than 3 days per week, the risk was 3.62 times higher than the non-passive smokers (=3.62, 95: 2.48-5.29). Data from the subgroup analysis showed that the association between maternal passive smoking during perinatal period and CHD in their offspring appeared stable. Maternal passive smoking during perinatal period seemed a risk factor for congenital heart disease related to their offspring. Pregnant women should avoid exposure to second-hand smoke as much as possible, so as to prevent the harm from passive smoking.
探讨围产期母亲被动吸烟与其后代先天性心脏病(CHD)之间的关联。设计了一项病例对照研究。所使用的数据基于2014年1月至2016年12月在陕西省收集的先天性心脏病病例对照研究。本研究中的病例为妊娠28周后至出生后7天被诊断为CHD的围产儿,以及妊娠小于28周但经超声诊断为CHD的胎儿。对照包括同期出生的无任何出生缺陷的新生儿。建立调整混杂因素后的Logistic回归模型,分析围产期母亲被动吸烟状况与其后代CHD之间的关联。进行亚组分析以探讨其稳定性。本研究共纳入2259名受试者,其中695例病例和1564名对照。病例组中被动吸烟者占26.76%,而对照组中仅占6.01%。在调整相关混杂因素后,围产期被动吸烟者后代患CHD的风险比非被动吸烟者高3.32倍(=3.32,95%:2.41 - 4.56)。结果还表明,相关风险随着被动吸烟暴露频率的增加而累积。对于每周被动吸烟1 - 3天的母亲,其后代患CHD的风险比非被动吸烟者高2.75倍(=2.75,95%:1.62 - 4.66)。对于每周被动吸烟超过3天的母亲,该风险比非被动吸烟者高3.62倍(=3.62,95%:2.48 - 5.29)。亚组分析数据显示,围产期母亲被动吸烟与其后代CHD之间的关联似乎稳定。围产期母亲被动吸烟似乎是其后代先天性心脏病的一个危险因素。孕妇应尽可能避免接触二手烟,以防止被动吸烟的危害。