Holly Wei, PhD, RN, CPN, NEA-BC, College of Nursing at East Carolina University, Greenville, North Carolina. Chongben Zhang, PhD, and Patricia Silveyra, PhD, Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, North Carolina.
J Addict Nurs. 2020 Oct/Dec;31(4):243-252. doi: 10.1097/JAN.0000000000000364.
The aim of this study was to evaluate the relationships between prenatal smoking exposure and telomere lengths (TLs) in fetuses, infants, and children.
This is a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Databases searched were Biomedical Reference Collection, MEDLINE via PubMed, CINAHL, PsycINFO, and Google Scholar. The latest search was on October 18, 2019.
Seven studies met the inclusion criteria and thus were reviewed. Five of the studies showed significant inverse relationships between prenatal tobacco exposure and TLs in fetuses, infants, and children. One study showed a modification effect of the postconceptual age, indicating that older fetuses with prenatal smoking exposure had shorter TLs than their counterparts. This effect was more prominent after 93 days of postconception. Another study reported a finding that was contrary to the above results, showing that the telomeres of newborns with prenatal smoking exposure were longer than those of their counterparts.
CONCLUSION/RECOMMENDATIONS: This review shows that the impact of prenatal smoking on the health of unborn fetuses, infants, and children is an understudied area. Because of the inconsistent findings and cross-sectional study designs, more research is required, especially longitudinally studies. Nonetheless, the findings of the review provide partial evidence that prenatal smoking can potentially impact the genetic biomarker, TLs, and, thus, health of fetuses, infants, and children. The evidence confirms the current practice that pregnant women should be encouraged to stop smoking as soon as they become pregnant.
本研究旨在评估胎儿、婴儿和儿童期的产前吸烟暴露与端粒长度（TLs）之间的关系。
本系统评价受系统评价和荟萃分析的首选报告项目指导。检索的数据库包括生物医学参考集、通过 PubMed 进行的 MEDLINE、CINAHL、PsycINFO 和 Google Scholar。最新搜索日期为 2019 年 10 月 18 日。
有 7 项研究符合纳入标准并进行了综述。其中 5 项研究表明，产前烟草暴露与胎儿、婴儿和儿童的 TLs 呈显著负相关。一项研究表明，后概念年龄存在修饰效应，表明有产前吸烟暴露的胎儿年龄越大，TLs 越短。这种效应在受孕后 93 天更为明显。另一项研究报告的结果与上述结果相反，表明有产前吸烟暴露的新生儿的端粒比对照组的更长。
结论/建议：本综述表明，产前吸烟对未出生胎儿、婴儿和儿童健康的影响是一个研究不足的领域。由于研究结果不一致且设计为横断面研究，因此需要进行更多的研究，特别是纵向研究。尽管如此，该综述的研究结果提供了部分证据，表明产前吸烟可能会影响胎儿、婴儿和儿童的遗传生物标志物 TLs，从而影响其健康。该证据证实了目前的实践，即应鼓励孕妇一旦怀孕就应戒烟。
