Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China.
Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China.
Environ Sci Pollut Res Int. 2021 Jun;28(21):27230-27237. doi: 10.1007/s11356-021-12626-1. Epub 2021 Jan 28.
Associations between environmental tobacco smoke (ETS) and the risk of adverse birth outcomes may be confounded. We aimed to clarify the associations of ETS before and during pregnancy with the risk of adverse birth outcomes and determine whether the associations were modified by key potential confounders. A total of 7147 non-smoking mothers from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China, were included in the final analyses. ETS status was self-reported by pregnant women at their first antenatal care visit before 16 gestational weeks. Information on birth outcomes was extracted from delivery records. Poisson regression was used to identify the association between ETS before and during pregnancy and the risk of adverse birth outcomes. Exposures to ETS before and during pregnancy were reported by 645 (9.0%) and 464 (6.5%) mothers, respectively. Compared with no ETS, continued ETS during pregnancy was associated with an increased risk of preterm birth (PTB) (RR: 1.55, 95% CI: 1.07, 2.25) after adjustment for potential confounders. The association remained consistent in medically indicated PTB and late PTB. The risk of PTB associated with continued ETS during pregnancy was significantly increased in mothers more educated (P for interaction < 0.05). However, the increased risk of low birth weight (LBW) or small for gestational age (SGA) births by ETS during pregnancy was not observed. Exposure to ETS during pregnancy was associated with a higher risk of PTB, but not LBW or SGA births in a Chinese birth cohort.
环境烟草烟雾 (ETS) 与不良出生结局风险之间的关联可能存在混杂。我们旨在阐明妊娠前和妊娠期间 ETS 与不良出生结局风险之间的关联，并确定这些关联是否受到关键潜在混杂因素的影响。中国武汉同济母婴队列（TMCHC）中的 7147 名不吸烟母亲被纳入最终分析。孕妇在 16 孕周前首次产前检查时通过自我报告来确定 ETS 状态。分娩记录中提取了出生结局信息。泊松回归用于确定妊娠前和妊娠期间 ETS 暴露与不良出生结局风险之间的关联。分别有 645 名（9.0%）和 464 名（6.5%）母亲报告了妊娠前和妊娠期间 ETS 暴露。与无 ETS 相比，妊娠期间持续 ETS 与早产（PTB）风险增加相关（RR：1.55，95%CI：1.07，2.25），在调整了潜在混杂因素后。在医学上确定的 PTB 和晚期 PTB 中，这种关联仍然一致。在受教育程度较高的母亲中（交互作用 P < 0.05），妊娠期间持续 ETS 与 PTB 风险增加的关联更为显著。然而，妊娠期间 ETS 与低出生体重 (LBW) 或小于胎龄儿 (SGA) 出生的风险增加无关。在这项中国出生队列研究中，妊娠期间接触 ETS 与 PTB 风险增加相关，但与 LBW 或 SGA 出生无关。
