Ogbu Chukwuemeka E, Ogbu Stella C, Khadka Dibya, Kirby Russell S
College of Public Health, University of South Florida, Tampa, USA.
Department of Biology, East Tennessee State University, Johnson City, USA.
Cureus. 2021 Apr 17;13(4):e14536. doi: 10.7759/cureus.14536.
Introduction Although studies have examined the association between childhood asthma and parental smoking and secondhand smoke, little research has explored the moderating role of birth weight and prematurity (BWP) status on this association. We examined the association between secondhand smoke exposure, asthma, and asthma severity in children aged six to 17 as well as the modifying effect of BWP on parental smoking and asthma. Methods We used data from 36,954 children from the National Survey of Children's Health 2017-2018. In addition to univariate analysis, adjusted and unadjusted logistic regression models were used to estimate the effect of secondhand smoke on asthma. The interaction term between parental smoking and BWP was tested. Multinomial regression was used to evaluate the association between secondhand smoke on asthma severity. Results About 15.1 % of children had asthma and 15.4% of parents reported smoking. Odds of asthma were higher in children living with an outdoor (AOR, 1.27; 95% CI, 1.06-1.52) and indoor (AOR, 1.46; 95% CI, 1.01-2.11) smoker in the adjusted model. The association of parental smoking with asthma differed by birth weight and premature status. Normal weight children who are premature had the highest odds ratio (AOR, 2.15; 95% CI, 1.2-3.86). In the multinomial model, low birth weight and premature children had higher odds of mild (AOR, 1.90; 95% CI, 1.40-2.56) and moderate/severe (AOR, 1.81; 95% CI, 1.16-2.84) asthma compared to the no asthma group. Conclusion The Association of parental smoking on asthma was modified by BWP. Focused asthma interventions in children should inquire about BWP status as well as parental smoking and household smoke exposure to reduce asthma morbidity and mortality.
引言 尽管已有研究探讨了儿童哮喘与父母吸烟及二手烟之间的关联，但很少有研究探究出生体重和早产（BWP）状况在此关联中的调节作用。我们研究了6至17岁儿童二手烟暴露、哮喘及哮喘严重程度之间的关联，以及BWP对父母吸烟与哮喘关系的影响。方法 我们使用了2017 - 2018年全国儿童健康调查中36,954名儿童的数据。除单因素分析外，还使用了调整和未调整的逻辑回归模型来估计二手烟对哮喘的影响。对父母吸烟与BWP之间的交互项进行了检验。使用多项回归评估二手烟与哮喘严重程度之间的关联。结果 约15.1%的儿童患有哮喘，15.4%的父母报告有吸烟行为。在调整模型中，与户外吸烟者（调整后比值比[AOR]，1.27；95%置信区间[CI]，1.06 - 1.52）和室内吸烟者同住的儿童患哮喘的几率更高（AOR，1.46；95% CI，1.01 - 2.11）。父母吸烟与哮喘的关联因出生体重和早产状况而异。早产的正常体重儿童的比值比最高（AOR，2.15；95% CI，1.2 - 3.86）。在多项模型中，与无哮喘组相比，低出生体重和早产儿童患轻度哮喘（AOR，1.90；95% CI，1.40 - 2.56）和中度/重度哮喘（AOR，1.81；95% CI，1.16 - 2.84）的几率更高。结论 父母吸烟与哮喘的关联受BWP影响。针对儿童的哮喘干预措施应询问BWP状况以及父母吸烟和家庭烟雾暴露情况，以降低哮喘发病率和死亡率。
