Bermúdez Barrezueta Lorena, Miñambres Rodríguez María, Palomares Cardador Marta, Torres Ballester Irune, López Casillas Pablo, Moreno Carrasco José, Pino Vázquez Asunción
Unidad de Cuidados Intensivos Pediátricos y Neonatales, Hospital Clínico Universitario, Valladolid, Spain.
Unidad de Cuidados Intensivos Pediátricos y Neonatales, Hospital Clínico Universitario, Valladolid, Spain.
An Pediatr (Engl Ed). 2021 Jun;94(6):385-395. doi: 10.1016/j.anpede.2020.05.011. Epub 2021 May 20.
Environmental exposure to tobacco increases the risk of respiratory disease in infants. However, the impact of maternal smoking on the development of acute bronchiolitis has hardly been assessed. The aim of this study was to determine the incidence of acute bronchiolitis and to analyse the effect of prenatal and postnatal maternal smoking on the development of this disease.
A prospective, observational study was performed on healthy newborns from a third level hospital born between October 2015 and February 2016. Questionnaires were completed by the mothers at discharge from maternity and followed-up for two years. These collected information about prenatal and postnatal smoking, lifestyle, family and personal history, and the development of bronchiolitis. A bivariate and multivariate logistic regression analysis was performed.
A total of 223 newborns were included, of whom 13.9% were exposed to tobacco smoking during gestation, 21.4% in the postnatal period, and 12.4% in both times. The incidence of bronchiolitis was 28.7% at one year of life, and 34.5% at two years. The multivariate analysis demonstrated that the prenatal and postnatal exposure to tobacco is an independent risk factor for the development of bronchiolitis (OR 4.38; 95% CI; 1.63-11.76), while prolonged breastfeeding is a protective factor (OR 0.13; 95% CI; 0.04-0.48). Other factors that were statistically significant were: atopic dermatitis (OR 2.91; 95% CI; 1.26-6.73), and gestational age (OR 1.42; 95% CI; 1.08-1.88).
Children exposed to prenatal and postnatal maternal smoking have a higher risk of suffering bronchiolitis. Reducing the smoking habit in women that intend to become pregnant must be a priority in preventive medicine.
婴儿接触烟草环境会增加患呼吸道疾病的风险。然而，母亲吸烟对急性细支气管炎发展的影响几乎未得到评估。本研究的目的是确定急性细支气管炎的发病率，并分析产前和产后母亲吸烟对该疾病发展的影响。
对2015年10月至2016年2月在一家三级医院出生的健康新生儿进行了一项前瞻性观察研究。母亲们在出院时填写问卷，并进行了两年的随访。问卷收集了有关产前和产后吸烟、生活方式、家族和个人病史以及细支气管炎发展情况的信息。进行了双变量和多变量逻辑回归分析。
共纳入223名新生儿，其中13.9%在孕期接触吸烟，21.4%在产后接触吸烟，12.4%在两个时期均接触吸烟。细支气管炎的发病率在1岁时为28.7%，在2岁时为34.5%。多变量分析表明，产前和产后接触烟草是细支气管炎发展的独立危险因素（比值比4.38；95%置信区间；1.63 - 11.76），而延长母乳喂养是一个保护因素（比值比0.13；95%置信区间；0.04 - 0.48）。其他具有统计学意义的因素包括：特应性皮炎（比值比2.91；95%置信区间；1.26 - 6.73）和胎龄（比值比1.42；95%置信区间；1.08 - 1.88）。
产前和产后接触母亲吸烟的儿童患细支气管炎的风险更高。在预防医学中，减少打算怀孕的女性的吸烟习惯必须是优先事项。
