Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi province, 710061, China.
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi province, 710061, China.
J Dev Orig Health Dis. 2022 Oct;13(5):626-633. doi: 10.1017/S2040174421000714. Epub 2022 Jan 6.
Previous studies have suggested that maternal active smoking can increase the risk of birth defects, but evidence on second-hand tobacco smoke (SHS) is limited. We aimed to assess the association between maternal exposure to SHS and birth defects in a Chinese population. The data were based on a large-scale cross-sectional survey conducted in Shaanxi Province, China. Considering the characteristics of survey design and the potential impact of confounding factors, we adopted propensity score matching (PSM) to match the SHS exposure group and the non-exposure group to attain a balance of the confounders between the two groups. Subsequently, conditional logistic regression was employed to estimate the effect of SHS exposure on birth defects. Furthermore, sensitivity analyses were conducted to verify the key findings. After nearest neighbor matching of PSM with a ratio of 2 and a caliper width of 0.03, there were 6,205 and 12,410 participants in the exposure and control group, respectively. Pregnant women exposed to SHS were estimated to be 58% more likely to have infants with overall birth defects (OR = 1.58, 95% CI: 1.30-1.91) and 75% more likely to have infants with circulatory system defects (OR = 1.75, 95% CI: 1.26-2.44). We also observed that the risk effect of overall birth defects had an increasing trend as the frequency of exposure increased. Additionally, sensitivity analyses suggested that our results had good robustness. These results indicate that maternal exposure to SHS likely increases the risk of overall birth defects, especially circulatory system defects, in Chinese offspring.
先前的研究表明，母亲主动吸烟会增加出生缺陷的风险，但二手烟草烟雾（SHS）的证据有限。我们旨在评估中国人群中母亲接触 SHS 与出生缺陷之间的关联。该数据基于在中国陕西省进行的一项大规模横断面调查。考虑到调查设计的特点和混杂因素的潜在影响，我们采用倾向评分匹配（PSM）来匹配 SHS 暴露组和非暴露组，以使两组之间的混杂因素达到平衡。随后，采用条件逻辑回归估计 SHS 暴露对出生缺陷的影响。此外，还进行了敏感性分析以验证关键发现。在 PSM 的最近邻匹配中，匹配比例为 2，卡尺宽度为 0.03，暴露组和对照组分别有 6205 名和 12410 名参与者。接触 SHS 的孕妇估计其婴儿整体出生缺陷的风险增加 58%（OR=1.58，95%CI：1.30-1.91），循环系统缺陷的风险增加 75%（OR=1.75，95%CI：1.26-2.44）。我们还观察到，随着暴露频率的增加，整体出生缺陷的风险效应呈增加趋势。此外，敏感性分析表明，我们的结果具有良好的稳健性。这些结果表明，母亲接触 SHS 可能会增加中国后代整体出生缺陷的风险，尤其是循环系统缺陷。
