National Research Institute for Family Planning, No. 12, Dahuisi Road, Haidian, Beijing, 100081, China.
Graduate School of Peking, Union Medical College, No. 9 Dong Dan San Tiao, Dongcheng, Beijing, 100005, China.
Reprod Health. 2022 Mar 24;19(1):72. doi: 10.1186/s12978-022-01378-x.
To comprehensively evaluate the association of paternal smoking and preterm birth (PTB).
We performed a population-based retrospective cohort study in rural areas of China among 5,298,043 reproductive-aged couples who participated in the National Free Pre-Pregnancy Checkups Project (NFPCP), regarding outcome events that occurred in 2010-2016. Multivariate Cox proportional regression was used to estimate hazard ratio (HR) and 95% confident intervals (95%CI), and restricted cubic spline (RCS) were used to estimate the dose-response relationship.
Compared to neither-smoker couples, the fully adjusted HR for PTB was 1.04 (95% CI, 1.03-1.04), 1.08 (0.96-1.22), and 1.11 (1.03-1.19) in the couples where only the female smoked, only the male smoked and both, respectively. HR of PTB for paternal smoking was 1.07 (1.06-1.07), compared with women without paternal smoking. Consistent with paternal smoking, preconception paternal smoking showed 1.07-fold higher risk of PTB (95%CI, 1.06-1.09). The multivariable-adjusted HRs of PTB were 1.05 (1.03-1.06), 1.04 (1.03-1.05), 1.05 (1.04-1.07), 1.07 (1.05-1.10) and 1.13 (1.12-1.14) for participants whose husband smoked 1-4, 5-9, 10-14, 15-19, and ≥ 20 cigarettes/day respectively, compared with participants without paternal smoking. The HRs of PTB also increased with the increment of paternal smoking and preconception paternal smoking categories (P < 0.05).
Paternal smoking and preconception paternal smoking was independently positively associated with PTB risk. The importance of tobacco control, should be emphasized during preconception and pregnancy counselling should be towards not only women but also their husband.
全面评估父亲吸烟与早产（PTB）之间的关联。
我们在中国农村地区进行了一项基于人群的回顾性队列研究，共有 5298043 对参加国家免费孕前检查计划（NFPCP）的育龄夫妇，研究结局事件发生在 2010 年至 2016 年。多变量 Cox 比例风险回归用于估计风险比（HR）和 95%置信区间（95%CI），限制性三次样条（RCS）用于估计剂量反应关系。
与非吸烟者夫妇相比，仅女性吸烟、仅男性吸烟和双方均吸烟的夫妇发生早产的调整后 HR 分别为 1.04（95%CI，1.03-1.04）、1.08（0.96-1.22）和 1.11（1.03-1.19）。与没有父亲吸烟的女性相比，父亲吸烟的早产 HR 为 1.07（1.06-1.07）。与父亲吸烟一致，孕前父亲吸烟显示出早产风险增加 1.07 倍（95%CI，1.06-1.09）。多变量调整后的 HR 分别为 1.05（1.03-1.06）、1.04（1.03-1.05）、1.05（1.04-1.07）、1.07（1.05-1.10）和 1.13（1.12-1.14），与没有父亲吸烟的参与者相比，丈夫每天吸烟 1-4、5-9、10-14、15-19 和≥20 支的参与者。PTB 的 HR 也随着父亲吸烟和孕前父亲吸烟类别的增加而增加（P<0.05）。
父亲吸烟和孕前父亲吸烟与早产风险呈独立正相关。应该强调烟草控制的重要性，在孕前和妊娠咨询中不仅要针对女性，还要针对其丈夫。
