Medical Bioscience, University of the Western Cape, Bellville, Western Cape, South Africa
Burden of Disease, South African Medical Research Council, Tygerberg, South Africa.
BMJ Open. 2022 Jul 15;12(7):e061811. doi: 10.1136/bmjopen-2022-061811.
Tobacco smoking and alcohol consumption during pregnancy are particularly prevalent in low socioeconomic status populations, with an adverse association with birth outcomes and cardiometabolic risk factors. However, the direct and indirect effects of prenatal cigarette smoking and alcohol consumption during pregnancy on cardiometabolic risk in offspring have been rather inconsistent. This may be attributed to multiple factors, such as the amount and timing of exposure to tobacco smoking and alcohol during pregnancy; the influence of maternal, environmental and socioeconomic factors; or how risk factors were defined by individual researchers and studies. Therefore, this review aims to provide a summary of the most recent evidence on birth outcomes and cardiometabolic risk in children associated with alcohol and/or tobacco exposure in utero.
PubMed, Scopus and Web of Science will be searched to identify published articles from 1 January 2001. Clinical studies that investigate the association between maternal cigarette smoking or alcohol consumption and birth weight and cardiometabolic risk factors in infants, children and adolescents will be included. Prospective cohort, case-control studies and birth cohort studies will be eligible for inclusion. Grey literature will be searched including conference proceedings, Google Scholar and the ProQuest Dissertation and Theses database. Only studies published in English will be included, with no restrictions regarding country, race or gender. Two independent reviewers will conduct the literature search and article screening. Eligibility criteria will be based on the population (infants, children, adolescents), exposure (maternal cigarette smoking, alcohol consumption or both), comparator (control group with no exposure during pregnancy) and outcomes (birth weight and cardiometabolic risk factors). Quality assessment and risk of bias will be assessed using a risk of bias tool for observational studies, and data will be extracted for analysis using a researcher-generated data extraction form. A meta-analysis will be performed to estimate pooled effect sizes if there are sufficient good-quality studies available. Sources of heterogeneity will be explored using subgroup analysis.
Ethical clearance will not be required as this review will extract publicly available secondary data. Findings from this review will be disseminated via publication in a peer-review journal.
CRD42021286630.
在社会经济地位较低的人群中，怀孕期间吸烟和饮酒尤其普遍，这与出生结局和心血管代谢危险因素不良相关。然而，产前吸烟和饮酒对后代心血管代谢风险的直接和间接影响一直相当不一致。这可能归因于多个因素，例如怀孕期间吸烟和饮酒的量和时间；母婴、环境和社会经济因素的影响；或个体研究人员和研究如何定义危险因素。因此，本综述旨在提供最新的关于与胎儿内暴露于酒精和/或烟草相关的出生结局和儿童心血管代谢风险的证据总结。
将从 2001 年 1 月 1 日起在 PubMed、Scopus 和 Web of Science 上搜索已发表的文章，以确定与母亲吸烟或饮酒以及婴儿、儿童和青少年的心血管代谢危险因素相关的研究。将纳入研究母亲吸烟或饮酒与婴儿体重和心血管代谢危险因素之间关联的临床研究。将有资格纳入前瞻性队列研究、病例对照研究和出生队列研究。将搜索灰色文献，包括会议记录、Google Scholar 和 ProQuest 论文和论文数据库。仅纳入发表英文的研究，不限制国家、种族或性别。两名独立的审查员将进行文献检索和文章筛选。入选标准将基于人群（婴儿、儿童、青少年）、暴露（母亲吸烟、饮酒或两者都有）、对照（怀孕期间无暴露的对照组）和结局（出生体重和心血管代谢危险因素）。使用观察性研究风险偏倚工具评估质量评估和风险偏倚，并使用研究人员生成的数据提取表提取数据进行分析。如果有足够的高质量研究，则将进行荟萃分析以估计汇总效应大小。使用亚组分析探索异质性的来源。
由于本综述将提取公开可得的二手数据，因此不需要伦理批准。本综述的结果将通过发表在同行评议的期刊上进行传播。
PROSPERO 注册号：CRD42021286630。
