Adams Kelly K, Beem Ashley, Diener Elizabeth, Merritt T Allen
Division of Neonatology, Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda, California.
School of Medicine, Loma Linda University, Loma Linda, California.
Pediatr Allergy Immunol Pulmonol. 2012 Mar;25(1):3-10. doi: 10.1089/ped.2011.0111. Epub 2011 Dec 22.
Tobacco use among pregnant women, as well as second- and third-hand smoke exposure of their infants, translates into the startling fact that more than one third of American children live with at least one parent who smokes cigarettes daily. Maternal smoking or second-hand smoke exposure during pregnancy is deleterious to the mother's health and contributes to prematurity, low birth-weight infants, and increased risk of sudden infant death syndrome (SIDS) and recurrent wheezing during the first year of life. Pregnant women who stop tobacco use during pregnancy are at high risk for postpartum relapse frequently associated with a partner who smokes tobacco, stress, poverty, and lack of social and medical support to remain tobacco free. Enhanced efforts to identify and support pregnant women who smoke, and to implement strategies to prevent exposure of their fetus and newborn to the hazards of tobacco-smoke exposure, are paramount in our public health efforts to eliminate health disparities in the United States. We discuss the critical elements of programs to assist mothers to stop smoking during pregnancy and toward family efforts to maintain a smoke-free environment for their infant. Postpartum interventions, whether in the neonatal intensive care unit (NICU), newborn nursery, or postnatal care setting, can provide assistance that women need to remain smoke free, to educate spouses or significant others and their families, and to aide in establishing goals of maintaining a tobacco smoke-free home and car. Physicians and other perinatal healthcare providers have a duty to identify pregnant women who smoke for "meaningful use" in the electronic medical record, and to provide advice and assistance in evidence-based smoking interventions in obstetrical care settings. Pediatricians, neonatologists, and others providing postpartum, "normal" nursery or NICU care have an opportunity to protect infants and young children from second- and third-hand smoke exposure by assisting their parents and family members in maintaining a tobacco-free environment to improve the health of infants, toddlers, and young children.
孕妇吸烟以及其婴儿接触二手烟和三手烟的情况，导致了一个惊人的事实：超过三分之一的美国儿童与至少一位每天吸烟的家长生活在一起。孕期母亲吸烟或接触二手烟对母亲健康有害，会导致早产、低体重儿，增加婴儿猝死综合征（SIDS）风险以及一岁内反复喘息的几率。孕期戒烟的孕妇产后复吸风险很高，这通常与伴侣吸烟、压力、贫困以及缺乏保持无烟状态的社会和医疗支持有关。加大力度识别并支持吸烟的孕妇，实施策略防止其胎儿和新生儿接触烟草烟雾危害，这在美国消除健康差距的公共卫生工作中至关重要。我们讨论了帮助母亲在孕期戒烟以及家庭努力为婴儿维持无烟环境的项目关键要素。产后干预，无论是在新生儿重症监护病房（NICU）、新生儿 nursery 还是产后护理环境中，都可以为女性提供保持无烟所需的帮助，教育配偶或重要他人及其家人，并协助设定维持家庭和汽车无烟的目标。医生和其他围产期医疗保健提供者有责任在电子病历中识别吸烟的孕妇以便“有效利用”，并在产科护理环境中提供基于证据的吸烟干预建议和帮助。儿科医生、新生儿科医生以及其他提供产后、“正常” nursery 或 NICU 护理的人员有机会通过协助父母和家庭成员维持无烟环境来保护婴幼儿免受二手烟和三手烟危害，从而改善婴幼儿的健康状况。
