母亲吸烟停止时间与儿童超重和肥胖的关联的荟萃分析：孕前和孕期。
Meta-Analysis on Associations of Timing of Maternal Smoking Cessation Before and During Pregnancy With Childhood Overweight and Obesity.
机构信息
Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA.
出版信息
Nicotine Tob Res. 2023 Mar 22;25(4):605-615. doi: 10.1093/ntr/ntac213.
INTRODUCTION
There is a lack of comprehensive review on associations of maternal smoking cessation (versus nonsmokers) with childhood overweight and obesity.
AIMS AND METHODS
We conducted a systematic review and meta-analysis of existing evidence in this field. Within PubMed, EMBASE, and CENTRAL databases, we identified and screened 1147 abstracts. We reviewed full-texts and extracted related information from 10 eligible articles. We pooled odds ratios for overweight/obesity and mean differences in BMI z-scores by maternal smoking status around pregnancy.
RESULTS
Among 10 eligible studies, 71 393 children were included from ages 2 to 18 years. Compared to children of nonsmokers, the pooled unadjusted odds ratio (OR) for overweight was 1.36 (95% Confidence Interval CI: 1.14, 1.62) in children of quitters and 1.44 (1.27, 1.64) in children of continued smokers. The pooled unadjusted OR for obesity was 1.65 (1.17, 2.32) in children of quitters and 1.94 (1.38, 2.73) in children of continued smokers. The pooled unadjusted mean difference in BMI z-score was 0.51 (0.41, 0.61) in children of quitters and 0.64 (0.58, 0.70) in children of continued smokers. The pooled unadjusted OR for overweight in children of mothers quitting before pregnancy was 1.46 (1.15, 1.85), during the first trimester was 1.52 (1.27, 1.82), and during pregnancy (mixed timing, mostly first trimester) was 0.97 (0.79, 1.20).
CONCLUSION
The risk of offspring overweight and obesity was moderately higher for quitters during pregnancy compared to nonsmokers, although it might not be as high as continued smokers.
IMPLICATIONS
Maternal smoking during pregnancy is an established risk factor of childhood overweight and obesity. Based on our systematic review, intervention to help mothers quit smoking has the potential to reduce the risk of childhood overweight and obesity in offspring related to prenatal tobacco exposure. Quitting before pregnancy is ideal, but quitting in early pregnancy is still helpful for reducing risk.
简介
目前缺乏关于母亲戒烟（与不吸烟者相比）与儿童超重和肥胖之间关联的全面综述。
目的和方法
我们对该领域的现有证据进行了系统评价和荟萃分析。在 PubMed、EMBASE 和 CENTRAL 数据库中，我们确定并筛选了 1147 篇摘要。我们查阅了 10 篇合格文章的全文并从中提取了相关信息。我们根据母亲在妊娠前后的吸烟状况，汇总了超重/肥胖的优势比和 BMI z 评分的平均差异。
结果
在 10 项合格研究中，纳入了年龄在 2 至 18 岁的 71393 名儿童。与不吸烟者的子女相比，在未调整的汇总中，戒烟者子女的超重比值比（OR）为 1.36（95%置信区间[CI]：1.14，1.62），持续吸烟者子女的 OR 为 1.44（1.27，1.64）。在未调整的汇总中，戒烟者子女的肥胖比值比（OR）为 1.65（1.17，2.32），持续吸烟者子女的 OR 为 1.94（1.38，2.73）。在未调整的汇总中，戒烟者子女的 BMI z 评分平均差异为 0.51（0.41，0.61），持续吸烟者子女的平均差异为 0.64（0.58，0.70）。在未调整的汇总中，母亲在妊娠前戒烟的子女超重比值比为 1.46（1.15，1.85），在妊娠早期戒烟的比值比为 1.52（1.27，1.82），在妊娠期间（混合时间，主要在妊娠早期）的比值比为 0.97（0.79，1.20）。
结论
与不吸烟者相比，妊娠期间戒烟的母亲所生子女超重和肥胖的风险略高，但可能不如持续吸烟者的风险高。
意义
妊娠期间母亲吸烟是儿童超重和肥胖的既定危险因素。基于我们的系统综述，帮助母亲戒烟的干预措施有可能降低与产前烟草暴露相关的子女超重和肥胖的风险。妊娠前戒烟是理想的，但在妊娠早期戒烟仍然有助于降低风险。
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