Tatsuta Nozomi, Asato Kaname, Anai Akane, Suzuki Tomohisa, Sakurai Kasumi, Ota Chiharu, Arima Takahiro, Sugawara Junichi, Yaegashi Nobuo, Nakai Kunihiko
Development and Environmental Medicine, the Department of Pediatrics, and the Environmental and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, and the School of Sport and Health Science, Tokai Gakuen University, Miyoshi, Japan.
Obstet Gynecol. 2023 Jan 1;141(1):119-125. doi: 10.1097/AOG.0000000000004991. Epub 2022 Nov 30.
To examine the relationship between timing of smoking cessation during pregnancy and anthropometric indices of newborns.
Mothers and neonates enrolled in the JECS (Japan Environment and Children's Study), a nationwide birth cohort study, were examined. Patients with full-term neonates were included in the analysis, and 73,025 mother-neonate pairs with complete data were identified. The mothers were classified into six groups according to smoking status during pregnancy (nonsmokers [Q1, n=44,198]; ex-smokers who quit before pregnancy [Q2, n=16,461]; ex-smokers who quit in the first trimester [Q3, n=8,948]; ex-smokers who quit in the second trimester [Q4, n=498]; ex-smokers who quit in the third trimester [Q5, n=651]; and smokers who smoked throughout pregnancy [Q6, n=2,269)]). Data on smoking were based on questionnaires administered in the first, second, or third trimester and 1 month after delivery. The primary outcomes were birth weight, height, and head circumference.
Compared with nonsmokers (Q1), no adverse outcomes were observed for ex-smokers who quit before pregnancy (Q2). The mean adjusted weights of male and female neonates were 135 g and 125 g lower, respectively, in Q6 participants than in Q1 participants. Comparing Q1 and Q6 participants, height was 0.6 cm and 0.7 cm smaller for male and female neonates, respectively. Head circumference in neonates of Q6 participants was 0.3 cm and 0.3 cm smaller for male and female neonates, respectively, than that in Q1 participants. Across all three measures, smoking cessation in the first and second trimester reduced the differential in outcomes between nonsmokers and individuals who smoked throughout pregnancy.
Smoking during pregnancy is associated with reduced newborn birth weight, height, and head circumference. Earlier smoking cessation during pregnancy reduces the adverse effects of smoking on fetal growth.
研究孕期戒烟时间与新生儿人体测量指标之间的关系。
对参与日本环境与儿童研究（JECS）这一全国性出生队列研究的母亲和新生儿进行检查。纳入足月新生儿的患者进行分析，共确定了73,025对具有完整数据的母婴对。母亲们根据孕期吸烟状况分为六组（非吸烟者[Q1，n = 44,198]；孕前戒烟的既往吸烟者[Q2，n = 16,461]；孕早期戒烟的既往吸烟者[Q3，n = 8,948]；孕中期戒烟的既往吸烟者[Q4，n = 498]；孕晚期戒烟的既往吸烟者[Q5，n = 651]；以及孕期全程吸烟的吸烟者[Q6，n = 2,269]）。吸烟数据基于孕早期、孕中期或孕晚期以及分娩后1个月进行的问卷调查。主要结局指标为出生体重、身高和头围。
与非吸烟者（Q1）相比，孕前戒烟的既往吸烟者（Q2）未观察到不良结局。Q6组参与者中，男、女新生儿的平均校正体重分别比Q1组参与者低135克和125克。比较Q1组和Q6组参与者，男、女新生儿的身高分别低0.6厘米和0.7厘米。Q6组参与者的男、女新生儿头围分别比Q1组参与者小0.3厘米和0.3厘米。在所有这三项指标中，孕早期和孕中期戒烟缩小了非吸烟者与孕期全程吸烟者之间的结局差异。
孕期吸烟与新生儿出生体重、身高和头围降低有关。孕期更早戒烟可减少吸烟对胎儿生长的不良影响。
