Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Hypertens Res. 2023 Apr;46(4):834-844. doi: 10.1038/s41440-022-01144-3. Epub 2023 Feb 3.
Hypertensive disorders of pregnancy (HDP) are associated with poor maternal and neonatal prognoses. Although several studies have indicated an effect of secondhand smoke (SHS) exposure on HDP, such evidence is lacking in Japan. Therefore, we analyzed data from the Japan Environment and Children's Study, a large-scale epidemiological investigation, to elucidate a possible link between SHS exposure and HDP risk. Data were obtained from the all-birth fixed datasets and included information on 104,062 fetuses and their parents. SHS exposure was assessed in terms of the frequency (rarely, 1-3, or 4-7 days/week) and the daily duration of exposure (<1, 1-2, or ≥2 h(s)/day). Modified Poisson regression model analyses were performed with adjustment for known risk factors for HDP. Additionally, the population attributable fractions (PAFs) of SHS exposure and maternal smoking to HDP prevalence were estimated. The relative risks of developing HDP among individuals with SHS exposures of 4-7 days/week and ≥2 h/day were 1.18 and 1.27 (95% confidence interval: 1.02-1.36 and 0.96-1.67), respectively, compared to the reference groups (rare exposure and <1 h/day). The PAFs for the risk of HDP due to SHS exposure and perinatal smoking were 3.8% and 1.8%, respectively. Japanese women with greater exposure to SHS have a higher risk of HDP after adjustment for possible confounding factors; thus, relevant measures are required to reduce SHS exposure to alleviate HDP risk. The association between second-hand smoking exposure and hypertensive disorders of pregnancy risk was analyzed using the JECS data. The relative risks in 4-7 days/week and ≥2 h/day of SHS exposures were 1.18 and 1.27, respectively. The PAFs due to SHS exposure and maternal smoking were 3.80% and 1.81%, respectively.
妊娠高血压疾病（HDP）与母婴不良预后相关。虽然有几项研究表明二手烟（SHS）暴露与 HDP 有关，但日本缺乏这方面的证据。因此，我们分析了日本环境与儿童研究（一项大规模的流行病学调查）的数据，以阐明 SHS 暴露与 HDP 风险之间可能存在的联系。数据来自所有出生固定数据集，包括 104062 名胎儿及其父母的信息。SHS 暴露的评估标准是暴露频率（很少，每周 1-3 天或 4-7 天）和每天暴露时间（<1、1-2 或≥2 小时）。采用调整了 HDP 已知危险因素的改良泊松回归模型进行分析。此外，还估计了 SHS 暴露和母亲吸烟对 HDP 患病率的人群归因分数（PAF）。与参考组（偶尔暴露和<1 小时/天）相比，每周暴露 4-7 天和每天暴露≥2 小时的个体发生 HDP 的相对风险分别为 1.18 和 1.27（95%置信区间：1.02-1.36 和 0.96-1.67）。由于 SHS 暴露和围产期吸烟导致 HDP 的 PAF 分别为 3.8%和 1.8%。日本女性 SHS 暴露量较大，调整了可能的混杂因素后，患 HDP 的风险较高；因此，需要采取相关措施减少 SHS 暴露，以降低 HDP 风险。使用 JECS 数据分析了二手烟暴露与妊娠高血压疾病风险之间的关系。4-7 天/周和≥2 小时/天 SHS 暴露的相对风险分别为 1.18 和 1.27。由于 SHS 暴露和母亲吸烟导致的 PAF 分别为 3.80%和 1.81%。
