Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Z Orthop Unfall. 2024 Aug;162(4):410-418. doi: 10.1055/a-2103-6915. Epub 2023 Jul 18.
Fractures account for the most frequent cause of hospitalization during childhood and numbers have increased over time. Of all fractures in childhood and young adulthood, 66% are recurrent fractures, suggesting that some people are predestined for fractures. The aim of this study was to investigate the association between maternal smoking during late pregnancy and the risk of fractures in the children.The study included 11,082 mothers and their children from the cohort "Healthy Habits for Two" born between 1984 and 1987. Information about maternal smoking during pregnancy came from questionnaires filled out in pregnancy, while information about fractures was derived from the Danish National Patient Registry. Over a follow-up of 24 years (1994-2018), Cox regression with multiple failures was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for fractures in childhood and young adulthood according to maternal smoking in late pregnancy. Information about body mass index (BMI) and smoking status in young adulthood was included as time variant covariates.During an age span of 8-32 years, 6,420 fractures were observed. Of the mothers, 39.1% smoked during late pregnancy. Compared to children of mothers who did not smoke, children of mothers who smoked 1-9 cigarettes per day and 10+ cigarettes per day had an increased risk of fractures (HR 1.14 [CI: 1.06; 1.21] and HR 1.14 [CI: 1.07; 1.22], respectively). After adjusting for BMI and smoking status in young adulthood, the findings were slightly strengthened, showing an increased risk of fractures of 23 and 25% in children of mothers smoking 1-9 cigarettes per day and 10+ cigarettes per day, respectively.Maternal smoking during late pregnancy was associated with a higher risk of fractures in the child. This result indicates that exposure to cigarette smoke may play a role in lifelong bone health.
骨折是儿童时期住院的最常见原因，且其数量随时间推移而增加。在儿童和青年时期的所有骨折中，66%为复发性骨折，这表明有些人注定会发生骨折。本研究旨在调查妊娠晚期母亲吸烟与儿童骨折风险之间的关系。该研究纳入了 1984 年至 1987 年期间出生于“健康二人组”队列的 11082 名母亲及其子女。妊娠期间母亲吸烟的信息来自妊娠期间填写的调查问卷，而骨折的信息则来自丹麦国家患者登记处。在 24 年的随访期间（1994 年至 2018 年），使用 Cox 多重失败回归来估计根据妊娠晚期母亲吸烟情况，儿童和青年时期骨折的风险比（HR）及其 95%置信区间（CI）。将青年时期的体重指数（BMI）和吸烟状况信息作为时变协变量纳入。在 8-32 岁的年龄范围内，共观察到 6420 例骨折。其中 39.1%的母亲在妊娠晚期吸烟。与母亲不吸烟的儿童相比，母亲每天吸烟 1-9 支和 10 支以上香烟的儿童发生骨折的风险增加（HR 1.14 [CI：1.06；1.21]和 HR 1.14 [CI：1.07；1.22]）。调整青年时期的 BMI 和吸烟状况后，结果略有增强，表明母亲每天吸烟 1-9 支和 10 支以上香烟的儿童发生骨折的风险分别增加了 23%和 25%。妊娠晚期母亲吸烟与儿童骨折风险增加相关。这一结果表明，暴露于香烟烟雾可能在终生骨骼健康中发挥作用。
