Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Clinical Research Center, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Epidemiol Community Health. 2024 Oct 9;78(11):690-699. doi: 10.1136/jech-2024-222259.
The association of maternal cigarette smoking during pregnancy with severe neonatal morbidity (SNM) is still inconclusive. We aimed to examine the associations of the timing and the intensity of maternal cigarette smoking with infant SNM in the USA.
We used birth certificate data of 12 150 535 women aged 18-49 years who had live singleton births from the 2016-2019 US National Vital Statistics System. Women self-reported the daily number of cigarettes they consumed before pregnancy and in each trimester of pregnancy. Composite SNM was defined as one or more of the following complications: assisted ventilation immediately following delivery, assisted ventilation for >6 hours, neonatal intensive care unit admission, surfactant replacement therapy, suspected neonatal sepsis, and seizure.
Maternal cigarette smoking either before pregnancy or during any trimester of pregnancy significantly increased the risk of infant SNM, even at a very low intensity (ie, 1-2 cigarettes per day). For example, compared with women who did not smoke before pregnancy, the adjusted odds ratios and 95% confidence intervals (OR, 95% CI) of composite SNM in the newborn from women who smoked 1-2, 3-5, 6-9, 10-19, and ≥20 cigarettes per day before pregnancy were 1.16 (1.13 to 1.19), 1.22 (1.20 to 1.24), 1.26 (1.23 to 1.29), 1.27 (1.25 to 1.28), and 1.31 (1.30 to 1.33), respectively. Furthermore, smokers who stopped smoking during pregnancy still had a higher risk of composite SNM than never smokers before and throughout pregnancy.
Maternal cigarette smoking before or during pregnancy increased the risk of infant SNM, even at a low dose of 1-2 cigarettes/day. Interventions should emphasise the detrimental effects of even light smoking before and during pregnancy.
母亲在怀孕期间吸烟与严重新生儿发病（SNM）之间的关联仍不确定。我们旨在研究美国孕妇吸烟时间和强度与婴儿 SNM 的关联。
我们使用了来自 2016-2019 年美国国家生命统计系统的 12150535 名年龄在 18-49 岁之间的有活产单胎的分娩妇女的出生证明数据。妇女自我报告了她们在怀孕前和每个孕期每天吸烟的数量。复合 SNM 的定义为以下一种或多种并发症：分娩后立即辅助通气、辅助通气超过 6 小时、新生儿重症监护病房入院、表面活性剂替代治疗、疑似新生儿败血症和癫痫发作。
无论是在怀孕前还是在怀孕的任何一个孕期吸烟，都会显著增加婴儿 SNM 的风险，即使吸烟强度非常低（即每天 1-2 支香烟）。例如，与不吸烟的孕妇相比，每天吸烟 1-2、3-5、6-9、10-19 和≥20 支香烟的孕妇所生新生儿的复合 SNM 的调整优势比和 95%置信区间（OR，95%CI）分别为 1.16（1.13-1.19）、1.22（1.20-1.24）、1.26（1.23-1.29）、1.27（1.25-1.28）和 1.31（1.30-1.33）。此外，怀孕期间戒烟的吸烟者与整个怀孕期间从未吸烟的孕妇相比，仍然有更高的复合 SNM 风险。
孕妇在怀孕前或怀孕期间吸烟会增加婴儿 SNM 的风险，即使每天吸烟 1-2 支也会有这种风险。干预措施应强调在怀孕前和怀孕期间即使是轻度吸烟也会造成的有害影响。
