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孕期二手烟暴露与4岁子代左心室结构和功能的关联:一项前瞻性出生队列研究

Association of secondhand smoke exposure during pregnancy with left ventricle structure and function in offspring at 4 years old: a prospective birth cohort study.

作者信息

Wang Bo, Peng Yongxuan, Wang Hualin, Xu Zhikang, Du Bowen, Niu Yiwei, Li Zhuoyan, Wang Zhi, Wang Qianchuo, Xu Caifang, Yin Shengju, Lu Yanan, Wang Jian, Sun Kun

机构信息

Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.

Institute for Cardiovascular Development and Regenerative Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

BMC Pregnancy Childbirth. 2025 Apr 29;25(1):515. doi: 10.1186/s12884-025-07636-7.

Abstract

BACKGROUND

The association of secondhand smoke exposure during pregnancy with childhood cardiac alterations remains insufficiently elucidated. This study aims to explore the correlation between maternal passive smoking during gestation with cardiac structure and function of offspring.

METHODS

1089 mother-offspring pairs from the Shanghai Birth Cohort were included. Information on secondhand smoke exposure during each trimester of pregnancy and baseline characteristics was documented during pregnancy via structured questionnaire. Subsequent follow-up assessments, encompassing anthropometric information and echocardiographic evaluation, were conducted from 2018 to 2021, when the children were 4 years old. Multiple linear regressions models were used to explore the association of secondhand smoke exposure during pregnancy with left ventricular measurements in early childhood.

RESULTS

Secondhand smoke exposure during pregnancy was correlated with increased left ventricle (LV) internal diameter in diastole [LVIDd; β = 0.38, 95%CI: (0.06, 0.70)] and in systole [LVIDs; β = 0.28, 95%CI: (0.02, 0.54)] adjusted for maternal and child characteristics. Specifically, maternal passive smoking in early pregnancy (≤ 12 weeks of gestation) showed a positive association with LV internal diameter in diastole [LVIDd; β = 0.46, 95%CI: (0.14, 0.79)], in systole [LVIDs; β = 0.35, 95%CI: (0.09, 0.60)], end diastolic volume [LVEDV; β = 1.45, 95%CI: (0.26, 2.63)] and end systolic volume [LVESV; β = 0.68, 95%CI: (0.18, 1.19)]. No significant association was observed between secondhand smoke exposure during pregnancy and LV function of offspring.

CONCLUSION

Secondhand smoke exposure during pregnancy was correlated with subclinical alterations in LV dimensions of offspring, especially during the early stage of pregnancy. Further research is necessary to confirm our findings and to explore the long-term effect of these cardiac changes on later cardiovascular risks.

摘要

背景

孕期二手烟暴露与儿童心脏改变之间的关联仍未得到充分阐明。本研究旨在探讨孕期母亲被动吸烟与子代心脏结构和功能之间的相关性。

方法

纳入来自上海出生队列的1089对母婴。孕期通过结构化问卷记录孕期各阶段二手烟暴露信息及基线特征。在2018年至2021年期间,当儿童4岁时,进行后续随访评估,包括人体测量信息和超声心动图评估。采用多元线性回归模型探讨孕期二手烟暴露与儿童早期左心室测量值之间的关联。

结果

在调整母婴特征后,孕期二手烟暴露与舒张期左心室内径[LVIDd;β = 0.38,95%CI:(0.06, 0.70)]和收缩期左心室内径[LVIDs;β = 0.28,95%CI:(0.02, 0.54)]增加相关。具体而言,孕早期(≤妊娠12周)母亲被动吸烟与舒张期左心室内径[LVIDd;β = 0.46,95%CI:(0.14, 0.79)]、收缩期左心室内径[LVIDs;β = 0.35,95%CI:(0.09, 0.60)]、舒张末期容积[LVEDV;β = 1.45,95%CI:(0.26, 2.63)]和收缩末期容积[LVESV;β = 0.68,95%CI:(0.18, 1.19)]呈正相关。未观察到孕期二手烟暴露与子代左心室功能之间存在显著关联。

结论

孕期二手烟暴露与子代左心室尺寸的亚临床改变相关,尤其是在孕早期。有必要进一步研究以证实我们的发现,并探索这些心脏变化对后期心血管风险的长期影响。

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