Morley R, Leeson Payne C, Lister G, Lucas A
MRC Dunn Nutrition Unit, Cambridge.
Arch Dis Child. 1995 Feb;72(2):120-4. doi: 10.1136/adc.72.2.120.
Reduced fetal growth in babies born preterm may be associated with reduced later blood pressure, but in children born at term, higher blood pressure. It was hypothesised, therefore, that maternal smoking in pregnancy, associated with reduced fetal growth, programmes later blood pressure differentially according to length of gestation. Six hundred and eighteen children born preterm and now aged 7.5 to 8 years were studied prospectively. Systolic blood pressure in children from smoking compared with non-smoking mothers was significantly lower in those born before 33 weeks' gestation and significantly higher in those born at 33 or more weeks. Within the range 0-40 cigarettes per day until delivery (after adjusting for potentially confounding factors, including social class and current weight) each 10 was associated with a 1.5 mm Hg fall and 2.9 mm Hg rise in pressure for children born below or above 33 weeks' gestation respectively. Similar though smaller differences were seen in diastolic pressure. These data support our hypothesis that later effects of insults impairing fetal growth are gestation dependent, and provide the first evidence that maternal smoking may have long term consequences for blood pressure in children.
早产婴儿出生时胎儿生长受限可能与日后血压降低有关，但足月出生的儿童则与血压升高有关。因此，有人提出假设，孕期母亲吸烟与胎儿生长受限有关，会根据妊娠期长短对日后血压产生不同影响。对618名早产且目前年龄在7.5至8岁的儿童进行了前瞻性研究。孕期母亲吸烟的儿童与不吸烟母亲的儿童相比，妊娠33周前出生的儿童收缩压显著较低，而33周及以上出生的儿童收缩压显著较高。在分娩前每天吸烟0至40支的范围内（在调整了包括社会阶层和当前体重等潜在混杂因素后），每增加10支烟，妊娠33周以下或以上出生的儿童血压分别下降1.5毫米汞柱和上升2.9毫米汞柱。舒张压也出现了类似但较小的差异。这些数据支持了我们的假设，即损害胎儿生长的不良影响的后期效应取决于妊娠期，并首次证明母亲吸烟可能对儿童血压产生长期影响。
