Bardy A H, Seppälä T, Lillsunde P, Kataja J M, Koskela P, Pikkarainen J, Hiilesmaa V K
National Public Health Institute, Helsinki, Finland.
Br J Obstet Gynaecol. 1993 Aug;100(8):721-6. doi: 10.1111/j.1471-0528.1993.tb14262.x.
To measure quantitatively and objectively the maternal and fetal tobacco exposure during pregnancy and its neonatal effects.
Tobacco exposure was assessed from maternal serum samples, obtained during the first half of pregnancy and from umbilical serum samples obtained at delivery, by measuring the concentration of nicotine metabolite, cotinine. Data on the respective pregnancies and neonates were collected from the Finnish Medical Birth Registry.
Finland.
One thousand two hundred and thirty-seven pregnancies and newborns, representing all pregnancies resulting in a liveborn infant during one week in one country.
Gestational age, birthweight and crown-heel length of newborns.
Cotinine (> 6 micrograms/l) was detected in either maternal or umbilical serum in 300 pregnancies, and these mothers and newborns were classified as exposed. Important differences occurred between measured exposure and reported smoking behaviour. Of the exposed mothers, 38% were nonsmokers and 3.4% of the nonexposed mothers were smokers. Tobacco exposure was associated with shorter gestational age, reduced birthweight and shorter crown-heel length of the newborns. After correction for parity, gender, and gestational age, the exposed newborns were on average 188 g (95% confidence interval (CI) 123-253 g) lighter and 10 mm (95% CI 7-13 mm) shorter than the nonexposed newborns. One micrograms/ml of cotinine in maternal serum resulted in a mean decrease of 1.29 g (95% CI 0.55-2.02 g) in birthweight and in a mean decrease of 0.059 mm (95% CI 0.035-0.083 mm) in birth length. Maternal cotinine concentrations better explained the neonatal findings than the reported smoking habits.
There is a quantitative dose and effect relation between tobacco exposure and a decrease in the gestational age at birth and size of the neonate. The smoking habit reported by mothers themselves is not an accurate measure of fetal tobacco exposure.
定量、客观地测量孕期母婴烟草暴露情况及其对新生儿的影响。
通过测量尼古丁代谢物可替宁的浓度，从妊娠前半期采集的孕妇血清样本以及分娩时采集的脐血血清样本中评估烟草暴露情况。从芬兰医学出生登记处收集各相关妊娠和新生儿的数据。
芬兰。
1237例妊娠及新生儿，代表该国某一周内所有活产婴儿的妊娠情况。
新生儿的胎龄、出生体重和顶臀长度。
在300例妊娠的孕妇或脐血血清中检测到可替宁（>6微克/升），这些母亲和新生儿被归类为暴露组。实测暴露情况与报告的吸烟行为之间存在重要差异。在暴露组母亲中，38%为非吸烟者，在非暴露组母亲中，3.4%为吸烟者。烟草暴露与新生儿胎龄缩短、出生体重降低和顶臀长度缩短有关。在对产次、性别和胎龄进行校正后，暴露组新生儿平均比非暴露组新生儿轻188克（95%置信区间（CI）123 - 253克），短10毫米（95%CI 7 - 13毫米）。孕妇血清中每1微克/毫升可替宁导致出生体重平均下降1.29克（95%CI 0.55 - 2.02克），出生身长平均下降0.059毫米（95%CI 0.035 - 0.083毫米）。孕妇可替宁浓度比报告的吸烟习惯能更好地解释新生儿的情况。
烟草暴露与出生时胎龄减少和新生儿体型减小之间存在定量的剂量 - 效应关系。母亲自己报告的吸烟习惯并非胎儿烟草暴露的准确衡量指标。
