孕期母亲吸烟及哮喘家族史对新生儿呼吸功能的影响。

Effects of maternal smoking during pregnancy and a family history of asthma on respiratory function in newborn infants.

作者信息

Stick S M, Burton P R, Gurrin L, Sly P D, LeSouëf P N

机构信息

Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia.

出版信息

Lancet. 1996 Oct 19;348(9034):1060-4. doi: 10.1016/s0140-6736(96)04446-7.

DOI:10.1016/s0140-6736(96)04446-7

PMID:8874457

Abstract

INTRODUCTION

Infants of mothers who smoke have reduced respiratory function and are more likely to develop wheezing. Little evidence is available on the effect of in-utero cigarette-smoke exposure as opposed to postnatal exposure to environmental tobacco smoke. We used a previously validated non-invasive method to measure the time to peak tidal expiratory flow (tPTEF) as a proportion of expiratory time (tE) in newborn infants soon after birth to examine the effects of a family history of asthma and in-utero cigarette-smoke exposure on the infants' respiratory function.

METHODS

We collected respiratory-function data from 500 healthy infants of mothers taking part in the Western Australia Pregnancy Cohort Study. During behaviourally defined quiet sleep, measurements were obtained a median of 58 h (range 26-159) after the infants were born. We used uncalibrated inductance plethysmography. The uncalibrated volume signal was differentiated to flow and used to calculate respiratory rate, total inspiratory time, tE, and tPTEF. Mothers answered questionnaires on demographic, medical, and pregnancy characteristics, including smoking history. Serum cotinine measurements were available to validate self-reported smoking history in a subset of mothers (238).

RESULTS

Data suitable for analysis were obtained from 461 infants. In multivariate regression analysis, lower values of tPTEF/tE were independently associated with respiratory rate (beta coefficient per 10 breaths/min 0.018 [SE 0.005], p < 0.01), age (beta coefficient per 10 h -0.008 [0.003], p < 0.01), maternal smoking during pregnancy (> 10 cigarettes daily; beta coefficient -0.049 [0.022], p < 0.05), maternal hypertension during pregnancy (-0.037 [0.015], p < 0.02), and a family history of asthma (-0.028[0.014], p < 0.05).

CONCLUSIONS

In-utero smoke exposure, a family history of asthma, and maternal hypertension during pregnancy are associated with reduced respiratory function after birth. We speculate that these factors adversely affect lung development in utero.

摘要

引言

母亲吸烟的婴儿呼吸功能会降低，且更易出现喘息。与出生后暴露于环境烟草烟雾相比，关于子宫内接触香烟烟雾影响的证据较少。我们使用一种先前验证过的非侵入性方法，在新生儿出生后不久测量呼气潮流量峰值时间（tPTEF）占呼气时间（tE）的比例，以研究哮喘家族史和子宫内接触香烟烟雾对婴儿呼吸功能的影响。

方法

我们从参与西澳大利亚妊娠队列研究的500名母亲的健康婴儿中收集呼吸功能数据。在行为学定义的安静睡眠期间，在婴儿出生后中位数时间为58小时（范围26 - 159小时）进行测量。我们使用未校准的感应体积描记法。将未校准的体积信号微分得到流量，并用于计算呼吸频率、总吸气时间、tE和tPTEF。母亲们回答了关于人口统计学、医学和妊娠特征的问卷，包括吸烟史。在一部分母亲（238名）中可获得血清可替宁测量值以验证自我报告的吸烟史。

结果

从461名婴儿中获得了适合分析的数据。在多变量回归分析中，tPTEF/tE值较低与呼吸频率（每10次呼吸/分钟的β系数为0.018 [标准误0.005]，p < 0.01）、年龄（每10小时的β系数为 - 0.008 [0.003]，p < 0.01）、孕期母亲吸烟（每天> 10支香烟；β系数为 - 0.049 [0.022]，p < 0.05）、孕期母亲高血压（ - 0.037 [0.015]，p < 0.02）以及哮喘家族史（ - 0.028[0.014]，p < 0.05）独立相关。