文章摘要
李晶,杜玉娇,王红丽,杜姣洋,屈鹏飞,张若,郭乐倩,颜虹,党少农.母亲围孕期被动吸烟与子代先天性心脏病关系的病例对照研究[J].中华流行病学杂志,2020,41(6):884-889
母亲围孕期被动吸烟与子代先天性心脏病关系的病例对照研究
Association between maternal passive smoking during perinatal period and congenital heart disease in their offspring-based on a case-control study
收稿日期:2019-07-10  出版日期:2020-06-16
DOI:10.3760/cma.j.cn112338-20190710-00509
中文关键词: 先天性心脏病;围孕期;被动吸烟;病例对照研究
英文关键词: Congenital heart disease;Perinatal period;Passive smoking;Case-control study
基金项目:陕西省卫生和计划生育委员会出生缺陷防治课题研究(Sxwsjswzfcght2016-013);国家自然科学基金(81230016);国家重点研发计划(2017YFC0907200,2017YFC0907201)
作者单位E-mail
李晶 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
杜玉娇 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
王红丽 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
杜姣洋 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
屈鹏飞 西安交通大学附属西北妇女儿童医院辅助生殖中心 710003  
张若 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
郭乐倩 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
颜虹 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061  
党少农 西安交通大学医学部公共卫生学院流行病与卫生统计学系 710061 tjdshn@mail.xjtu.edu.cn 
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中文摘要:
      目的 探讨母亲围孕期被动吸烟与子代先天性心脏病(CHD)的关系。方法 采用病例对照研究设计,于2014年1月至2016年12月在陕西省开展的CHD病例对照研究。病例组为妊娠满28周至出生后7 d确诊为CHD的围产儿和妊娠<28周但经超声等检查确诊为CHD的胎儿;对照组为未发生任何出生缺陷的同时期新生儿。采用logistic回归模型分析母亲围孕期被动吸烟与子代发生CHD的关系,并进行亚组分析探索其稳定性。结果 共纳入2 259例调查对象,其中病例组695例,对照组1 564例。病例组中围孕期被动吸烟者占26.76%,而对照组中仅占6.01%。在控制了混杂因素后,围孕期被动吸烟者子代患CHD的风险是无被动吸烟者的3.32倍(OR=3.32,95% CI:2.41~4.56)。该风险随着孕妇被动吸烟暴露频率的增加而增大:每周被动吸烟1~3 d的孕妇生育CHD子代的风险是无被动吸烟者的2.75倍(OR=2.75,95% CI:1.62~4.66);而每周被动吸烟超过3 d的孕妇生育CHD子代的风险是无被动吸烟者的3.62倍(OR=3.62,95% CI:2.48~5.29)。亚组分析显示,母亲围孕期被动吸烟和子代CHD的关系稳定。结论 母亲围孕期被动吸烟是子代发生CHD的危险因素。孕妇应尽可能避免二手烟的暴露,防范被动吸烟的危害。
英文摘要:
      Objective To explore the association between maternal passive smoking during perinatal period and congenital heart disease (CHD) in their offspring. Methods A case-control study was designed. Data being used was based on a case-control study of congenital heart disease collected in Shaanxi province from January 2014 to December 2016. Cases under this study were perinatal infants diagnosed as CHD from 28 weeks of gestation to 7 days after birth, and fetus less than 28 weeks of gestation but diagnosed as CHD by ultrasonography. The controls would include newborn infants without any birth defects, born at the same period of the cases. Logistic regression model with confounding factors adjusted was established to analyze the association between maternal passive smoking status during perinatal period and CHD in their offspring. Subgroup analysis was carried out to explore its stability. Results A total of 2 259 subjects, consisting 695 cases and 1 564 controls were included in this study. Passive smokers accounted for 26.76% in the case group while only 6.01% in the control group. After adjusting for related confounding factors, the risk of CHD in the offspring of passive smokers was 3.32 times higher than that of the non-passive smokers (OR=3.32, 95%CI: 2.41-4.56), during the perinatal period. Results also showed that related risk accumulated with the increase of exposure frequency to passive smoking. For mothers who smoked passively for 1-3 days per week, the risk of CHD in their offspring was 2.75 times higher than that of those non-passive smokers (OR=2.75, 95%CI: 1.62-4.66). For mothers who smoked passively for more than 3 days per week, the risk was 3.62 times higher than the non-passive smokers (OR=3.62, 95%CI: 2.48-5.29). Data from the subgroup analysis showed that the association between maternal passive smoking during perinatal period and CHD in their offspring appeared stable. Conclusions Maternal passive smoking during perinatal period seemed a risk factor for congenital heart disease related to their offspring. Pregnant women should avoid exposure to second-hand smoke as much as possible, so as to prevent the harm from passive smoking.
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