Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function

Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, California 90033, USA.
Thorax (Impact Factor: 8.29). 05/2000; 55(4):271-6.
Source: PubMed


Exposure to environmental tobacco smoke (ETS) during childhood and in utero exposure to maternal smoking are associated with adverse effects on lung growth and development.
A study was undertaken of the associations between maternal smoking during pregnancy, exposure to ETS, and pulmonary function in 3357 school children residing in 12 Southern California communities. Current and past exposure to household ETS and exposure to maternal smoking in utero were assessed by a self-administered questionnaire completed by parents of 4th, 7th, and 10th grade students in 1993. Standard linear regression techniques were used to estimate the effects of in utero and ETS exposure on lung function, adjusting for age, sex, race, Hispanic ethnicity, height, weight, asthma, personal smoking, and selected household characteristics.
In utero exposure to maternal smoking was associated with reduced peak expiratory flow rate (PEFR) (-3.0%, 95% CI -4.4 to -1.4), mean mid expiratory flow (MMEF) (-4.6%, 95% CI -7.0 to -2.3), and forced expiratory flow (FEF(75)) (-6.2%, 95% CI -9.1 to -3.1), but not forced expiratory volume in one second (FEV(1)). Adjusting for household ETS exposure did not substantially change these estimates. The reductions in flows associated with in utero exposure did not significantly vary with sex, race, grade, income, parental education, or personal smoking. Exposure to two or more current household smokers was associated with reduced MMEF (-4.1%, 95% CI -7.6 to -0. 4) and FEF(75) (-4.4%, 95% CI -9.0 to 0.4). Current or past maternal smoking was associated with reductions in PEFR and MMEF; however, after adjustment for in utero exposure, deficits in MMEF and FEF(75) associated with all measurements of ETS were substantially reduced and were not statistically significant.
In utero exposure to maternal smoking is independently associated with decreased lung function in children of school age, especially for small airway flows.

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    • "A variety of adverse health outcomes are linked to cigarette smoking before and during pregnancy, and there are no speculations about the possible difference in health effects by children's sex. Maternal prenatal cigarette smoke damages the antioxidant system, has a negative impact on both the mother and the fetus on the genetic and cellular levels, and might disturb the development of the immune system in the fetus [1, 46]. Genetic polymorphism associated with airway hyperresponsiveness also has an impact on the expression of asthma symptoms [18, 47]. "
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    ABSTRACT: Aim: To investigate the association between maternal smoking during pregnancy, second-hand tobacco smoke (STS) exposure, education level, and preschool children's wheezing and overweight. Methods: This cohort study used data of the KANC cohort--1,489 4-6-year-old children from Kaunas city, Lithuania. Multivariate logistic regression was employed to study the influence of prenatal and postnatal STS exposure on the prevalence of wheezing and overweight, controlling for potential confounders. Results: Children exposed to maternal smoking during pregnancy had a slightly increased prevalence of wheezing and overweight. Postnatal exposure to STS was associated with a statistically significantly increased risk of wheezing and overweight in children born to mothers with lower education levels (OR 2.12; 95% CI 1.04-4.35 and 3.57; 95% CI 1.76-7.21, accordingly). Conclusions: The present study findings suggest that both maternal smoking during pregnancy and STS increase the risk of childhood wheezing and overweight, whereas lower maternal education might have a synergetic effect. Targeted interventions must to take this into account and address household smoking.
    BioMed Research International 07/2014; 2014:240757. DOI:10.1155/2014/240757 · 3.17 Impact Factor
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    • "Between the ages of five and thirty-four (when asthma is easier to distinguish from other causes of ventilatory impairment), African Americans experience an asthma mortality rate approximately three to five times higher than that of whites (Akinbami , Moorman, & Liu, 2011). Multiple risk factors have been implicated for asthma morbidity and mortality for racial and ethnic minorities: tobacco smoke exposure, obesity, air pollution, house dust mite allergens, cockroaches , and cat hair (Luder, Melnik, & DiMaio, 1998; Gilliland, et al., 2000). An elevated level of severe asthma and related hospitalization among inner-city minority children is associated with features of health care and treatment, such as inadequate use of long-term controller steroid medications and overuse of quick-acting reliever drugs such as albuterol (Ortega & Calderon, 2000). "
    Changing the U.S. Health Care System, 4th Edition edited by Gerald F. Kominski, 01/2014: chapter 4: pages 103-134; , ISBN: 978-1118128916
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    • "Due to previous findings that showed lower lung function outcomes due to various tobacco smoke exposures [2-4,32], we assessed the critical period where lung development may be severely impaired by tobacco smoke exposure. No two-way interaction effects of tobacco smoke with GSTM2-5 loci were seen, which is in contrast to findings by Breton et al., who reported interaction effects with GSTM2 and in utero tobacco smoke [13]. "
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