Maternal Second-Hand Smoke Exposure in Pregnancy Is Associated With Childhood Asthma Development.
ABSTRACT Childhood asthma development has been associated with active maternal smoking during pregnancy, but its association with maternal second-hand smoke exposure in pregnancy needs to be evaluated.
We investigated longitudinal associations between maternal smoke exposure in pregnancy and childhood asthma development.
In a population-based cohort of 5619 seven-year-old Toronto children, parents reported age of physician-diagnosed asthma development, maternal smoking during pregnancy, home second-hand smoke exposure from pregnancy until 7 years, demographics, and family history of atopy. By using Cox proportional and discrete-time hazard survival analyses, we evaluated associations between asthma and maternal smoking or home second-hand smoke exposure in pregnancy.
During pregnancy, 5.0% of mothers smoked and 6.2% were nonsmokers and exposed to home second-hand smoke; 15.5% of children developed asthma. Children whose mothers smoked or were exposed to home second-hand smoke during pregnancy were more likely to develop asthma (adjusted hazard ratio [HR] 1.30 [95% CI, 1.06-1.60]). The association persisted for children of nonsmoking mothers with home second-hand smoke exposure during pregnancy (adjusted HR 1.34 [95% CI, 1.01-1.76]), children with asthma symptoms in the past year (adjusted HR 1.36 [95% CI, 1.03-1.79]), and after adjusting for home second-hand smoke exposure from birth to age 7 years.
Maternal home second-hand smoke exposure during pregnancy is associated with incident physician-diagnosed childhood asthma, even if the mother does not smoke actively during pregnancy. Childhood asthma prevention programs should include smoking cessation strategies targeted toward smokers who live in the homes of smoking and nonsmoking pregnant women as well as pregnant women who smoke.
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ABSTRACT: Last year's "Advances in pediatric asthma in 2013: Coordinating asthma care" concluded that, "Enhanced communication systems will be necessary among parents, clinicians, health care providers and the pharmaceutical industry so that we continue the pathway of understanding the disease and developing new treatments that address the unmet needs of patients who are at risk for severe consequences of unchecked disease persistence or progression." This year's summary will focus on further advances in pediatric asthma related to prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding the management of asthma in children as indicated in Journal of Allergy and Clinical Immunology publications in 2014. A major theme of this review is how new research reports can be integrated into medical communication in a population health perspective to assist clinicians in asthma management. The asthma specialist is in a unique position to convey important messages to the medical community related to factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. By enhancing communication among patients, parents, primary care physicians, and specialists within provider systems, the asthma specialist can provide timely information that can help to reduce asthma morbidity and mortality. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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ABSTRACT: The prevalence of asthma has increased dramatically over the past several decades. While hereditary factors are highly important, the rapid rise outstrips the pace of genomic variation. Great emphasis has been placed on potential modifiable early life exposures leading to childhood asthma.International Immunopharmacology 06/2014; DOI:10.1016/j.intimp.2014.06.005 · 2.71 Impact Factor