孕期被动吸烟对胎儿生长和婴儿神经发育的影响

The Effects of Maternal Passive Smoking During Pregnancy on Fetal Growth and Infant Development.

目的 研究孕期被动吸咽对胎儿生长和婴儿发育的影响。 方法 运用前瞻性队列研究的方法,对102 名孕期有和无被动吸烟史个体所生新生儿的出生体重( 离均差值) 进行比较,并在3 月、6 月和12 月龄时应用Bayley 婴儿发育量表对婴儿进行为期一年的神经发育纵向随访研究。 结果 孕期被动吸烟组新生儿出生体重的离均差值明显低于对照组。在用协方差分析的方法校正了孕龄对出生体重的影响后,差异仍有显著的统计学意义。被动吸烟组在3 月龄时MDI 低于对照组,差异仍有显著的统计学意义。但用多元协方差分析的方法校正了掺杂因素后,被动吸烟对MDI 影响的统计学意义不复存在。 结论 孕期被动吸烟可以降低新生儿的出生体重,这种作用完全独立于孕龄对出生体重的影响。孕期被动吸烟还可能对婴儿早期发育有一过性的损害。

Objective To study the effects of maternal passive smoking duing pregnancy on fetal growth and infant development. Methods We investigated 77 subjects who had prenatally exposed to tobacco by maternal passive smoking and 25 subjects who had no prenatal exposure to tobacco. Birthweight was carefully measured and expressed by Z score and afterwards neurodevelopment was longitudinally followed up by Bayley scale for infant development (BSID) at the ages of 3 month, 6 month and 12 month in all subjects. Results Association between maternal passive smoking during pregnancy and decreased birthweight was shown even after gestational age had been controlled. As for neurodevelopmental outcome, we found a mental development index(MDI) difference between study groups and control group in BSID at 3 month of age, which was statistically significant. However, the significance no longer existed when adjusted for potential confoundings. When the subjects were measured at 6 and 12 months of age, no significant difference was shown between study groups and control group. Conclusions Maternal passive smoking during pregnancy could adversely affect the birthweight. However,there is not strong evidence that prenatal tobacco exposure by maternal passive smoking impacts the neurodevelopment of infant.