Persistent Effects of Maternal Smoking during Pregnancy on Lung Function and Asthma in Adolescents

Hollams, Elysia M.; Klerk, Nicholas de; Holt, Patrick G.; Sly, Peter D.

doi:10.1164/rccm.201302-0323oc

Cited by 100 publications

(76 citation statements)

References 51 publications

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“…25 In our study, the influence of SHS exposure was strongest on asthma in preschool age, whereas there was no elevated risk for incident cases of asthma at later ages. Recent findings from an Australian birth cohort reported an elevated risk for current asthma at 14 years associated with maternal smoking during pregnancy, 26 which is not supported by our findings.…”

Section: Discussioncontrasting

confidence: 99%

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Thacher¹,

Gruzieva²,

Pershagen

et al. 2014

Pediatrics

111

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WHAT'S KNOWN ON THIS SUBJECT: Exposure to second-hand tobacco smoke during pregnancy and infancy has been linked to development of asthma, rhinitis, and eczema in young children. It is unclear whether these risks persist into adolescence. WHAT THIS STUDY ADDS:Exposure to second-hand smoke in utero or during infancy influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages. abstract OBJECTIVES: To examine the role of prenatal and postnatal secondhand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age. METHODS:A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.RESULTS: Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15-1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01-1.51), rhinitis (OR = 1.18; 95% CI, 1.01-1.39), and eczema (OR = 1.26; 95% CI, 1.09-1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages. CONCLUSIONS:Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.

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Section: Discussioncontrasting

confidence: 99%

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Thacher¹,

Gruzieva²,

Pershagen

et al. 2014

Pediatrics

111

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“…Others have described cross-sectional (23)(24)(25)(26)(27) and longitudinal associations (18) between lower lung function and second-hand smoke exposure, but the effect of maternal smoking during pregnancy on lung function in children with CF has not to our knowledge been examined elsewhere. The effect of maternal smoking during pregnancy has been shown to be associated with lower lung function in healthy infants and adolescents and more symptoms in young children with asthma (28)(29)(30). Our results will need to be corroborated in other cohorts, but encouraging mothers known to be expecting a child with CF, for example, with positive results on prenatal screening, to stop smoking may provide benefit to later lung function.…”

Section: Original Researchmentioning

confidence: 70%

Early Childhood Risk Factors for Decreased FEV₁at Age 6-7 Years in Young Children with Cystic Fibrosis

et al. 2015

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Rationale: There are limited objective measures of the severity of lung disease before children are able to routinely perform spirometry, generally at age 6 years. Identifying risk factors for reduced lung function at age 6 provides opportunities to intervene and slow the progression of cystic fibrosis (CF) lung disease.Objectives: To evaluate early childhood predictors of lung function at age 6-7 in a large U.S. CF cohort in the current era of widespread early eradication therapy for Pseudomonas aeruginosa (P. aeruginosa).Methods: Participants were children with CF enrolled before age 4 in the Early Pseudomonas Infection Control (EPIC) Observational Study, a multicenter, longitudinal study that enrolled P. aeruginosa-negative children not exceeding 12 years of age. Linear regression was used to estimate the association between potential early childhood risk factors and the best FEV 1 % predicted at age 6-7 years.Measurements and Main Results: Four hundred and eightyfour children (of 1,797 enrolled in the EPIC Observational Study) met the eligibility criteria for this analysis. Mean (SD) age at enrollment was 2.0 (1.3) years. In a multivariable model adjusted for age at enrollment, the following risk factors were significantly associated with lower mean (95% confidence interval) FEV 1 % predicted at age 6-7: weight percentile less than 10% during the year of enrollment (-5.3 [-9.1, -1.5]), P. aeruginosa positive during the year of enrollment (-2. Conclusions:In this large U.S. cohort, we identified several early childhood risk factors for lower FEV 1 at age 6-7 years, most of which are modifiable. Clinical trial registered with www.clinicaltrials.gov (NCT00097773).Keywords: cystic fibrosis; lung function; microbiology; tobacco smoke pollution Correspondence and requests for reprints should be addressed to Don B. Sanders, M.D., M.S.,

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“…See Figure 1. They comprised 6 birth cohorts [17][18][19][20][21][22] and 19 population-based longitudinal studies. [12,13,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Tables 1 and 2 give an overview of the included studies.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of early life factors which adversely affect subsequent lung function

Kouzouna

Gilchrist

Ball

et al. 2016

Paediatric Respiratory Reviews

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It has been known for many years that multiple early life factors can adversely affect lung function and future respiratory health. This is the first systematic review to attempt to analyse all these factors simultaneously. We adhered to strict a priori criteria for inclusion and exclusion of studies.The initial search yielded 29,351 citations of which 208 articles were reviewed in full and 25 were included in the review. This included 6 birth cohorts and 19 longitudinal population studies. The 25 studies reported the effect of 74 childhood factors (on their own or in combinations with other factors) on subsequent lung function reported as percent predicted forced expiration in one second (FEV 1 ). The childhood factors that were associated with a significant reduction in future FEV 1 could be grouped as: early infection, bronchial hyper-reactivity (BHR) / airway lability, a diagnosis of asthma, wheeze, family history of atopy or asthma, respiratory symptoms and prematurity / low birth weight. A complete mathematical model will only be possible if the raw data from all previous studies is made available. This highlights the need for increased cooperation between researchers and the need for international consensus about the outcome measures for future longitudinal studies.

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Persistent Effects of Maternal Smoking during Pregnancy on Lung Function and Asthma in Adolescents

Cited by 100 publications

References 51 publications

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Early Childhood Risk Factors for Decreased FEV₁at Age 6-7 Years in Young Children with Cystic Fibrosis

A systematic review of early life factors which adversely affect subsequent lung function

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Persistent Effects of Maternal Smoking during Pregnancy on Lung Function and Asthma in Adolescents

Cited by 100 publications

References 51 publications

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Early Childhood Risk Factors for Decreased FEV1at Age 6-7 Years in Young Children with Cystic Fibrosis

A systematic review of early life factors which adversely affect subsequent lung function

Contact Info

Product

Resources

About

Early Childhood Risk Factors for Decreased FEV₁at Age 6-7 Years in Young Children with Cystic Fibrosis