母亲在孕早期戒烟与出生后子代4年内的体重状态：前瞻性队列研究
2009/05/20
背景：母亲孕期吸烟与胎儿生长受到抑制及后代儿童期体重超重风险增加有关。若母亲在怀孕早期戒烟，胎儿生长将不会受到抑制，但后代超重的风险是否增加尚不清楚。
目的：研究与非吸烟母亲的后代相比，母亲在怀孕早期戒烟，出生后4岁的儿童是否具有较高的平均体重指数（BMI）和/或超重的危险增加。
研究设计：基于挪威母亲和儿童的前瞻性研究。
受试对象：共711名儿童入选，540名儿童的母亲从不吸烟，114名儿童的母亲在怀孕早期戒烟，57名儿童的母亲在整个怀孕期吸烟。
结果检测：儿童4岁时采用国际标准检测BMI和超重。
结果：与从不吸烟母亲的小孩相比，吸烟母亲的小孩具有较高的平均体重指数（平均差: 0.47; 95% CI: 0.10, 0.84 kg/m2），但与从不吸烟母亲的小孩相比，停止吸烟母亲的小孩平均BMI无增加(平均差: 0.02; 95% CI: -0.24, 0.28 kg/m2)。与其类似，吸烟母亲的小孩超重的危险增加（校正后OR=2.83; 95% CI: 1.13, 7.10），而与从未吸烟母亲的小孩相比，停止吸烟母亲的小孩超重危险不增加（校正后OR=1.29; 95% CI: 0.62, 2.68）。
结论：若母亲怀孕早期戒烟，吸烟暴露与儿童超重之间的关系将不再维持。
（林江涛 审校）
Fasting MH, et al. Early Hum Dev. 2009 Jan;85(1):19-24. Epub 2008 Jul 3.
Maternal smoking cessation in early pregnancy and offspring weight status at four years of age. A prospective birth cohort study.
BACKGROUND: Maternal smoking during pregnancy is associated with fetal growth restriction, but also with increased risk for overweight in childhood. If the mother stops smoking in early pregnancy fetal growth is not restricted, but whether the risk for later overweight persists is unclear.
AIM: To study if four year old children of mothers who stopped smoking in early pregnancy have higher mean body mass index (BMI) and/or increased odds of being overweight compared with children of non-smokers.
STUDY DESIGN: Prospective population based study on Norwegian mothers and children.
SUBJECTS: Among 711 children available for analysis, 540 were children of never smoking mothers, 114 of mothers who stopped smoking in early pregnancy, and 57 of mothers who continued to smoke throughout pregnancy.
OUTCOME MEASURES: BMI and overweight defined by international criteria at age four.
RESULTS: Compared with children of never smoking mothers, children of smoking mothers had higher mean BMI (mean difference: 0.47; 95% CI: 0.10, 0.84 kg/m(2)), whereas mean BMI was not higher among children of mothers who stopped smoking (mean difference: 0.02; 95% CI: -0.24, 0.28 kg/m(2). Similarly, children of smoking mothers had increased odds for overweight (adjusted OR: 2.83; 95% CI: 1.13, 7.10), whereas children of mothers who stopped smoking did not have increased odds (adjusted OR: 1.29; 95% CI: 0.62, 2.68) compared with children of never smoking mothers.
CONCLUSIONS: In this study, the association between smoking exposure and childhood overweight did not persist in children of mothers who stopped smoking early in pregnancy.
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