母体孕期主动或被动吸烟与后代多指(趾)畸形的病例对照研究

目的 近年来，临床上所见多指（趾）畸形的患儿数量与日俱增。除了遗传因素外，母体怀孕期间自身行为和环境因素的影响也越显重要；然而，关于这些影响的流行病学数据十分匮乏。方法 采用以医院为基础、以患儿年龄配对的1∶2病例对照研究，对多指（趾）患儿与正常儿的母亲进行问卷调查。采用交互作用分析、协变量筛选和多元logistic回归分析探究母亲孕期吸烟（主动或被动）和后代多指（趾）畸形的危险因素关系。结果 研究对象共纳入病例组143例，对照组286例。孕妇在怀孕期间吸烟，显著增加后代多指（趾）畸形的发病风险（主动吸烟：OR=4.74，95% CI：1.43～15.65，P=0.011；被动吸烟：OR=2.42，95% CI：1.32～4.44，P=0.004）。调整混杂因素后，母亲孕期吸烟对后代多指（趾）畸形的影响仍显著存在（主动吸烟：aOR=7.27，95% CI：1.72～30.72，P=0.007；被动吸烟：aOR=2.41，95% CI：1.11～5.23，P=0.026）。结论 母亲孕期主动或被动吸烟是后代发生多指（趾）畸形的危险因素，显著增加其发病风险。

Active and passive maternal smoking during pregnancy and risk of having a child with polydactyly: a case-control study

Objective The number of children with polydactyly is increasing. In addition to genetic factors, an influence of maternal behavior or environmental effects during pregnancy is becoming increasingly apparent. However, epidemiological data on these effects are lacking. Methods This hospital-based, case-control study enrolled 143 infants with polydactyly and 286 controls without genetic diseases to evaluate the association between active and passive maternal smoking during pregnancy and the likelihood of giving birth to a child with polydactyly. Results Active and passive maternal smoking during pregnancy was associated with an increased risk of giving birth to a child with polydactyly (active smoking:OR=4.74, 95% CI:1.43-15.65, P=0.011; passive smoking:OR=2.42, 95% CI:1.32-4.44, P=0.004). After adjusting for confounders, smoking during pregnancy remained significant influence on polydactyly (active smoking:aOR=7.27, 95% CI:1.72-30.72, P=0.007; passive smoking:aOR=2.41, 95% CI:1.11-5.23, P=0.026). Conclusion Active and passive maternal smoking during pregnancy appears to be a risk factor for polydactyly in newborns.