孕期被动吸烟对妊娠并发症及妊娠结局的影响

目的了解孕期被动吸烟发生情况,并探讨其对妊娠并发症及结局的影响。方法选取2012年4月―2013年3月在我国15家医疗保健机构分娩的8926例单胎活产产妇作为研究对象,使用自制调查问卷收集孕期被动吸烟发生情况、妊娠并发症和结局等信息,采用单因素和多因素Logistic回归分析模型分析孕期被动吸烟对妊娠并发症及结局的影响。结果共1801例产妇在孕期经历被动吸烟。控制混杂因素后,孕期经历被动吸烟的产妇妊娠期糖尿病(gestational diabetes mellitus,GDM)的发生风险是非被动吸烟者的1.359倍(95%CI:1.146~1.612,P<0.001),胎膜早破的风险为1.290倍(95%CI:1.095~1.520,P=0.002),早产的风险为1.367倍(95%CI:1.155~1.619,P<0.001),娩出低出生体重儿的风险为1.341倍(95%CI:1.079~1.668,P=0.008)。与非被动吸烟者相比,平均每周被动吸烟天数≥4天者胎膜早破、早产和低出生体重儿的发生风险分别为非被动吸烟者的1.402倍(95%CI:1.104~1.780,P=0.006)、1.690倍(95%CI:1.339~2.132,P<0.001)和1.584倍(95%CI:1.172~2.141,P=0.023)。结论被调查产妇孕期被动吸烟率较高,孕期经历被动吸烟能够增加妊娠期糖尿病、胎膜早破、早产和低出生体重儿的发生风险。

The effect of passive smoking during pregnancy on pregnancy complications and outcomes

  Objective  To assess the prevalence of passive smoking during pregnancy, and toexplore the effect of passive smoking during pregnancy on pregnancy complications and outcomes.  Methods  A total of 8 926 postpartum women who delivered live singletons between April, 2012 to March, 2013 in 15 hospitals were enrolled. A self-made questionnaire was used to collect general information, occurrence of passive smoking during pregnancy, pregnancy complications and outcomes. Logistic regression models were used to analyze the effect of passive smoking during pregnancy on pregnancy complications and outcomes.  Results  A total of 1 801 women had experienced passive smoking during pregnancy. After adjusting for covariates, women who experienced passive smoking during pregnancy had an increased risk of gestational diabetes mellitus(OR=1.359, 95% CI:1.146-1.612, P < 0.001), premature rupture of membranes(OR=1.290, 95% CI:1.095-1.520, P=0.002), preterm birth(OR=1.367, 95% CI:1.155-1.619, P < 0.001), and delivering low birth weight infants(OR=1.341, 95% CI:1.079-1.668, P=0.008). Compared to those who did not experience passive smoking, women experienced passive smoking≥4 days/week had an increased risk of premature rupture of membranes(OR=1.402, 95% CI:1.104-1.780, P=0.006), preterm birth(OR=1.690, 95% CI:1.339-2.132, P < 0.001), and low birth weight(OR=1.584, 95% CI:1.172-2.141, P=0.023).  Conclusions  In this study, passive smoking during pregnancy is prevalent, and passive smoking during pregnancy may increase the risk of pregnancy outcomes like gestational diabetes mellitus, premature rupture of membranes, preterm birth and low birth weight.