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。     

孕妇被动吸烟对妊娠和胎儿影响的调查研究

本文通过1283名被动吸烟产妇和899名正常对照产妇调查提示,被动吸烟也能使孕早期流产率和出生缺陷儿发生率显著上升,被动吸烟组的新生儿窒息率、围产儿死亡率和平均产程时间均相应延长。提出妊娠前后禁烟是实现优生优育的重要措施之一。     

被动吸烟对孕期生殖结局影响的研究

目的:研究孕妇被动吸烟对孕期生殖结局(包括妊娠结局和新生儿情况)的影响.方法:应用生殖流行病学研究方法,对兰州市4所医院500名住院待产妇进行了相关因素调查并追踪至产后7 d.按孕期有、无被动吸烟自然分为吸烟组和对照组.观察各组早产、胎膜早破、过期产、死胎死产及胎儿宫内发育迟缓(IUGR)、新生儿窒息、新生儿出生体重、性别等的发生率及Logistic回归分析进行多因素分析.结果:61.4%孕产妇处于被动吸烟的环境中,且以农村、文化程度低的人群分布较高.孕产妇被动吸烟组早产、过期产、死胎死产、胎膜早破发生率明显高于无被动吸烟组(P＜0.05～P＜0.01).被动吸烟组的新生儿身长、体重明显低于对照组,而IUGR、新生儿窒息的发生率则明显高于对照组,差异显著(P＜0.05～P＜0.01).另外,被动吸烟组的女婴出生率亦高于对照组,差异有显著性(P＜0.05).被动吸烟对妇女早产、胎膜早破、过期产、死胎死产及IUGR、新生儿窒息、低出生体重、性别的关联性最强,OR值分别为3.41、3.07、2.92、1.89和6.16、3.51、2.91、1.83.新生儿死亡、畸胎发生与被动吸烟关联性弱,OR值为0.73与0.68.结论:孕妇被动吸烟可严重影响孕妇与胎儿的生长发育及健康,影响优生.为了减少这种危害,应对工作环境、公共场所限制吸烟,甚至家庭也要限定吸烟地点,对妇女孕期前后应尽量减少暴露于被动吸烟环境.     

被动吸烟对孕期生殖结局影响的研究

目的:研究孕妇被动吸烟对孕期生殖结局(包括妊娠结局和新生儿情况)的影响。方法:应用生殖流行病学研究方法,对兰州市4所医院500名住院待产妇进行了相关因素调查并追踪至产后7 d。按孕期有、无被动吸烟自然分为吸烟组和对照组。观察各组早产、胎膜早破、过期产、死胎死产及胎儿宫内发育迟缓(IUGR)、新生儿窒息、新生儿出生体重、性别等的发生率及Logistic回归分析进行多因素分析。结果:61.4％孕产妇处于被动吸烟的环境中,且以农村、文化程度低的人群分布较高。孕产妇被动吸烟组早产、过期产、死胎死产、胎膜早破发生率明显高于无被动吸烟组(P<0.05-P<0.01)。被动吸烟组的新生儿身长、体重明显低于对照组,而IUGR、新生儿窒息的发生率则明显高于对照组,差异显著(P<0.05-P<0.01)。另外,被动吸烟组的女婴出生率亦高于对照组.差异有显著性(P<0.05)。被动吸烟对妇女早产、胎膜早破、过期产、死胎死产及IUGR、新生儿窒息、低出生体重、性别的关联性最强,OR值分别为3.41、3.07、2.92、1.89和6.16、3.51、2.91、1.83。新生儿死亡、畸胎发生与被动吸烟关联性弱,OR值为0.73与0.68。结论:孕妇被动吸烟可严重影响孕妇与胎儿的生长发育及健康,影响优生。为了减少这种危害,应对工作环境、公共场所限制吸烟,甚至家庭也要?     

流动人口孕妇被动吸烟现状及其对妊娠结局的影响

目的了解不同户籍孕妇被动吸烟现状、影响因素及其对不良妊娠结局及新生儿出生体重的影响。方法采用自愿参加的形式,对于2008年1月至2009年6月在浦江镇流动人口分娩点单胎活产分娩的产妇进行面对面的问卷调查（n=1020）。结果孕妇被动吸烟率84．90％;被动吸烟更多见于20岁以上人群;经产妇、文化水平低、经济状况差被动烟草暴露的比例高;妊娠期高血压、子痫前期更多见于被动吸烟对象;胎儿生长受限更多见于被动吸烟孕妇。结论被动吸烟能对妊娠结局造成不良影响,与新生儿体重过低有关,应加强城市流动人口孕产妇保健知识宣传教育。     

妊娠早期被动吸烟与不良妊娠结局的队列研究

目的分析城市孕早期妇女被动吸烟状况,探讨被动吸烟对不良妊娠结局的影响,减少不良妊娠结局的发生。方法调查孕早期妇女被动吸烟状况,将其分成被动吸烟组与无被动吸烟组,追踪其妊娠结局,采用χ2检验和Logistic回归分析方法,分析被动吸烟与不良妊娠结局的关系。结果城市孕早期妇女被动吸烟率为38·2%,被动吸烟与不良妊娠结局呈一定的剂量-反应关系,每日被动吸烟的时间越长发生不良妊娠结局的可能性就越大,每日被动吸烟的时间超过3h对不良妊娠有显著影响。结论被动吸烟可使不良妊娠发生的危险增加,每日被动吸烟的时间超过3h是不良妊娠的强危险因素。加强孕前对孕妇的宣教和指导,尽量避免暴露于吸烟环境,可减少不良妊娠结局的发生。     

妊娠早期被动吸烟与不良妊娠结局关系的队列研究

目的:分析城市孕早期妇女被动吸烟状况,探讨被动吸烟与不良妊娠结局的关系。方法:调查孕早期妇女被动吸烟状况,追踪其妊娠结局,采用卡方检验和Logistic回归分析的方法,分析被动吸烟与不良妊娠结局的关系。结果:城市孕早期妇女被动吸烟率为38.2%,被动吸烟与不良妊娠结局有一定的剂量反应关系,每日被动吸烟时间超过3 h对妊娠结局有显著影响。结论:被动吸烟可使不良妊娠结局发生的危险增加,每日被动吸烟时间超过3 h是不良妊娠的高危因素,孕妇应尽量避免暴露于吸烟环境,以减少不良妊娠结局的发生。     

孕期保健对孕妇妊娠结局的影响分析

目的对全程孕期保健影响孕妇妊娠结局的效果进行分析与探讨。方法随机选取2015年1~6月在孕期保健的孕妇共480例为研究对象,将其分为对照组与观察组,对照组孕妇实施最基本的常规保健,观察组孕妇实施孕期保健,然后观察两组的孕妇妊辰结局情况。结果观察组的剖宫产率低于对照组,观察组的妊娠期高血压和糖尿病疾病发生率低于对照组,观察组产后出血率低于对照组,观察组自然分娩率高于对照组,观察组妊娠结局优于对照组。结论孕期保健可以有效提高孕妇的自然分娩率,降低妊娠期高血压、糖尿病的发病率及产后出血率,降低不良妊娠结局的发生率,值得临床推广应用。     

孕期发热对妊娠结局影响的研究

目的探讨孕期发热(体温》38℃)对妊娠结局的影响.方法采用产科记录结合问卷调查,收集了北京市8所医院妇产科在1992年5月-1993年4月之间分娩的12 224例初产妇妊娠及妊娠结局资料,并获取有关孕期发热及一般情况资料,从中抽取孕期曾有发热史的产例(发热组)以及孕期无发热史的产例(对照组)分别组成队列,分析孕期发热与不良妊娠结局有无关联,采用Logistic回归分析,调整产妇年龄、自然流产史、孕期患糖尿病史、孕期职业有害因素接触史、孕期吸烟、孕期饮酒等混杂因素.结果孕期曾有发热史的产妇占产妇总数的9.7%.发热组先兆流产、早产、低出生体重儿、宫内发育迟缓、新生儿中枢神经系统畸形、新生儿窒息及新生儿死亡的发生率增高,与对照组比较,差异有显著性(P《0.05).Logistic回归分析结果与单因素分析结果一致.结论孕妇孕期发热(体温》38℃)与不良妊娠结局,特别是与新生儿中枢神经系统畸形的发生间具有一定关联.     

孕妇孕期被动吸烟现状及KAP调查

目的分析孕妇孕期被动吸烟情况及有关被动吸烟知识、态度和行为(KAP)。方法以湖北省武汉市3所医院住院分娩和产前检查的孕妇为研究对象, 采用面对面访谈方式问卷调查孕妇一般特征、被动吸烟状况及有关被动吸烟的KAP信息。结果共调查孕妇806人, 孕期被动吸烟率为34.9%, 无烟家庭共计210户(21.2%);被动吸烟的知识平均得分为(8.75±3.46)分, 暴露组得分(8.35±3.57)分低于非暴露组(8.96±3.38)分, 2组差异有统计学意义(t=2.32, P=0.021);吸烟态度方面, 70%的孕妇反对丈夫抽烟, 80%认为公共场所应该禁烟;对待丈夫吸烟采取的行为方式均以劝阻为主, 对待其他场所其他吸烟者采取的行为以回避为主, 主动劝阻较少, 不同场所的回避率为42.0%～73.0%。结论武汉市孕妇被动吸烟率较高, 孕妇有关被动吸烟的知识掌握不足, 可能使其无法真正采取有效行为避免被动吸烟。     

产妇孕期被动吸烟现况及有关被动吸烟的KAP研究

目的:了解产妇孕期被动吸烟现况及其有关被动吸烟的知识、态度及行为(KAP)。方法:采用随机抽样的方法于2005年4～8月对长沙市5家医院住院分娩的620名产妇进行面对面的问卷访谈,收集产妇孕期被动吸烟的情况及有关被动吸烟的KAP。结果:产妇孕期被动吸烟率为38.9%,烟雾主要来源是家中,其次为打麻将场所;产妇有关被动吸烟的知识平均得分为(5.32±2.08)分(总分12分);其态度有70.2%的产妇认为丈夫应该戒烟,91.0%认为公共场所应该禁烟;对吸烟者采取的行为以回避为主,不同场所的回避率为53.8%～76.6%,而敢于主动劝阻的较少。结论:产妇孕期被动吸烟率较高,烟雾主要来源是在家中,产妇有关被动吸烟的知识掌握不够深入,对于别人吸烟的态度虽然是正面的,但是能够真正采取有效行为避免被动吸烟的很少。     

Influence of maternal active and passive smoking during pregnancy on birthweight in newborns

Many studies have documented a strong association of active smoking during pregnancy with fetal growth retardation. Increasing interest has also been focused on whether there is an association between exposure of pregnant women to environmental tobacco smoke (ETS) and low birthweight of their babies. In the intervention controlled study "Healthy Pregnancy--Healthy Child", mothers after delivery were interviewed by medical students who collected data about their smoking and nutrition. Students were also trained to stimulate non-smoking behaviour and to explain the risks related to smoking and exposure to ETS. Data from 1147 mothers after delivery were collected but only single births were included in the analysis of birthweight. In our study, 63.4% women never smoked and 32.2% women reported they had stopped smoking either before pregnancy or during the first trimester. Only 4.4% of mothers (n = 50) smoked during the whole pregnancy. Women with the history of smoking were exposed to ETS more often than mothers who never smoked (51.6% vs 17.4%; p < 0.001). The number of heavily exposed both at home and workplaces was more than twice higher among former smokers compared with never smokers (22.4% versus 9.4%, p < 0.01). The average birthweight of babies born to women who had stopped smoking was higher than that born to never smokers. The average birthweight of babies born to women who smoked during pregnancy was lower by 119 g and 171 g than that of the babies born to never smokers and former smokers, respectively. When pre-term neonates were excluded, differences in birthweight between babies born to never smokers and either formerly smoking or still smoking mothers were slightly lower. The greatest effect of ETS exposure on birthweight was recorded in never smoking mothers; an average reduction in birthweight was 88 g. A strong dose-effect was observed; in mothers heavily exposed to ETS both at home and at work, the babies' birthweight was lower by 189 g in comparison with the group of non-exposed, never smoking mothers and even by 70 g compared with mothers smoking during pregnancy.     

The impact of maternal smoking during pregnancy on delivery outcome

BACKGROUND: Maternal smoking during pregnancy is associated with pre-term birth, intrauterine growth retardation, a small head circumference, a low Apgar score at 5 min and stillbirths and neonatal deaths. This study was undertaken in order to investigate the impact of maternal smoking during pregnancy when all these outcomes were considered. METHODS: With the use of the Swedish Medical Birth Registry, infants in any one of the above mentioned outcome groups were selected from 1,413,811 infants born between 1983 and 1996 with known smoking exposure in early pregnancy. Confounders such as year of birth, maternal age, parity and educational level were controlled for. The attributable risk of maternal smoking on the various negative delivery outcomes was obtained by application of the risk estimates to population counts. RESULTS: The present study confirmed the associations between maternal smoking and the miscellaneous outcomes mentioned above with high significance. The odds ratios (with 95% confidence intervals) for maternal smoking (< 10 cigarettes/day and > or = 10 cigarettes/day) for any one of the outcomes were 1.39 (1.37-1.41) and 1.65 (1.62-1.68) respectively (dose-response p < 0.001). The number of attributable cases caused by maternal smoking was estimated at 15,000, which represents 9% of all cases and 1% of all infants born in Sweden during the study period. CONCLUSION: Maternal smoking during pregnancy accounts for a substantial part of various negative delivery outcomes.     

孕妇被动吸烟状况分析

目的:了解孕妇被动吸烟状况及相关影响因素。方法:选取河南省妇幼保健院、开封市妇幼保健院、开封市妇产医院、开封县妇幼保健院、杞县妇幼保健院及杞县阳固乡卫生院6家医疗保健机构作为研究现场。抽取在研究现场进行产前检查的孕妇共1660人进行调查研究。结果:被调查对象中有82.4%的孕妇在孕前接触过"二手烟",68.3%的孕妇在孕期接触过"二手烟",孕期被动吸烟率为26.6%。孕周13周、年龄20岁、居住于城镇、孕妇文化程度为小学及以下、孕妇职业为农民、丈夫文化程度为小学、丈夫职业为农民、家庭月收入500～999元、孕期家庭结构为独居、孕妇孕前吸烟、孕前丈夫吸烟以及丈夫吸烟时间10年的孕妇,孕期被动吸烟率较高。孕妇居住地、孕妇孕前吸烟状况及孕前丈夫吸烟时间与孕妇被动吸烟状况有关联。结论:孕妇被动吸烟状况不容忽视,建立无烟家庭势在必行。