孕妇被动吸烟与低出生体重关系的Meta分析

目的分析孕妇孕早期和不同孕期被动吸烟对新生儿低出生体重的影响。方法通过Meta分析方法分析孕妇被动吸烟与新生儿低出生体重之间的关系。对NCBI、OVID-MEDLINE、CNKI、VIP以及CBM数据库进行检索(截止日期为2008年4月),结果报告合并OR值及95%CI。结果共获得26篇文献,其中队列研究20篇,病例对照研究6篇。总体分析,孕妇被动吸烟的合并效应值OR=1.65(95%CI:1.39～1.97);调整合并效应值OR=1.60(95%CI:1.25～2.05);最低和最高暴露量的合并效应值分别为OR=1.53(95%CI:1.14～2.04)和OR=2.53(95%CI:1.46～4.36);孕早期暴露的合并效应值OR=1.12(95%CI:0.82～1.55),没有统计学意义。结论孕妇被动吸烟增加新生儿低出生体重的危险性;孕中晚期可能是被动吸烟效应的敏感期;被动吸烟的阈值是否存在尚不明确。

Meta analysis of effects on maternal passive smoking during pregnancy on fetal low birth weight

Objective To analyze the effect of passive smoking of pregnancy women in early pregnancy and different stages during pregnancy on fetal Low-Birth-Weight. Methods Meta analysis was applied to analyze the relationship between maternal passive smoking during pregnancy and fetal low-birth-weight. NCBI, OVID-MEDLINE, CNKI, VIP and CBM were searched with the language limited to Chinese and English. The search was finished in April 2008. Pooled ORs with 95% CI were estimated. Results Totally, 26 papers were got, including 20 cohort studies and 6 case-control studies. Maternal passive smoking was associated with an increased risk of low-birth-weight. The unadjusted pooled OR was 1.65 (95% CI = 1.39 - 1.97), and the adjusted pooled OR was 1.60 (95% CI = 1.25 - 2.05) . The pooled OR of exposure with lowest and highest level were OR = 1.53 (95 % CI: 1.14 - 2.04 ) and OR = 2.53 (95 % CI: 1.46 - 4.36), respectively. The pooled OR of exposure at early pregnancy was 1.12 (95% CI - 0.82-1.55), with no statistically significance. Conclusion Maternal passive smoking during pregnancy could increase the risk of delivering a low birth-weight baby. Middle or late pregnancy might be the sensitive period of passive smoking's effect. Whether passive smoking' s threshold effect exists or not is still not sure.