Prenatal and Postnatal Tobacco Smoke Exposure and Risk of Severe Bronchiolitis During Infancy

Details

• Personal Author:
  Balekian DS ; Behrooz L ; Camargo CA Jr ; Espinola JA ; Faridi MK ; Townley LP
• Description:
  Background: Maternal prenatal smoking has adverse effects on the growing fetus including those of respiratory nature. Although postnatal smoke exposure is a risk factor for respiratory infections, the effects of prenatal smoking independent of postnatal smoke exposure are less established. We hypothesized that both maternal prenatal smoking, and postnatal smoke exposure are risk factors for severe bronchiolitis during infancy. Methods: We performed a case-control study of 1353 children born between 1996 and 2011 at a single teaching hospital. Cases were admitted to the same hospital for bronchiolitis during infancy. Maternal prenatal smoking was collected from birth records. Postnatal smoke exposure was collected from review of electronic health records. Multivariable logistic regression was used to evaluate the independent associations of the two smoking variables with severe bronchiolitis. Results: 6% of cases were exposed to maternal prenatal smoking, compared with 4% of controls (P = 0.10). Postnatal smoke exposure was present in the households of 17% of cases compared with 3% of controls (P < 0.001). In a multivariable model with both smoking variables and adjustment for 10 covariates, maternal prenatal smoking was not a significant risk factor for severe bronchiolitis (adjusted OR = 1.02, 95%CI 0.56-1.84). By contrast, postnatal smoke exposure was associated with >300% increased odds (adjusted OR 4.19, 95%CI 2.51-6.98). Conclusions: Although maternal prenatal smoking has many known adverse effects, it was not associated with increased odds of severe bronchiolitis in either unadjusted or multivariable analyses. Postnatal smoke exposure was a consistently strong risk factor. Our findings support ongoing efforts to decrease infant exposure to ambient smoke. [Description provided by NIOSH]
• Subjects:
  Fetus Occupational Health Pregnancy Risk Assessment Risk Factors Safety Smokers Tobacco Products
• Keywords:
  Author Keywords: Prenatal Smoking Bronchiolitis Children Cigarette Smoke Cigarette Smoking Postnatal Smoke Prenatal Exposure Risk Factors Smoking
• ISSN:
  0954-6111
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  21-26
• Volume:
  140
• NIOSHTIC Number:
  nn:20056533
• Citation:
  Respir Med 2018 Jul; 140:21-26
• Contact Point Address:
  Leili Behrooz MD, MPH, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
• Email:
  lbehrooz@mah.harvard.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  Harvard School of Public Health
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Respiratory Medicine
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b461e0b59b27f998cf7392ba5c17131573e2a567ddfb3a6e740db29ddf907c707068f972d1b8d91341ed8d6e471718d4f13f3b359c8b45d7ca69f6ff5ce075fb
• Download URL:
  https://stacks.cdc.gov/view/cdc/214124/cdc_214124_DS1.pdf
• File Type:
  [PDF - 348.62 KB ]