PURPOSE OF THE STUDY.
The study was conducted to determine if the negative effects of maternal smoking during pregnancy on respiratory health persist into adolescence and, if so, to identify a mechanism.
The study population included 1129 Australian children, age 14 years, seen for one of multiple scheduled follow-up visits as part of a birth cohort study.
Clinical data were collected on current asthma status; serum was collected for total and allergen-specific IgE measurements and for cytokine measurements; and urine was collected for prostaglandin F2α and eosinophil protein X measurements. Prenatal maternal smoking was determined by using an antenatal questionnaire for all participants and with urine cotinine measurements in some participants.
Prenatal exposure to maternal smoking was reported in 21%, and current smoke exposure was reported in 8%. Maternal smoking in pregnancy resulted in a significantly increased risk for current asthma, current wheeze, exercise-induced wheeze, and forced expiratory volume in 1 second/forced vital capacity <80%. However, there was no increased risk for atopy, current asthma medication use, or bronchial hyperresponsiveness. These associations were not altered when adjustments were made for various factors, including current lung function, specific IgE level, and cytokine and inflammatory markers.
Maternal smoking during pregnancy resulted in increased risk of asthma and wheezing at age 14 years. This increased risk was not due to increased atopic sensitization or reduced lung function at this age.
This study is novel in that it assesses the effects of maternal smoking during the prenatal period on asthma and wheezing during adolescence. The findings suggest that prenatal counseling regarding smoking can be used to assist in the primary prevention of asthma.
- Copyright © 2014 by the American Academy of Pediatrics