Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Exposure to second-hand tobacco smoke during pregnancy and infancy has been linked to development of asthma, rhinitis, and eczema in young children. It is unclear whether these risks persist into adolescence. WHAT THIS STUDY ADDS:Exposure to second-hand smoke in utero or during infancy influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages. abstract OBJECTIVES: To examine the role of prenatal and postnatal secondhand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age. METHODS:A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.RESULTS: Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15-1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01-1.51), rhinitis (OR = 1.18; 95% CI, 1.01-1.39), and eczema (OR = 1.26; 95% CI, 1.09-1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages. CONCLUSIONS:Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.

Lifetime prevalence of childhood eczema and the effect of indoor environmental factors: Analysis in Hispanic and non-Hispanic white children

“…30,31 There are a few studies that do not show an association between maternal smoking during pregnancy and eczema. 9,32 In our study, maternal smoking during pregnancy increased the risk of eczema more in Hispanic white children, especially those who did not have a parental history of allergic disease. The discrepancies between the results may have occurred because it is difficult to pinpoint the critical window of exposure and because many prenatal exposures, e.g., heavy maternal smoking in pregnancy, tend to coexist with other environmental and socioeconomic factors.…”

“…26,27 Maternal smoking is a frequently cited early life exposure that has been shown to have an effect on the development of atopic disorders. 9,28,29 Tobacco smoke exacerbates the T-helper 2 response by increasing production of interleukin 4, interleukin 5, and other proinflammatory cytokines that result in increased allergic responses, whereas it reduces the T-helper 1 response by altering natural killer T-cell function and suppressing interferon-␥ production. 30,31 There are a few studies that do not show an association between maternal smoking during pregnancy and eczema.…”

“…Therefore, the environmental exposures during pregnancy or in early life could be important for the development of childhood eczema. Some of the previous studies reported that high mite allergen levels, mold in the kitchen during pregnancy, 7 and maternal smoking in the child's first year of life 8,9 were associated with an increased risk of childhood eczema. Among environmental factors, early life exposure to outdoor air pollution was reported to increase the risk of respiratory tract diseases but not for eczema.…”

A Comparison of the Fagerström Test for Cigarette Dependence and Cigarette Dependence Scale in a Treatment-Seeking Sample of Pregnant Smokers

“…Smoking during pregnancy is not only harmful for the mother but also for the fetus; it is strongly associated with low birth weight, premature delivery, and several medical and psychiatric disorders in the offspring not only in childhood but also later in life. [11][12][13][14][15][16][17][18][19][20] Although pregnant smokers are aware of the harmful effect of smoking, 21,22 those who do not quit are probably those who are the most dependent on cigarettes. Therefore, assessment of cigarette dependence among pregnant smokers is a major issue and instruments assessing it should be extensively studied to learn which one is the best measure of cigarette dependence and the best predictor of postquit abstinence.…”

Variable prevalence of allergic rhinitis and risk factors affecting the prevalence

“…Otuz altı çalışmayı içeren sistematik derlemede ise pasif içicilikle AR arasında ilişki bulunamamıştır. [56,88,[96][97][98][99] …”