The association between maternal exposure to secondhand smoke during pregnancy and their children’s cerebral palsy, Shandong, China

Abstract

INTRODUCTION Tobacco use poses a threat to the health of pregnant women and their children. Our study assessed the association between maternal exposure to secondhand smoke (SHS) during pregnancy and children’s cerebral palsy (CP) in Shandong, China. METHODS In our observational study, 5067 mother–child pairs were included from Shandong Province, China. Mothers filled in questionnaires about exposure to SHS during pregnancy. Statistical analysis and logistic regression models were built in R program to estimate the association in adjusted odds ratio (AOR) between SHS exposure during pregnancy and risk of children’s CP, after adjustment for potential confounders including delivery mode and baby’s birthweight. RESULTS Exposure to SHS was noted among 3663 (72.3%) of the 5067 non-smoking mothers during their pregnancy. Of the 239 CP children within the study, 192 (80.3%) were exposed to SHS during pregnancy. Children born to mothers exposed to SHS during pregnancy had a higher risk of CP (AOR=1.44; 95% CI: 1.02–2.04) than those born to non-exposed mothers, the risk increased by exposure time in the logistic regression model. The association between SHS exposure during pregnancy and CP children remained significant when adjusting for delivery mode and infant’s birthweight due to their significant association with CP, with an AOR of 1.46 (95% CI: 1.13–1.91) for 1–4 days/week and 1.63 (95% CI: 1.22–2.01) for 5–7 days/week exposure to SHS. CONCLUSIONS Our study suggests that maternal exposure to secondhand smoke during pregnancy is associated with children’s CP. Future preventive interventions of CP should include strategies that target the antenatal women who are exposed to SHS.

The Impact of Prenatal Environmental Tobacco Smoking (ETS) and Exposure on Chinese Children: A Systematic Review

“…Ren et al [ 27 ] noted that there was a higher rate of maternal exposure to ETS during pregnancy in children with cerebral palsy compared to the general population. After adjusting for confounding factors such as the delivery mode and birth weight, the results still revealed that children born to mothers exposed to ETS during pregnancy had a higher risk of cerebral palsy than the children of unexposed mothers, and this risk increased with increasing durations of ETS exposure [ 27 ]. Moreover, He et al [ 4 ] study indicated that prenatal ETS exposure led to impairment in children’s early cognitive and language development in their first two years of life.…”

“…Two studies explored the relationship between ETS exposure and developmental delay. Ren et al [27] noted that there was a higher rate of maternal exposure to ETS during pregnancy in children with cerebral palsy compared to the general population. After adjusting for confounding factors such as the delivery mode and birth weight, the results still revealed that children born to mothers exposed to ETS during pregnancy had a higher risk of cerebral palsy than the children of unexposed mothers, and this risk increased with increasing durations of ETS exposure [27].…”

Etiological risk factors in children with cerebral palsy

“…[ 9 ] Smoking during pregnancy has been shown to be directly associated with low birth weight. [ 10 ] The patient’s history, physical examination, and laboratory tests are decisive in diagnosis. Teamwork covering many areas of expertise is required in the treatment of CP since many symptoms and clinical findings coexist.…”