title: Maternal cigarette smoking and invasive meningococcal disease: a cohort study among young children in metropolitan Atlanta, 1989-1996.
abstract: OBJECTIVE
  This study assessed the association between maternal cigarette smoking during pregnancy and the risk of invasive meningococcal disease during early childhood.
  
  
  METHODS
  Using a retrospective cohort study design, cases from an active surveillance project monitoring all invasive meningococcal disease in the metropolitan Atlanta area from 1989 to 1995 were merged with linked birth and death certificate data files. Children who had not died or acquired meningococcal disease were assumed to be alive and free of the illness. The Cox proportional hazards analysis was used to assess the independent association between maternal smoking and meningococcal disease.
  
  
  RESULTS
  The crude rate of meningococcal disease was 5 times higher for children whose mothers smoked during pregnancy than for children whose mothers did not smoke (0.05% vs 0.01%). Multivariate analysis revealed that maternal smoking (risk ratio [RR] = 2.9; 95% confidence interval [CI] = 1.5, 5.7) and a mother's having fewer than 12 years of education (RR = 2.1; 95% CI = 1.0, 4.2) were independently associated with invasive meningococcal disease.
  
  
  CONCLUSIONS
  Maternal smoking, a likely surrogate for tobacco smoke exposure following delivery, appears to be a modifiable risk factor for sporadic meningococcal disease in young children.
authors.affiliation: Division of Public Health, Georgia Department of Human Resources, Atlanta, USA.
authors.forename: H R
authors.initials: HR
authors.lastname: Yusuf
authors.forename: R W
authors.initials: RW
authors.lastname: Rochat
authors.forename: W S
authors.initials: WS
authors.lastname: Baughman
authors.forename: P M
authors.initials: PM
authors.lastname: Gargiullo
authors.forename: B A
authors.initials: BA
authors.lastname: Perkins
authors.forename: M D
authors.initials: MD
authors.lastname: Brantley
authors.forename: D S
authors.initials: DS
authors.lastname: Stephens
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001719:Birth Certificates; D002675:Child, Preschool; D015331:Cohort Studies; D003644:Death Certificates; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000209:etiology*; D009035:Mothers / Q000193:education; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014504:Urban Health