title: Tobacco smoke exposure, wheeze, and atopy.
abstract: We investigated the effect of in utero and postnatal environmental tobacco smoke (ETS) exposure on respiratory symptoms and atopy in the first 3 years of life in children at high risk of allergic disease (both parents atopic). Three hundred and sixty-nine children were followed from birth and reviewed at ages 1 and 3 years (respiratory questionnaire, skin testing). Parental smoking questionnaires were administered, and plasma cotinine in cord and peripheral blood (at age 1 year) was measured (capillary column gas-liquid chromatography). Wheezing starting in the first year of life was significantly more common in children of smoking mothers (54.2% vs. 39.5%, P = 0.017), but not wheezing starting after age 1 year (10.8% vs. 10.9%, smoking and nonsmoking mothers, P = 0.99). Detectable cord cotinine was not associated with wheeze. More frequent wheeze in infancy was significantly more common in those with detectable 1-year cotinine (e.g., wheeze without colds, 17.8% vs. 5.6%, P = 0.02; wheeze most days, 6.5% vs. 0%, P = 0.04). ETS exposure was not associated with atopy. In the multivariate regression analysis, maternal smoking during pregnancy and/or in the first year of life remained associated with wheeze in the first year of life (odds ratio, 1.88; 95% confidence interval, 1.14-3.12; P = 0.01). ETS exposure in "high-risk" infants increases the risk of wheezing starting in the first year of life, but not after age 1 year. However, ETS exposure has little or no effect on the development of atopy. Measurement of plasma cotinine was no more useful than tobacco exposure assessment by questionnaire in our cohort.
authors.affiliation: North West Lung Centre, Wythenshawe Hospital, Manchester, UK. cmurray@fs1.with.man.ac.uk
authors.forename: Clare S
authors.initials: CS
authors.lastname: Murray
authors.forename: Ashley
authors.initials: A
authors.lastname: Woodcock
authors.forename: Frazer I
authors.initials: FI
authors.lastname: Smillie
authors.forename: Greg
authors.initials: G
authors.lastname: Cain
authors.forename: Patricia
authors.initials: P
authors.lastname: Kissen
authors.forename: Adnan
authors.initials: A
authors.lastname: Custovic
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003367:Cotinine / Q000032:analysis; D004781:Environmental Exposure; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine