Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure.
OBJECTIVE
Adverse effects have been reported of prenatal and/or postnatal passive exposure to smoking on children's health. Uncertainties remain about the relative importance of smoking at different periods in the child's life. We investigate this in a pooled analysis, on 53,879 children from 12 cross-sectional studies--components of the PATY study (Pollution And The Young).


METHODS
Effects were estimated, within each study, of three exposures: mother smoked during pregnancy, parental smoking in the first two years, current parental smoking. Outcomes were: wheeze, asthma, "woken by wheeze", bronchitis, nocturnal cough, morning cough, "sensitivity to inhaled allergens" and hay fever. Logistic regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results, and mean effects (allowing for heterogeneity) were estimated using meta-analytical tools.


RESULTS
There was strong evidence linking parental smoking to wheeze, asthma, bronchitis and nocturnal cough, with mean odds ratios all around 1.15, with independent effects of prenatal and postnatal exposures for most associations.


CONCLUSIONS
Adverse effects of both pre- and postnatal parental smoking on children's respiratory health were confirmed. Asthma was most strongly associated with maternal smoking during pregnancy, but postnatal exposure showed independent associations with a range of other respiratory symptoms. All tobacco smoke exposure has serious consequences for children's respiratory health and needs to be reduced urgently.
Pattenden
Sam
S
London School of Hygiene & Tropical Medicine, London, UK.
Antova
Temenuga
T
Neuberger
Manfred
M
Nikiforov
Bojidar
B
De Sario
Manuela
M
Grize
Leticia
L
Heinrich
Joachim
J
Hruba
Frantiska
F
Janssen
Nicole
N
Luttmann-Gibson
Heike
H
Privalova
Larissa
L
Rudnai
Peter
P
Splichalova
Anna
A
Zlotkowska
Renata
R
Fletcher
Tony
T
D016902:Air Pollution, Indoor / Q000009:adverse effects*; D002648:Child; D002669:Child Welfare; D003371:Cough / Q000209:etiology; D003430:Cross-Sectional Studies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D012135:Respiratory Sounds / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution