title: The effect of active and passive household cigarette smoke exposure on pregnant women with asthma.
abstract: BACKGROUND
  The article was designed to estimate the effect of active and passive household cigarette smoke exposure on asthma severity and obstetric and neonatal outcomes in pregnant women with asthma.
  
  
  METHODS
  We used a secondary observational analysis of pregnant women with mild and moderate-severe asthma enrolled in a prospective observational cohort study of asthma in pregnancy and a randomized clinical trial (RCT) comparing inhaled beclomethasone and oral theophylline. A baseline questionnaire detailing smoking history and passive household smoke exposure was given to each patient. Smoking status was confirmed in the RCT using cotinine levels. Data on asthma severity and obstetric and neonatal outcomes were collected and analyzed with respect to self-reported tobacco smoke exposure. Kruskal-Wallis and Pearson chi(2) statistics were used to test for significance.
  
  
  RESULTS
  A total of 2,210 women were enrolled: 1,812 in the observational study and 398 in the RCT. Four hundred and eight (18%) women reported current active smoking. Of the nonsmokers, 790 (36%) women reported passive household smoke exposure. Active smoking was associated with more total symptomatic days (P < .001) and nights of sleep disturbance (P < .001). Among the newborns of active smokers, there was a greater risk of small for gestational age < 10th percentile (P < .001), and a lower mean birth weight (P < .001). There were no differences in symptom exacerbation or outcome between nonsmokers with and without passive household cigarette smoke exposure.
  
  
  CONCLUSIONS
  Among pregnant women with asthma, active but not passive smoking is associated with increased asthma symptoms and fetal growth abnormalities.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Ste 634, Charleston, SC 29425, USA. newmanr@musc.edu
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: Valerija
authors.initials: V
authors.lastname: Momirova
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Dombrowski
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Robert
authors.initials: R
authors.lastname: Wise
authors.forename: Mark
authors.initials: M
authors.lastname: Landon
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Marshall
authors.initials: M
authors.lastname: Lindheimer
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Jeanne
authors.initials: J
authors.lastname: Sheffield
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Conway
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D001507:Beclomethasone / Q000008:administration & dosage*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D013806:Theophylline / Q000008:administration & dosage*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D013806:Theophylline; D001507:Beclomethasone