title: Maternal smoking affects lung function and airway inflammation in young children with multiple-trigger wheeze.
abstract: BACKGROUND
  Exposure to tobacco smoke is a well-known risk factor for childhood asthma and reduced lung function, but the effect on airway inflammation in preschool-aged children is unclear.
  
  
  OBJECTIVE
  To examine the effect of parental smoking on lung function and fractional concentration of exhaled nitric oxide (Feno) in relation to both parental reports and children's urine cotinine concentrations in preschool-aged children with multiple-trigger wheeze.
  
  
  METHODS
  A total of 105 3- to 7-year-old children with multiple-trigger wheeze and lung function abnormalities were recruited. Lung function was assessed by impulse oscillometry, and Feno measurements were performed. Exposure to tobacco smoke was determined by parental reports and measurement of children's urinary cotinine concentrations.
  
  
  RESULTS
  Forty-three percent of the children were exposed to environmental tobacco smoke according to parental reports. The Feno level was significantly higher in children with a smoking mother (n = 27) than in children with a nonsmoking mother (23.4 vs 12.5 ppb, P = .006). The Feno level expressed as z score and the cotinine level correlated significantly (P = .03). Respiratory resistance at 5 Hz was higher in children exposed to maternal smoking than in others (0.99 vs 0.88 kPas/L, P = .005). Urinary cotinine concentrations reflected well parental reports on their daily smoking and increased relative to the number of cigarettes smoked in the family (P < .01). Atopy was found in 75% of the children, but it was not associated with the Feno value (P = .65).
  
  
  CONCLUSIONS
  Maternal smoking was associated with increased Feno value and poorer lung function in steroid-naive preschool children with multiple-trigger wheeze. Larger controlled trials are needed to generalize the results.
authors: Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland. satu.kalliola@hus.fi
authors: Satu
authors: S
authors: Kalliola
authors: Anna S
authors: AS
authors: Pelkonen
authors: L Pekka
authors: LP
authors: Malmberg
authors: Seppo
authors: S
authors: Sarna
authors: Mauri
authors: M
authors: Hämäläinen
authors: Ilkka
authors: I
authors: Mononen
authors: Mika J
authors: MJ
authors: Mäkelä
mesh_terms: D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D009035:Mothers; D009569:Nitric Oxide / Q000378:metabolism; D009991:Oscillometry; D011014:Pneumonia / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D012135:Respiratory Sounds / Q000209:etiology / Q000503:physiopathology*; D012882:Skin Tests; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D009569:Nitric Oxide; D003367:Cotinine