title: Pre- and postnatal exposure to parental smoking and allergic disease through adolescence.
abstract: OBJECTIVE
  To examine the role of prenatal and postnatal second-hand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age.
  
  
  METHODS
  A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.
  
  
  RESULTS
  Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15-1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01-1.51), rhinitis (OR = 1.18; 95% CI, 1.01-1.39), and eczema (OR = 1.26; 95% CI, 1.09-1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages.
  
  
  CONCLUSIONS
  Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.
authors.affiliation: Institute of Environmental Medicine, and jesse.thacher@ki.se.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Thacher
authors.affiliation: Institute of Environmental Medicine, and.
authors.forename: Olena
authors.initials: O
authors.lastname: Gruzieva
authors.affiliation: Institute of Environmental Medicine, and Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden;
authors.forename: Göran
authors.initials: G
authors.lastname: Pershagen
authors.affiliation: Institute of Environmental Medicine, and Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden; and.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Neuman
authors.affiliation: Institute of Environmental Medicine, and Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Wickman
authors.affiliation: Institute of Environmental Medicine, and Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden;
authors.forename: Inger
authors.initials: I
authors.lastname: Kull
authors.affiliation: Institute of Environmental Medicine, and Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Melén
authors.affiliation: Institute of Environmental Medicine, and.
authors.forename: Anna
authors.initials: A
authors.lastname: Bergström
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: allergy; asthma; children; cohort study; eczema; rhinitis; tobacco smoking