title: Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants.
abstract: BACKGROUND
  Tobacco smoke exposure (TSE) is a worldwide health problem and it is considered a risk factor for pregnant women's and children's health, particularly for respiratory morbidity during the first year of life. Few significant birth cohort studies on the effect of prenatal TSE via passive and active maternal smoking on the development of severe bronchiolitis in early childhood have been carried out worldwide.
  
  
  METHODS
  From November 2009 to December 2012, newborns born at ≥ 33 weeks of gestational age (wGA) were recruited in a longitudinal multi-center cohort study in Italy to investigate the effects of prenatal and postnatal TSE, among other risk factors, on bronchiolitis hospitalization and/or death during the first year of life.
  
  
  RESULTS
  Two thousand two hundred ten newborns enrolled at birth were followed-up during their first year of life. Of these, 120 (5.4%) were hospitalized for bronchiolitis. No enrolled infants died during the study period. Prenatal passive TSE and maternal active smoking of more than 15 cigarettes/daily are associated to a significant increase of the risk of offspring children hospitalization for bronchiolitis, with an adjHR of 3.5 (CI 1.5-8.1) and of 1.7 (CI 1.1-2.6) respectively.
  
  
  CONCLUSIONS
  These results confirm the detrimental effects of passive TSE and active heavy smoke during pregnancy for infants' respiratory health, since the exposure significantly increases the risk of hospitalization for bronchiolitis in the first year of life.
authors.affiliation: Pediatrics and Neonatology Unit, Imola Hospital, Via Montericco, 4, Imola, Italy. m.lanari@ausl.imola.bo.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Lanari
authors.affiliation: Neonatology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 11 40138, Bologna, Italy. silviavandini@gmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vandini
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. fulvio.adorni@itb.cnr.it.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Adorni
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. federica.prinelli@itb.cnr.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Prinelli
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. s.disanto@hsantalucia.it.|Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy. s.disanto@hsantalucia.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Di Santo
authors.affiliation: Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy. michelasilvestri@ospedale-gaslini.ge.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Silvestri
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. massimo.musicco@itb.cnr.it.|Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy. massimo.musicco@itb.cnr.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Musicco
mesh_terms: D000328:Adult; D000367:Age Factors; D001988:Bronchiolitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019570:Inhalation Exposure / Q000009:adverse effects*; D007558:Italy; D008137:Longitudinal Studies; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution