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Tobacco smoke exposure, wheeze, and atopy.
Murray CS, Murray CS, Woodcock AA, Smillie F, Cain G, Kissen P, Custovic A
Pediatr Pulmonol. 2004;37( 6).
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Abstract
We investigated the effect of in utero and postnatal environmental tobacco smoke (ETS) exposure on respiratory symptoms and atopy in the first 3 years of life in children at high risk of allergic disease (both parents atopic).Three hundred and sixty-nine children were followed from birth and reviewed at ages 1 and 3 years (respiratory questionnaire, skin testing).Parental smoking questionnaires were administered, and plasma cotinine incord and peripheral blood (at age 1 year) was measured (capillary columngas-liquid chromatography). Wheezing starting in the first year of lifewas significantly more common in children of smoking mothers (54.2% vs.39.5%, P = 0.017), but not wheezing starting after age 1 year (10.8% vs.10.9%, smoking and nonsmoking mothers, P = 0.99). Detectable cord cotininewas not associated with wheeze. More frequent wheeze in infancy wassignificantly more common in those with detectable 1-year cotinine (e.g.,wheeze without colds, 17.8% vs. 5.6%, P = 0.02; wheeze most days, 6.5% vs.0%, P = 0.04). ETS exposure was not associated with atopy. In themultivariate regression analysis, maternal smoking during pregnancy and/orin the first year of life remained associated with wheeze in the firstyear of life (odds ratio, 1.88; 95% confidence interval, 1.14-3.12; P =0.01). ETS exposure in "high-risk" infants increases the risk of wheezingstarting in the first year of life, but not after age 1 year. However, ETSexposure has little or no effect on the development of atopy. Measurementof plasma cotinine was no more useful than tobacco exposure assessment byquestionnaire in our cohort. Copyright 2004 Wiley-Liss, Inc.
Keyword(s)
Adult; Child, Preschool; Environmental Exposure; Female; Humans; Infant; Infant, Newborn; Male; Multivariate Analysis; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Regression Analysis; Research Support, Non-U.S. Gov't; Respiratory Function Tests; adverse effects: Tobacco Smoke Pollution; analysis: Cotinine; chemistry: Fetal Blood; etiology: Hypersensitivity, Immediate; etiology: Respiratory Sounds