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Parental smoking and post-infancy wheezing in children: a prospective cohort study
D R Neuspiel1, D Rush, N R Butler
1Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY.
Insights
Maternal smoking significantly increases the risk of childhood wheezy bronchitis. Even after accounting for various factors, children of mothers who smoke are more likely to develop this respiratory condition.
Area of Science:
- Environmental Health
- Pediatric Respiratory Medicine
- Epidemiology
Background:
- Childhood wheezing and bronchitis are significant public health concerns.
- Parental smoking is a known environmental risk factor for respiratory illnesses in children.
- Understanding the specific contribution of maternal smoking is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate the association between maternal smoking and the incidence of wheezing and wheezy bronchitis in children up to 10 years of age.
- To determine if this association persists after controlling for confounding factors.
- To explore potential mediating factors for the observed association.
Main Methods:
- Analysis of a large birth cohort (N = 9,670) from the 1970 British birth survey.
- Longitudinal follow-up to assess cumulative incidence of wheezing and wheezy bronchitis.
- Multiple logistic regression to adjust for paternal smoking, socioeconomic status, and other environmental and familial factors.
Main Results:
- Children of smoking mothers had a higher cumulative incidence of post-infancy wheezing (18.0% vs 16.2%).
- The association was primarily driven by wheezy bronchitis, with a higher incidence in children of smokers (7.4% vs 5.2%).
- The risk of wheezy bronchitis increased with the number of cigarettes smoked by the mother, persisting after adjustment for confounders.
Conclusions:
- Maternal smoking is a significant, independent risk factor for childhood wheezy bronchitis.
- Maternal respiratory symptoms and depression partially explained the association.
- Reducing maternal smoking could mitigate the burden of childhood wheezy bronchitis.
Abstract:
The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 per cent, and those of nonsmokers had 5.2 per cent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily.
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