Skip to main content
PMC home page
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1997 Mar;105(3):302–306. doi: 10.1289/ehp.97105302

Maternal smoking during pregnancy and postnatal exposure to environmental tobacco smoke as predisposition factors to acute respiratory infections.

W Jedrychowski 1, E Flak 1
PMCID: PMC1470010  PMID: 9171991

Abstract

This study compared susceptibility to respiratory morbidity in a cohort of 9-year-old children exposed congenitally and postnatally to environmental tobacco smoke (ETS) to susceptibility in a cohort of unexposed children. The epidemiologic study included 1129 children: 594 boys and 535 girls attending the second grade of grammar schools in Kraków, Poland. We found strong evidence that children exposed to ETS in their homes were more susceptible to acute respiratory tract illnesses than unexposed children. A dose-response relationship between degree of exposure [for lower ETS exposure, odds ratio (OR) = 1.32; for higher ETS exposure, OR = 1.74] supports a causal explanation for the association observed. The significant trend of increased risk of respiratory infections due to ETS level in nonatopic children whose mothers did not smoke cigarettes during pregnancy suggests a direct effect of ETS exposure on the child's respiratory health. ETS combined with allergy nearly tripled the risk of acute respiratory tract illness (OR = 3.39; 95% CI, 1.93-5.93), and maternal smoking during pregnancy had a modifying effect on the risk of respiratory illnesses due to ETS after accounting for atopy. The stronger effect of ETS in atopic children and in those whose mothers smoked during pregnancy may be result of biologic interaction of endogenous and environmental factors. The results of this study are of relevance to public health policy, as children with higher risk of respiratory infections may be more susceptible to environmental hazards later in adolescence or in adulthood. Respiratory infections also increase demands for medical interventions in terms of outpatient services and hospital administrations. In addition, respiratory illnesses cause missed school days, and caring for a sick child may lead to absenteeism from work.

Full text

PDF
302

Images in this article

303Figure 1.
on p.303
303Figure 2.
on p.303
303Figure 3.
on p.303
304Figure 4.
on p.304

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barron B. A. The effects of misclassification on the estimation of relative risk. Biometrics. 1977 Jun;33(2):414–418. [PubMed] [Google Scholar]
  2. Bland M., Bewley B. R., Pollard V., Banks M. H. Effect of children's and parents' smoking on respiratory symptoms. Arch Dis Child. 1978 Feb;53(2):100–105. doi: 10.1136/adc.53.2.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burchfiel C. M., Higgins M. W., Keller J. B., Howatt W. F., Butler W. J., Higgins I. T. Passive smoking in childhood. Respiratory conditions and pulmonary function in Tecumseh, Michigan. Am Rev Respir Dis. 1986 Jun;133(6):966–973. doi: 10.1164/arrd.1986.133.6.966. [DOI] [PubMed] [Google Scholar]
  4. Cameron P., Kostin J. S., Zaks J. M., Wolfe J. H., Tighe G., Oselett B., Stocker R., Winton J. The health of smokers' and nonsmokers' children. J Allergy. 1969 Jun;43(6):336–341. doi: 10.1016/0021-8707(69)90078-1. [DOI] [PubMed] [Google Scholar]
  5. Chen Y., Li W. X., Yu S. Z., Qian W. H. Chang-Ning epidemiological study of children's health: I: Passive smoking and children's respiratory diseases. Int J Epidemiol. 1988 Jun;17(2):348–355. doi: 10.1093/ije/17.2.348. [DOI] [PubMed] [Google Scholar]
  6. Chen Y., Li W., Yu S. Influence of passive smoking on admissions for respiratory illness in early childhood. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):303–306. doi: 10.1136/bmj.293.6542.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chen Y. Synergistic effect of passive smoking and artificial feeding on hospitalization for respiratory illness in early childhood. Chest. 1989 May;95(5):1004–1007. doi: 10.1378/chest.95.5.1004. [DOI] [PubMed] [Google Scholar]
  8. Colley J. R., Holland W. W., Corkhill R. T. Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood. Lancet. 1974 Nov 2;2(7888):1031–1034. doi: 10.1016/s0140-6736(74)92148-5. [DOI] [PubMed] [Google Scholar]
  9. Coultas D. B., Howard C. A., Peake G. T., Skipper B. J., Samet J. M. Discrepancies between self-reported and validated cigarette smoking in a community survey of New Mexico Hispanics. Am Rev Respir Dis. 1988 Apr;137(4):810–814. doi: 10.1164/ajrccm/137.4.810. [DOI] [PubMed] [Google Scholar]
  10. Ekwo E. E., Weinberger M. M., Lachenbruch P. A., Huntley W. H. Relationship of parental smoking and gas cooking to respiratory disease in children. Chest. 1983 Dec;84(6):662–668. doi: 10.1378/chest.84.6.662. [DOI] [PubMed] [Google Scholar]
  11. Forastiére F., Corbo G. M., Michelozzi P., Pistelli R., Agabiti N., Brancato G., Ciappi G., Perucci C. A. Effects of environment and passive smoking on the respiratory health of children. Int J Epidemiol. 1992 Feb;21(1):66–73. doi: 10.1093/ije/21.1.66. [DOI] [PubMed] [Google Scholar]
  12. Haddow J. E., Knight G. J., Palomaki G. E., McCarthy J. E. Second-trimester serum cotinine levels in nonsmokers in relation to birth weight. Am J Obstet Gynecol. 1988 Aug;159(2):481–484. doi: 10.1016/s0002-9378(88)80114-5. [DOI] [PubMed] [Google Scholar]
  13. Hawke M., van Nostrand A. W. The Ontario Temporal Bone Bank program and the University of Toronto Temporal Bone Histopathology Laboratory. J Otolaryngol. 1982 Jun;11(3):214–220. [PubMed] [Google Scholar]
  14. Idle J. R. Titrating exposure to tobacco smoke using cotinine--a minefield of misunderstandings. J Clin Epidemiol. 1990;43(4):313–317. doi: 10.1016/0895-4356(90)90117-8. [DOI] [PubMed] [Google Scholar]
  15. Lebowitz M. D., Burrows B. Respiratory symptoms related to smoking habits of family adults. Chest. 1976 Jan;69(1):48–50. doi: 10.1378/chest.69.1.48. [DOI] [PubMed] [Google Scholar]
  16. Leeder S. R., Corkhill R. T., Irwig L. M., Holland W. W. Influence of family factors on asthma and wheezing during the first five years of life. Br J Prev Soc Med. 1976 Dec;30(4):213–218. doi: 10.1136/jech.30.4.213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Martinez F. D., Antognoni G., Macri F., Bonci E., Midulla F., De Castro G., Ronchetti R. Parental smoking enhances bronchial responsiveness in nine-year-old children. Am Rev Respir Dis. 1988 Sep;138(3):518–523. doi: 10.1164/ajrccm/138.3.518. [DOI] [PubMed] [Google Scholar]
  18. Martinez F. D., Cline M., Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics. 1992 Jan;89(1):21–26. [PubMed] [Google Scholar]
  19. Monto A. S. Acute respiratory infection in children of developing countries: challenge of the 1990s. Rev Infect Dis. 1989 May-Jun;11(3):498–505. doi: 10.1093/clinids/11.3.498. [DOI] [PubMed] [Google Scholar]
  20. Murray A. B., Morrison B. J. The effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma. J Allergy Clin Immunol. 1986 Apr;77(4):575–581. doi: 10.1016/0091-6749(86)90348-9. [DOI] [PubMed] [Google Scholar]
  21. Pandey M. R., Boleij J. S., Smith K. R., Wafula E. M. Indoor air pollution in developing countries and acute respiratory infection in children. Lancet. 1989 Feb 25;1(8635):427–429. doi: 10.1016/s0140-6736(89)90015-9. [DOI] [PubMed] [Google Scholar]
  22. Pérez-Stable E. J., Marín G., Marín B. V., Benowitz N. L. Misclassification of smoking status by self-reported cigarette consumption. Am Rev Respir Dis. 1992 Jan;145(1):53–57. doi: 10.1164/ajrccm/145.1.53. [DOI] [PubMed] [Google Scholar]
  23. Schenker M. B., Samet J. M., Speizer F. E. Risk factors for childhood respiratory disease. The effect of host factors and home environmental exposures. Am Rev Respir Dis. 1983 Dec;128(6):1038–1043. doi: 10.1164/arrd.1983.128.6.1038. [DOI] [PubMed] [Google Scholar]
  24. Stoddard J. J., Miller T. Impact of parental smoking on the prevalence of wheezing respiratory illness in children. Am J Epidemiol. 1995 Jan 15;141(2):96–102. doi: 10.1093/oxfordjournals.aje.a117418. [DOI] [PubMed] [Google Scholar]
  25. Taylor B., Wadsworth J. Maternal smoking during pregnancy and lower respiratory tract illness in early life. Arch Dis Child. 1987 Aug;62(8):786–791. doi: 10.1136/adc.62.8.786. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Victora C. G., Smith P. G., Barros F. C., Vaughan J. P., Fuchs S. C. Risk factors for deaths due to respiratory infections among Brazilian infants. Int J Epidemiol. 1989 Dec;18(4):918–925. doi: 10.1093/ije/18.4.918. [DOI] [PubMed] [Google Scholar]
  27. Ware J. H., Dockery D. W., Spiro A., 3rd, Speizer F. E., Ferris B. G., Jr Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis. 1984 Mar;129(3):366–374. doi: 10.1164/arrd.1984.129.3.366. [DOI] [PubMed] [Google Scholar]
  28. Weiss S. T., Tager I. B., Schenker M., Speizer F. E. The health effects of involuntary smoking. Am Rev Respir Dis. 1983 Nov;128(5):933–942. doi: 10.1164/arrd.1983.128.5.933. [DOI] [PubMed] [Google Scholar]
  29. Weiss S. T., Tager I. B., Speizer F. E., Rosner B. Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children. Am Rev Respir Dis. 1980 Nov;122(5):697–707. doi: 10.1164/arrd.1980.122.5.697. [DOI] [PubMed] [Google Scholar]
  30. Weitzman M., Gortmaker S., Walker D. K., Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990 Apr;85(4):505–511. [PubMed] [Google Scholar]
  31. Woodward A., Douglas R. M., Graham N. M., Miles H. Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking. J Epidemiol Community Health. 1990 Sep;44(3):224–230. doi: 10.1136/jech.44.3.224. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES