Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1999 May;89(5):712–717. doi: 10.2105/ajph.89.5.712

Maternal cigarette smoking and invasive meningococcal disease: a cohort study among young children in metropolitan Atlanta, 1989-1996.

H R Yusuf 1, R W Rochat 1, W S Baughman 1, P M Gargiullo 1, B A Perkins 1, M D Brantley 1, D S Stephens 1
PMCID: PMC1508714  PMID: 10224983

Abstract

OBJECTIVES: This study assessed the association between maternal cigarette smoking during pregnancy and the risk of invasive meningococcal disease during early childhood. METHODS: Using a retrospective cohort study design, cases from an active surveillance project monitoring all invasive meningococcal disease in the metropolitan Atlanta area from 1989 to 1995 were merged with linked birth and death certificate data files. Children who had not died or acquired meningococcal disease were assumed to be alive and free of the illness. The Cox proportional hazards analysis was used to assess the independent association between maternal smoking and meningococcal disease. RESULTS: The crude rate of meningococcal disease was 5 times higher for children whose mothers smoked during pregnancy than for children whose mothers did not smoke (0.05% vs 0.01%). Multivariate analysis revealed that maternal smoking (risk ratio [RR] = 2.9; 95% confidence interval [CI] = 1.5, 5.7) and a mother's having fewer than 12 years of education (RR = 2.1; 95% CI = 1.0, 4.2) were independently associated with invasive meningococcal disease. CONCLUSIONS: Maternal smoking, a likely surrogate for tobacco smoke exposure following delivery, appears to be a modifiable risk factor for sporadic meningococcal disease in young children.

Full text

PDF
712

Selected References

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

  1. Berg A. T., Shapiro E. D., Capobianco L. A. Group day care and the risk of serious infectious illnesses. Am J Epidemiol. 1991 Jan 15;133(2):154–163. doi: 10.1093/oxfordjournals.aje.a115854. [DOI] [PubMed] [Google Scholar]
  2. Bhatt K. M., Bhatt S. M., Mirza N. B. Meningococcal meningitis. East Afr Med J. 1996 Jan;73(1):35–39. [PubMed] [Google Scholar]
  3. Blackwell C. C., Tzanakaki G., Kremastinou J., Weir D. M., Vakalis N., Elton R. A., Mentis A., Fatouros N. Factors affecting carriage of Neisseria meningitidis among Greek military recruits. Epidemiol Infect. 1992 Jun;108(3):441–448. doi: 10.1017/s0950268800049943. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bredfeldt R. C., Cain S. R., Schutze G. E., Holmes T. M., McGhee L. A. Relation between passive tobacco smoke exposure and the development of bacterial meningitis in children. J Am Board Fam Pract. 1995 Mar-Apr;8(2):95–98. [PubMed] [Google Scholar]
  5. Cartwright K. A., Jones D. M., Smith A. J., Stuart J. M., Kaczmarski E. B., Palmer S. R. Influenza A and meningococcal disease. Lancet. 1991 Aug 31;338(8766):554–557. doi: 10.1016/0140-6736(91)91112-8. [DOI] [PubMed] [Google Scholar]
  6. Caugant D. A., Høiby E. A., Magnus P., Scheel O., Hoel T., Bjune G., Wedege E., Eng J., Frøholm L. O. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population. J Clin Microbiol. 1994 Feb;32(2):323–330. doi: 10.1128/jcm.32.2.323-330.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. 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]
  8. Cosio F. G., Hoidal J. R., Douglas S. D., Michael A. F. Binding of soluble immune complexes by human monocytes and pulmonary macrophages: effects of cigarette smoking. J Lab Clin Med. 1982 Sep;100(3):469–476. [PubMed] [Google Scholar]
  9. Dietz P. M., Adams M. M., Rochat R. W., Mathis M. P. Prenatal smoking in two consecutive pregnancies: Georgia, 1989-1992. Matern Child Health J. 1997 Mar;1(1):43–51. doi: 10.1023/a:1026276419551. [DOI] [PubMed] [Google Scholar]
  10. Farley M. M., Harvey R. C., Stull T., Smith J. D., Schuchat A., Wenger J. D., Stephens D. S. A population-based assessment of invasive disease due to group B Streptococcus in nonpregnant adults. N Engl J Med. 1993 Jun 24;328(25):1807–1811. doi: 10.1056/NEJM199306243282503. [DOI] [PubMed] [Google Scholar]
  11. Farries J. S., Dickson W., Greenwood E., Malhotra T. R., Abbott J. D., Jones D. M. Meningococcal infections in Bolton, 1971-74. Lancet. 1975 Jul 19;2(7925):118–120. doi: 10.1016/s0140-6736(75)90016-1. [DOI] [PubMed] [Google Scholar]
  12. Fingerhut L. A., Kleinman J. C., Kendrick J. S. Smoking before, during, and after pregnancy. Am J Public Health. 1990 May;80(5):541–544. doi: 10.2105/ajph.80.5.541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Fischer M., Hedberg K., Cardosi P., Plikaytis B. D., Hoesly F. C., Steingart K. R., Bell T. A., Fleming D. W., Wenger J. D., Perkins B. A. Tobacco smoke as a risk factor for meningococcal disease. Pediatr Infect Dis J. 1997 Oct;16(10):979–983. doi: 10.1097/00006454-199710000-00015. [DOI] [PubMed] [Google Scholar]
  14. Fortnum H. M., Davis A. C. Epidemiology of bacterial meningitis. Arch Dis Child. 1993 Jun;68(6):763–767. doi: 10.1136/adc.68.6.763. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Foster M. T., Jr, Sanders E., Ginter M. Epidemiology of sulfonamide-resistant meningococcal infections in a civilian population. Am J Epidemiol. 1971 May;93(5):346–353. doi: 10.1093/oxfordjournals.aje.a121267. [DOI] [PubMed] [Google Scholar]
  16. Haneberg B., Tønjum T., Rodahl K., Gedde-Dahl T. W. Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, symptoms of ill health. NIPH Ann. 1983 Dec;6(2):169–173. [PubMed] [Google Scholar]
  17. Hinton A. E. Surgery for otitis media with effusion in children and its relationship to parental smoking. J Laryngol Otol. 1989 Jun;103(6):559–561. doi: 10.1017/s0022215100109326. [DOI] [PubMed] [Google Scholar]
  18. Imrey P. B., Jackson L. A., Ludwinski P. H., England A. C., 3rd, Fella G. A., Fox B. C., Isdale L. B., Reeves M. W., Wenger J. D. Outbreak of serogroup C meningococcal disease associated with campus bar patronage. Am J Epidemiol. 1996 Mar 15;143(6):624–630. doi: 10.1093/oxfordjournals.aje.a008792. [DOI] [PubMed] [Google Scholar]
  19. Jackson L. A., Wenger J. D. Laboratory-based surveillance for meningococcal disease in selected areas, United States, 1989-1991. MMWR CDC Surveill Summ. 1993 Jun 4;42(2):21–30. [PubMed] [Google Scholar]
  20. Johnson J. D., Houchens D. P., Kluwe W. M., Craig D. K., Fisher G. L. Effects of mainstream and environmental tobacco smoke on the immune system in animals and humans: a review. Crit Rev Toxicol. 1990;20(5):369–395. doi: 10.3109/10408449009089870. [DOI] [PubMed] [Google Scholar]
  21. Jurado R. L., Farley M. M., Pereira E., Harvey R. C., Schuchat A., Wenger J. D., Stephens D. S. Increased risk of meningitis and bacteremia due to Listeria monocytogenes in patients with human immunodeficiency virus infection. Clin Infect Dis. 1993 Aug;17(2):224–227. doi: 10.1093/clinids/17.2.224. [DOI] [PubMed] [Google Scholar]
  22. Kaiser A. B., Hennekens C. H., Saslaw M. S., Hayes P. S., Bennett J. V. Seroepidemiology and chemoprophylaxis disease due to sulfonamide-resistant Neisseria meningitidis in a civillian population. J Infect Dis. 1974 Sep;130(3):217–224. doi: 10.1093/infdis/130.3.217. [DOI] [PubMed] [Google Scholar]
  23. Kendrick J. S., Zahniser S. C., Miller N., Salas N., Stine J., Gargiullo P. M., Floyd R. L., Spierto F. W., Sexton M., Metzger R. W. Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project. Am J Public Health. 1995 Feb;85(2):217–222. doi: 10.2105/ajph.85.2.217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Krasinski K., Nelson J. D., Butler S., Luby J. P., Kusmiesz H. Possible association of mycoplasma and viral respiratory infections with bacterial meningitis. Am J Epidemiol. 1987 Mar;125(3):499–508. doi: 10.1093/oxfordjournals.aje.a114556. [DOI] [PubMed] [Google Scholar]
  25. Kremastinou J., Blackwell C., Tzanakaki G., Kallergi C., Elton R., Weir D. Parental smoking and carriage of Neisseria meningitidis among Greek schoolchildren. Scand J Infect Dis. 1994;26(6):719–723. doi: 10.3109/00365549409008641. [DOI] [PubMed] [Google Scholar]
  26. Liberatos P., Link B. G., Kelsey J. L. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. doi: 10.1093/oxfordjournals.epirev.a036030. [DOI] [PubMed] [Google Scholar]
  27. Marier R. The reporting of communicable diseases. Am J Epidemiol. 1977 Jun;105(6):587–590. doi: 10.1093/oxfordjournals.aje.a112424. [DOI] [PubMed] [Google Scholar]
  28. Moore P. S., Hierholzer J., DeWitt W., Gouan K., Djoré D., Lippeveld T., Plikaytis B., Broome C. V. Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis. JAMA. 1990 Sep 12;264(10):1271–1275. [PubMed] [Google Scholar]
  29. Moore P. S. Meningococcal meningitis in sub-Saharan Africa: a model for the epidemic process. Clin Infect Dis. 1992 Feb;14(2):515–525. doi: 10.1093/clinids/14.2.515. [DOI] [PubMed] [Google Scholar]
  30. Mullen P. D., Quinn V. P., Ershoff D. H. Maintenance of nonsmoking postpartum by women who stopped smoking during pregnancy. Am J Public Health. 1990 Aug;80(8):992–994. doi: 10.2105/ajph.80.8.992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Pedreira F. A., Guandolo V. L., Feroli E. J., Mella G. W., Weiss I. P. Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics. 1985 Mar;75(3):594–597. [PubMed] [Google Scholar]
  32. Pinner R. W., Gellin B. G., Bibb W. F., Baker C. N., Weaver R., Hunter S. B., Waterman S. H., Mocca L. F., Frasch C. E., Broome C. V. Meningococcal disease in the United States--1986. Meningococcal Disease Study Group. J Infect Dis. 1991 Aug;164(2):368–374. doi: 10.1093/infdis/164.2.368. [DOI] [PubMed] [Google Scholar]
  33. Schuchat A., Robinson K., Wenger J. D., Harrison L. H., Farley M., Reingold A. L., Lefkowitz L., Perkins B. A. Bacterial meningitis in the United States in 1995. Active Surveillance Team. N Engl J Med. 1997 Oct 2;337(14):970–976. doi: 10.1056/NEJM199710023371404. [DOI] [PubMed] [Google Scholar]
  34. Schwartz B., Moore P. S., Broome C. V. Global epidemiology of meningococcal disease. Clin Microbiol Rev. 1989 Apr;2 (Suppl):S118–S124. doi: 10.1128/cmr.2.suppl.s118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Standaert S. M., Lefkowitz L. B., Jr, Horan J. M., Hutcheson R. H., Schaffner W. The reporting of communicable diseases: a controlled study of Neisseria meningitidis and Haemophilus influenzae infections. Clin Infect Dis. 1995 Jan;20(1):30–36. doi: 10.1093/clinids/20.1.30. [DOI] [PubMed] [Google Scholar]
  36. Stanwell-Smith R. E., Stuart J. M., Hughes A. O., Robinson P., Griffin M. B., Cartwright K. Smoking, the environment and meningococcal disease: a case control study. Epidemiol Infect. 1994 Apr;112(2):315–328. doi: 10.1017/s0950268800057733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Stephens D. S., Hajjeh R. A., Baughman W. S., Harvey R. C., Wenger J. D., Farley M. M. Sporadic meningococcal disease in adults: results of a 5-year population-based study. Ann Intern Med. 1995 Dec 15;123(12):937–940. doi: 10.7326/0003-4819-123-12-199512150-00007. [DOI] [PubMed] [Google Scholar]
  38. Stuart J. M., Cartwright K. A., Dawson J. A., Rickard J., Noah N. D. Risk factors for meningococcal disease: a case control study in south west England. Community Med. 1988 May;10(2):139–146. [PubMed] [Google Scholar]
  39. Stuart J. M., Cartwright K. A., Robinson P. M., Noah N. D. Effect of smoking on meningococcal carriage. Lancet. 1989 Sep 23;2(8665):723–725. doi: 10.1016/s0140-6736(89)90781-2. [DOI] [PubMed] [Google Scholar]
  40. Tappero J. W., Reporter R., Wenger J. D., Ward B. A., Reeves M. W., Missbach T. S., Plikaytis B. D., Mascola L., Schuchat A. Meningococcal disease in Los Angeles County, California, and among men in the county jails. N Engl J Med. 1996 Sep 19;335(12):833–840. doi: 10.1056/NEJM199609193351201. [DOI] [PubMed] [Google Scholar]
  41. Tardif J., Borgeat P., Laviolette M. Inhibition of human alveolar macrophage production of leukotriene B4 by acute in vitro and in vivo exposure to tobacco smoke. Am J Respir Cell Mol Biol. 1990 Feb;2(2):155–161. doi: 10.1165/ajrcmb/2.2.155. [DOI] [PubMed] [Google Scholar]
  42. Thomas J. C., Bendana N. S., Waterman S. H., Rathbun M., Arakere G., Frasch C. E., Wenger J. D., Magsombol V., Clark J. H. Risk factors for carriage of meningococcus in the Los Angeles County men's jail system. Am J Epidemiol. 1991 Feb 1;133(3):286–295. doi: 10.1093/oxfordjournals.aje.a115873. [DOI] [PubMed] [Google Scholar]
  43. Weber A. Annoyance and irritation by passive smoking. Prev Med. 1984 Nov;13(6):618–625. doi: 10.1016/s0091-7435(84)80012-2. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES