Smoke exposure, wheezing, and asthma development: A systematic review and meta‐analysis in unselected birth cohorts

作者：Michela Silvestri, Sara Franchi, Angela Pistorio, Loredana Petecchia, Franca Rusconi · 发表于：Pediatric Pulmonology · 年份：2014 · DOI：10.1002/ppul.23037 · 被引用次数：150 · 研究领域：Asthma and respiratory diseases、Neonatal Respiratory Health Research、Smoking Behavior and Cessation

BACKGROUND: The understanding of the role of smoking exposure in the induction of wheezing and asthma in children is important for prevention. METHODS: A systematic review of literature and a meta-analysis were conducted to identify studies on unselected prospective birth cohorts. The effect of exposure to maternal/parental smoking on the induction of current wheezing or asthma was evaluated in children aged 6 months, <6 years, and ≥6 years. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated. RESULTS: We identified 43 papers. Exposure to maternal prenatal smoking was associated with an increased risk of wheezing in <6-year-olds (OR 1.36; 95% CI: 1.19-1.55) and of wheezing or asthma in ≥6-year-olds (OR: 1.22, 95% CI: 1.03-1.44). A positive association (OR: 1.24, 95% CI: 1.11-1.38) was also found in the only three studies that evaluated exposure to maternal prenatal smoking alone. Postnatal exposures to maternal/parental smoking were associated with wheezing in <6-year-olds (OR: 1.21; 95% CI: 1.13-1.31 and OR: 1.30; 95% CI: 1.13-1.51), although it was often impossible to separate the role of postnatal from that of prenatal exposure; data in schoolchildren are limited and this precluded a meta-analysis. No clear association was found between exclusive postnatal exposure and wheezing or asthma. CONCLUSIONS: We confirmed an important role of prenatal exposure to maternal smoking on the induction of wheezing and asthma in offspring, particularly in the first ...