Faustine D Ramirez1, Judith A Groner2, Joel L Ramirez3, Cindy T McEvoy4, Judith A Owens5, Charles E McCulloch6, Michael D Cabana7, Katrina Abuabara8. 1. Department of Pediatrics, University of California, San Francisco (FD Ramirez). Electronic address: faustine.ramirez@ucsf.edu. 2. Julius B. Richmond Center of Excellence, American Academy of Pediatrics (JA Groner), Itasca, Ill; Department of Pediatrics, Nationwide Children's Hospital (JA Groner), Columbus, Ohio. 3. Department of Surgery, University of California, San Francisco (JL Ramirez). 4. Department of Pediatrics, Oregon Health and Science University (CT McEvoy), Portland, Ore. 5. Center for Pediatric Sleep Disorders, Boston Children's Hospital (JA Owens), Boston, Mass; Department of Neurology, Boston Children's Hospital, Harvard Medical School (JA Owens), Waltham, Mass. 6. Department of Epidemiology & Biostatistics, University of California, San Francisco (CE McCulloch). 7. Department of Pediatrics, Albert Einstein College of Medicine (MD Cabana), Bronx, NY; Department of Pediatrics, Children's Hospital at Montefiore (MD Cabana), Bronx, NY. 8. Department of Dermatology, Program for Clinical Research, University of California, San Francisco (K Abuabara).
Abstract
OBJECTIVE: To determine whether prenatal and childhood tobacco smoke exposure (TSE) are each independently associated with mild sleep-disordered breathing (SDB) symptoms throughout early childhood, and whether the association between childhood TSE and SDB differs according to the level of prenatal exposure. METHODS: Longitudinal cohort study, using data from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort from the United Kingdom. Primary exposures were repeated measures of mother-reported prenatal and childhood TSE through age 7 years. Outcomes were mother-reported measures of mild SDB symptoms, including snoring, mouth breathing, and witnessed apnea, repeated annually through age 7 years. RESULTS: A total of 12,030 children were followed for a median duration of 7 years. About 24.2% were exposed to prenatal tobacco smoke, 46.2% were exposed at least once in childhood, and 20.6% were exposed during both periods. Both prenatal and childhood TSE were associated with SDB symptoms throughout early childhood (adjusted OR [aOR] for any prenatal TSE 1.23; 95% confidence interval [CI] 1.08, 1.40; aOR for any childhood TSE 1.17; 95% CI 1.06, 1.29). We observed a dose-response effect between TSE and SBD symptoms, and found evidence of effect modification for those exposed during both time periods (combined high level exposure both prenatally and during childhood: aOR snoring 2.43 [95% CI 1.50, 3.93], aOR apnea 2.65 [95% CI 1.46, 4.82]). CONCLUSIONS: Prenatal and childhood TSE were both independently associated with mild SDB symptoms throughout early childhood in a dose-dependent manner, further supporting the critical importance of maintaining a tobacco-free environment throughout gestation and childhood.
OBJECTIVE: To determine whether prenatal and childhood tobacco smoke exposure (TSE) are each independently associated with mild sleep-disordered breathing (SDB) symptoms throughout early childhood, and whether the association between childhood TSE and SDB differs according to the level of prenatal exposure. METHODS: Longitudinal cohort study, using data from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort from the United Kingdom. Primary exposures were repeated measures of mother-reported prenatal and childhood TSE through age 7 years. Outcomes were mother-reported measures of mild SDB symptoms, including snoring, mouth breathing, and witnessed apnea, repeated annually through age 7 years. RESULTS: A total of 12,030 children were followed for a median duration of 7 years. About 24.2% were exposed to prenatal tobacco smoke, 46.2% were exposed at least once in childhood, and 20.6% were exposed during both periods. Both prenatal and childhood TSE were associated with SDB symptoms throughout early childhood (adjusted OR [aOR] for any prenatal TSE 1.23; 95% confidence interval [CI] 1.08, 1.40; aOR for any childhood TSE 1.17; 95% CI 1.06, 1.29). We observed a dose-response effect between TSE and SBD symptoms, and found evidence of effect modification for those exposed during both time periods (combined high level exposure both prenatally and during childhood: aOR snoring 2.43 [95% CI 1.50, 3.93], aOR apnea 2.65 [95% CI 1.46, 4.82]). CONCLUSIONS: Prenatal and childhood TSE were both independently associated with mild SDB symptoms throughout early childhood in a dose-dependent manner, further supporting the critical importance of maintaining a tobacco-free environment throughout gestation and childhood.
Authors: Karen A Cullen; Andrea S Gentzke; Michael D Sawdey; Joanne T Chang; Gabriella M Anic; Teresa W Wang; MeLisa R Creamer; Ahmed Jamal; Bridget K Ambrose; Brian A King Journal: JAMA Date: 2019-12-03 Impact factor: 56.272
Authors: A Kahn; J Groswasser; M Sottiaux; I Kelmanson; E Rebuffat; P Franco; M Dramaix; J L Wayenberg Journal: Pediatrics Date: 1994-05 Impact factor: 7.124
Authors: Van T Tong; Patricia M Dietz; Brian Morrow; Denise V D'Angelo; Sherry L Farr; Karilynn M Rockhill; Lucinda J England Journal: MMWR Surveill Summ Date: 2013-11-08
Authors: Geetha Raghuveer; David A White; Laura L Hayman; Jessica G Woo; Juan Villafane; David Celermajer; Kenneth D Ward; Sarah D de Ferranti; Justin Zachariah Journal: Circulation Date: 2016-09-12 Impact factor: 29.690
Authors: Karen A Bonuck; Ronald D Chervin; Timothy J Cole; Alan Emond; John Henderson; Linzhi Xu; Katherine Freeman Journal: Sleep Date: 2011-07-01 Impact factor: 5.849
Authors: Andy Boyd; Jean Golding; John Macleod; Debbie A Lawlor; Abigail Fraser; John Henderson; Lynn Molloy; Andy Ness; Susan Ring; George Davey Smith Journal: Int J Epidemiol Date: 2012-04-16 Impact factor: 7.196
Authors: Marieke I Bouwland-Both; Nina H van Mil; Catharina P Tolhoek; Lisette Stolk; Paul H C Eilers; Michael M P J Verbiest; Bastiaan T Heijmans; André G Uitterlinden; Albert Hofman; Marinus H van Ijzendoorn; Liesbeth Duijts; Johan C de Jongste; Henning Tiemeier; Eric A P Steegers; Vincent W V Jaddoe; Régine P M Steegers-Theunissen Journal: Clin Epigenetics Date: 2015-08-11 Impact factor: 6.551