孕妇被动吸烟与胎儿出生体重关系的Meta分析  

Meta-analysis of effect of maternal passive smoking during pregnancy on fetal birth-weight

作　　者：刘涛[1] 陈维清[1] 

机构地区：[1]中山大学公共卫生学院医学统计与流行病学系,广东广州510080

出　　处：《中华疾病控制杂志》2010年第3期199-203,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(30872164);中华医学基金会(CMB)资助项目(00-729);广东省人口计生委资助项目(2008035)

摘　　要：目的分析孕妇不同孕期的被动吸烟情况对新生儿出生体重的影响,以及探讨不同测量方式对被动吸烟效应的影响。方法对NCBI、OVID-MEDLINE、CNKI、VIP以及CBM数据库进行检索(截止日期为2008年4月),通过Meta分析结果报告综合差值及95%CI。结果共获得38篇文献,其中19篇为前瞻性研究,19篇属回顾性研究。总合并效应值为-68.84g(95%CI:-89.84～-47.84),调整合并效应值为-44.92g(95%CI:-67.07～-22.77);生物标志测量的合并效应值为-73.87g(95%CI:-113.41～-34.34);问卷调查的合并效应值为-62.93g(95%CI:-84.49～-41.37);最低和最高水平暴露的合并效应值分别为-44.61g(95%CI:-78.36～-10.87)和-116.37g(95%CI:-180.74～-52.01);孕早期暴露的合并效应值为-2.70g(95%CI:-37.74～32.33),但没有统计学意义。结论孕妇被动吸烟能降低新生儿出生体重,问卷调查会低估真实暴露水平,孕中晚期可能是被动吸烟的效应期,被动吸烟引起低出生体重的阈值尚不明确。Objective To analyze effects of maternal passive smoking at different exposure level in different period of pregnancy on fetal birth weight and to reveal the influence of different measurement methods on the effects of maternal passive smoking. Methods Meta analysis was applied. NCBI, OVIDC-MEDLINE, CNKI, VIP and CBM were searched, all searched studies were retrieved, and their references were checked for other relevant publications, with the language limited to Chinese and English. The search was finished by April 2008. Pooled mean differences with 95 % confidence interval were estimated using data extracted from papers. Results A total of 38 papers were searched, and 19 of them were prospective studies and 19 were retrospective studies, respectively. Maternal passive smoking was associated with a reduction of 67.62 g （95% CI ： - 90.15- - 45.09） in mean birth-weight, and the adjusted reduction was 44.92 g （95% CI： - 67.07- - 22.77）. Based on biochemical markers measurement, the pooled effect size was - 73.87 g （95 % CI ： - 113.41 - - 34.34）, based on self-report measurement, the pooled effect size was - 62.93 g （95 % CI ： - 84.49 - - 41.37）. The lowest and highest level exposure＇ s effect sizes were 44.61 g （95% CI： 78.36- 10.87） and - 116.37 g （95 % CI ： - 180.74 - 52.01 ） , respectively. Maternal passive smoking in early pregnancy can reduce the birth-weight by 2.70 g （95 % CI： 37.74-32.33）, however, it was not statistically significant. Conclusions Maternal passive smoking during pregnancy could reduce infant birthweight. The middle or late period of pregnancy might be the sensitive period for passive smoking＇s effect. There is no clear threshold value for passive smoking causing low birth weight.

关 键 词：烟草烟污染 出生体重 婴儿 新生 META分析 

分 类 号：R195.1[医药卫生—卫生统计学] R722[医药卫生—卫生事业管理]