目的 分析鄂州市孕期被动吸烟与新生儿低出生体重的关系。方法 采用1∶2病例对照研究方法, 对2008年1月1日-2011年12月1日间在鄂州市妇幼保健院分娩的1 080名20~30岁非主动吸烟的产妇孕期被动吸烟情况与新生儿低出生体重关系进行分析。结果 病例组产妇被动吸烟发生率(47.5%)明显高于对照组 (28.3%,P<0.001)。控制相关混杂因素后,孕期每周平均累积被动吸烟时间为1~3 d或超过3 d的产妇发生新生儿低出生体重的风险相比无被动吸烟的产妇增加1.54倍(OR=2.54,95%CI:1.81~3.57)和3.29倍(OR=4.29,95%CI:2.62~7.04),相应归因分值AFe分别为60.6%和76.7%。孕期产检次数增加到7次以上可以减少被动吸烟组产妇约53%(OR=0.47,95%CI:0.30~0.73) 的低出生体重儿的发生风险。 结论 孕期被动吸烟与新生儿低出生体重发生密切相关,且暴露时间与新生儿低出生体重发生风险存在很明显的剂量反应关系。

Objective To detect the relationship between passive tobacco smoking exposure during pregnancy and low birth weight (LBW) neonates. Method A 1∶2 case control study was carried out among 1 080 women included 360 cases and 720 controls,aged 20 to 30 years who gave births in maternal care hospital of Ezhou from Jan 1st 2008 to Dec 31st 2011.Mothers giving birth to LBW neonate (<2.5 kg) were cases and those whose neonates weighed ≥2.5 kg at birth were controls.Information on passive tobacco smoking exposure and other potential risk factors of LBW within 24 hours of delivery were collected from hospital records and face to face investigation. Results The passive tobacco smoking exposure rate was higher in cases group (47.5%) than controls group (28.3%,P<0.001),and the OR was 1.30 times higher accordingly.The adjusted OR were 1.54 times(OR=2.54,95% CI:1.81~3.57) and 3.29 times (OR=4.29,95% CI:2.62~7.04)higher in cases who had accumulative exposed in passive tobacco smoking 1~3 days/week and >3 days/week than controls.And the AFe were 60.6% and 76.7%,respectively.Pregnant women who had taken antenatal examination more than 7 times might associate with 53% (OR=0.47,95% CI:0.30~0.73) decrease risk of low birth weight neonates. Conclusion There is a closely association and a significant dose-response relationship between passive tobacco smoking and low birth weight of neonates.