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Hashimoto K, Maeda H, Iwasa H, Kyozuka H, Maeda R, Kume Y, Ono T, Chishiki M, Sato A, Ogata Y, Murata T, Fujimori K, Shinoki K, Nishigori H, Yasumura S, Hosoya M. Tobacco Exposure During Pregnancy and Infections in Infants up to 1 Year of Age: The Japan Environment and Children's Study. J Epidemiol 2023; 33:489-497. [PMID: 35400710 PMCID: PMC10483106 DOI: 10.2188/jea.je20210405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/23/2022] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Tobacco exposure during pregnancy is associated with several adverse outcomes in infants. We investigated the association between tobacco exposure during pregnancy (both active and second-hand) and various infections in infants up to 1 year. METHODS This prospective cohort study used a fixed dataset (jecs-an-20180131) from the Japan Environment and Children's Study of registered births in Japan during 2011-2014 that included 104,065 fetal records from enrolled pregnant women. Based on the participants' responses to the questionnaire on smoking status, mothers were first divided into "never smoked," "quit smoking," and "current smoker" groups and then into "no second-hand smoking (SHS)" and "SHS" groups. Infectious diseases included central nervous system infection, otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastroenteritis (GI), and urinary tract infection. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis and adjusted for maternal, socioeconomic, and postnatal confounding factors. RESULTS Among the 73,205 newborns enrolled, multivariable analysis revealed that the aOR of LRTI and GI was 1.20 (95% CI, 1.07-1.33) and 1.18 (95% CI, 1.04-1.35), respectively, for the "current smoker with/without SHS" group compared with the "never smoked without SHS" group. "Quit smoking without SHS" was not associated with the risk of LRTI. SHS was associated with an increased risk of OM, URTI, LRTI, and GI, especially with LRTI and GI. CONCLUSION Exposure to tobacco smoke during pregnancy was associated with an increased risk of OM, URTI, LRTI, and GI in infants during their first year of life.
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Affiliation(s)
- Koichi Hashimoto
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hajime Iwasa
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Ryo Maeda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yohei Kume
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Ono
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Hidekazu Nishigori
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - the Japan Environment and Children’s Study (JECS) Group
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
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