Ethnic Variability in Persistent Asthma After In Utero Tobacco Exposure

Author:

Akuete Kwei1,Oh Sam S.23,Thyne Shannon4,Rodriguez-Santana Jose R.5,Chapela Rocio6,Meade Kelley7,Rodriguez-Cintron William8,LeNoir Michael9,Ford Jean G.10,Williams L. Keoki11,Avila Pedro C.12,Burchard Esteban González131415,Tcheurekdjian Haig116

Affiliation:

1. Departments of Medicine and Pediatrics, Case Western Reserve University, Cleveland Ohio;

2. Center for Tobacco Control Research and Education,

3. Department of Medicine and Cardiovascular Research Institute,

4. Department of Pediatrics, San Francisco General Hospital, San Francisco, California;

5. Centro de Neumologia Pediatrica, CSP, San Juan, Puerto Rico;

6. Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico;

7. Children's Hospital and Research Institute, Oakland, California;

8. Veterans Caribbean Health Care System, San Juan, Puerto Rico;

9. Bay Area Pediatrics, Oakland, California;

10. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;

11. Center for Health Services Research, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan;

12. Division of Allergy-Immunology, Northwestern University, Chicago, Illinois; and

13. Department of Bioengineering and Therapeutic Sciences,

14. Lung Biology Center, and

15. Institute for Human Genetics, University of California, San Francisco, California;

16. Allergy/Immunology Associates Inc, Cleveland, Ohio

Abstract

BACKGROUND: The effects of in utero tobacco smoke exposure on childhood respiratory health have been investigated, and outcomes have been inconsistent. OBJECTIVE: To determine if in utero tobacco smoke exposure is associated with childhood persistent asthma in Mexican, Puerto Rican, and black children. PATIENTS AND METHODS: There were 295 Mexican, Puerto Rican, and black asthmatic children, aged 8 to 16 years, who underwent spirometry, and clinical data were collected from the parents during a standardized interview. The effect of in utero tobacco smoke exposure on the development of persistent asthma and related clinical outcomes was evaluated by logistic regression. RESULTS: Children with persistent asthma had a higher odds of exposure to in utero tobacco smoke, but not current tobacco smoke, than did children with intermittent asthma (odds ratio [OR]: 3.57; P = .029). Tobacco smoke exposure from parents in the first 2 years of life did not alter this association. Furthermore, there were higher odds of in utero tobacco smoke exposure in children experiencing nocturnal symptoms (OR: 2.77; P = .048), daily asthma symptoms (OR: 2.73; P = .046), and emergency department visits (OR: 3.85; P = .015) within the year. CONCLUSIONS: Exposure to tobacco smoke in utero was significantly associated with persistent asthma among Mexican, Puerto Rican, and black children compared with those with intermittent asthma. These results suggest that smoking cessation during pregnancy may lead to a decrease in the incidence of persistent asthma in these populations.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference52 articles.

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2. From the American Academy of Pediatrics: Technical report—secondhand and prenatal tobacco smoke exposure;Best;Pediatrics,2009

3. Prenatal and postnatal environmental tobacco smoke exposure and children's health;DiFranza;Pediatrics,2004

4. Detrimental effects of tobacco smoke exposure during development on postnatal lung function and asthma;Wang;Birth Defects Res C Embryo Today,2008

5. Effects of maternal smoking during pregnancy and a family history of asthma on respiratory function in newborn infants;Stick;Lancet,1996

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