Chest
Volume 107, Issue 2, February 1995, Pages 389-394
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Clinical Investigations: Airways
Postnatal Maternal Smoking Increases the Prevalence of Asthma But Not of Bronchial Hyperresponsiveness or Atopy in Their Children

https://doi.org/10.1378/chest.107.2.389Get rights and content

We have compared the prevalence of asthma, bronchial hyperresponsiveness (BHR), and atopy in relation to parental smoking in children aged 7 to 13 years. Information on the presence of asthma was obtained from a questionnaire, BHR was assessed by a methacholine challenge test, and atopy was defined as a positive response to a skin prick test. A complete history of the parents’ smoking habits during their children’s life, including prenatal smoking habits, was recorded. The prevalence of maternal smoking increased from 37.9% during pregnancy to 45.3% at the cross-sectional survey. None of the outcomes was significantly related to paternal smoking, whereas postnatal maternal smoking was positively associated with asthma (odds ratio [OR]=2.8; 95% confidence interval [CI], 1.3 to 6.1). A negative association between prenatal maternal smoking and atopy was found (OR=0.6; 95% CI, 0.3 to 0.9). We found no significant association between BHR and parental smoking. Our results indicate that postnatal maternal smoking increases the prevalence of asthma in the offspring without inducing BHR.

Section snippets

Population and Questionnaires

The study was conducted in two valleys in western Norway. All the schoolchildren in the first, third, and fifth grades (ie, aged 7 to 13 years) were invited to participate in a cross-sectional study during the 1989 to 1992 winter seasons. One of the parents attended the examination with the child. All the children and their parents were informed about the aims of the study and the test procedures. The protocol was approved by the regional ethics committee. A total of 620 from 645 eligible

RESULTS

Of the 620 subjects who participated in the cross-sectional examination, 573 (92.4%) performed spirometry and BHR was assessed in 529 (85.3%) using a methacholine challenge or reversibility test. The characteristics of the different subgroups are given in Table 1. The relationship among BHR, atopy, and age is shown in Figure 1. After stratification by age, the odds ratio (OR) of having BHR was 3.4 (95% confidence interval [CI], 2.0-6.0) in atopic children compared with nonatopic children.

The

DISCUSSION

In this study, we found that the prevalence of asthma was increased in children whose mothers had a history of postnatal smoking compared with children with never-smoking mothers. A significant decreased prevalence of atopy was associated with prenatal maternal smoking. The data also indicated that the prevalence of maternal smoking increased from pregnancy to the date of investigation contrary to the prevalence of smoking among Norwegian women in the age range 20 to 34 years in the same period.

ACKNOWLEDGMENTS

The authors thank Drs. P. Broen, D. Haarr, P. Lilleng, and O. Strand who participated in the data collection, Dr. R. Bolle who developed the questionnaire, and Jeanette Kliger for linguistic help.

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    The study was supported by grants from the Norwegian Aluminum Industry’s research program of environmental effects (“The Effect Study”), the Norwegian Research Council, Årdal Municipality, and the Norwegian Asthma and Allergy Association.

    Revision accepted June 2.

    Reprint requests: Dr. Søyseth, Hydro Aluminum, Health Dept. N-5870, Ovre Ardal, Norway

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