Pre- and postnatal exposure to parental smoking and allergic disease through adolescence

• Published in: Pediatrics (Evanston) Vol. 134; no. 3; pp. 428 - 434
• Main Authors: Thacher, Jesse D, Gruzieva, Olena, Pershagen, Göran, Neuman, Åsa, Wickman, Magnus, Kull, Inger, Melén, Erik, Bergström, Anna
• Format: Journal Article
• Language: English
• Published: United States American Academy of Pediatrics 01-09-2014
• Subjects: Adolescence; Adolescent; Allergic reaction; Allergies; Allergy; asthma; Child; Child development; Child, Preschool; children; Cohort Studies; cohort study; Demographic aspects; eczema; Female; Health aspects; Human exposure; Humans; Hypersensitivity - diagnosis; Hypersensitivity - epidemiology; Infant; Longitudinal Studies; Male; Medicin och hälsovetenskap; Parents & parenting; Passive smoking; Pediatrics; Population Surveillance - methods; Pregnancy; Prenatal Exposure Delayed Effects - diagnosis; Prenatal Exposure Delayed Effects - epidemiology; rhinitis; Risk factors; Smoking - adverse effects; Smoking - epidemiology; Tobacco smoke; Tobacco Smoke Pollution - adverse effects; tobacco smoking; United States; tobacco smoking; cohort study; children; eczema; allergy; asthma; rhinitis
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2014-0427

To examine the role of prenatal and postnatal second-hand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age.
A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.
Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15-1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01-1.51), rhinitis (OR = 1.18; 95% CI, 1.01-1.39), and eczema (OR = 1.26; 95% CI, 1.09-1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages.
Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.