|
|
TABLE 4.1
SUDDEN INFANT DEATH SYNDROME (SIDS)
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Study Size |
Exposure Group Comparison |
Comments |
Location |
|
Exposure Group1 |
Odds Ratio
(95% CI) |
|
Bergman & Wiesner
(1976) |
56 cases,
86 controls |
•Any vs. no MS
during pregnancy |
2.2 (1.0-4.5) |
Matched on sex, race. Poor study participation. Virtually all
mothers who |
| United States (King County, |
|
*Any vs. no MS after
pregnancy |
2.4 (1.2-4.8) |
smoked in pregnancy also smoked afterwards. |
| Washington) |
|
*Any vs. no PS |
1.5 (0.7-3.2) |
|
McGlashan (1989)
Tasmania |
167 cases,
334 controls |
•Any vs. no MS
during pregnancy |
1.9 (1.2-2.9) |
Matched on sex; no other adjustment. ORs were calculated from
table; author |
| |
|
*Any vs. no MS in
child's first year |
1.9 (1.2-2.9) |
presented results of a matched analysis that were different.
Virtually all mothers who |
| |
|
*Any vs. no PS |
"significantly increased" |
smoked in pregnancy also smoked afterwards. |
Mitchell et al. (1991)
New Zealand |
128 cases,
503 controls (subset of |
•Any vs. no MS during pregnancy (from medical records) |
2.7 (crude) |
Controlled for many demographic and social factors,
breastfeeding, season, and sleeping position. Strong dose-response |
| |
Mitchell et al.
(1993)) |
*Any vs. no recent
MS (from interview) |
3.0 (crude)
1.8 (1.0-3.3; adj) |
noted in crude analysis. Virtually all mothers who smoked in
pregnancy also smoked afterwards. |
Nicholl & O'Cathain
(1992) United Kingdom |
242 cases,
251 controls |
•Any vs. no MS
during pregnancy |
2.1 (1.5-3.1)
|
Matched for date and place of birth. Controlled for spousal
smoking only. Effect of PS increased as infants' ages increased. |
|
|
*Any vs. no PS
|
1.6 (1.1-2.4) |
|
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure.
TABLE 4.1 (continued)
SUDDEN INFANT DEATH SYNDROME (SIDS)
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Study Size |
Exposure Group Comparison |
Comments |
| |
|
Exposure Group1 |
Odds Ratio
(95% CI) |
|
Schoendorf & Kiely
(1992)
United States |
435 cases,
6,000 controls |
•Any vs. no MS
during and after
pregnancy |
White Black
3.1 3.1
(2.3-4.2) (2.2-4.3) |
Restricted to infants with birth weights >2,500 g.
Controlled for maternal age, education, and marital status. Smokers |
| (U.S. National Maternal and Infant |
|
*Any vs. no MS after
pregnancy only |
1.8 2.3
(1.0-3.0) (1.5-3.7) |
in "during and after" category were heavier smokers
than smokers in the |
| Health Survey) |
|
*Other household
smokers (vs. no other
household smokers) |
1.4 0.9
(1.0-1.9) (0.7-1.3) |
"after only" category |
Mitchell et al. (1993)
New Zealand |
485 cases,
1,800 controls |
*Any vs. no recent
MS |
1.7 (1.2 -2.3) |
The first 3 ORs are adjusted for region season,
breastfeeding, and bed sharing; |
| |
|
*Any vs. no PS |
1.4 (1.0-1.8) |
mother’s marital status, SES, age, and |
| |
|
*Any vs. no other
household smokers |
1.2 (0.8-1.6) |
smoking during pregnancy; infant’s age, sex,
birthweight, race, and sleeping |
| |
|
*MS cigs/day:
0
1-19
>20
|
No PS PS
1.0 1.0
(ref) (0.6-1.6)
2.6 4.4
(1.7-3.8) (3.3-6.0)
3.4 7.4
(2.0-5.8) (4.9-11.1) |
position; and where appropriate, smoking by the mother,
father and other household numbers. |
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure.
TABLE 4.1 (continued)
SUDDEN INFANT DEATH SYNDROME (SIDS)
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Study Size |
Exposure Group Comparison |
Comments |
| |
|
Exposure Group 1,2 |
Odds Ratio (95% CI)
Unadjusted Adjusted |
|
| Klonoff-Cohen et al. |
200 cases, |
*Any MS |
3.1 (1.8, 5.6) |
2.3 (1.0, 5.0) |
Adjusted ORs were controlled for birth |
| (1995) |
200 controls |
*Any same-room MS |
6.2 (2.6, 14.6) |
4.6 (1.8, 11.8) |
weight, routine sleep position, medical |
| United States |
|
*Any PS |
3.5 (2.0, 6.3) |
3.5 (2.0, 6.3) |
conditions at birth, prenatal care, |
| (Southern California) |
|
*Any same-room PS |
9.2 (3.7, 23.2) |
8.5 (3.3, 21.6) |
breast feeding, and maternal smoking |
| |
|
*Any household smoking |
3.8 (2.3, 6.4) |
3.5 (1.8, 6.8) |
during pregnancy. |
| |
|
*Any same-room household smoking |
6.2 (3.3, 11.7) |
5.0 (2.4, 11.0) |
|
| |
|
Total number of
household smokers:
1
2
3 |
3.1 (1.8, 5.5)
5.2 (2.5, 10.7)
8.1 (1.5, 44.5 |
3.0 (1.5, 6.0)
5.3 (1.9, 14.5)
5.1 (0.7, 36.6) |
|
|
|
Total cig exposure/day
1 - 10
11 - 20
³ 21 |
2.3 (1.1, 4.7)
3.5 (1.7, 7.1)
12.6 (4.3, 37.1) |
2.4 (1.1,5.4)
3.6 (1.5, 8.8)
22.7 (4.8, 107.2) |
|
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure.
2 All odds ratios are for postnatal exposure and are relative to
infants with no smoke exposure.
TABLE 4.1 (continued)
SUDDEN INFANT DEATH SYNDROME (SIDS)
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Study Size |
Exposure Group Comparison |
Comments |
| |
|
Exposure Group1 |
Odds Ratio
(95% CI) |
|
Blair et al. (1996)
United Kingdom |
195 cases,
780 controls |
*Any vs. no PS |
2.5 (1.5-4.2) |
Matching by age and region. First OR is adjusted for maternal
age, marital status, SES, maternal smoking, drug and alcohol use, gestational age,
sleeping position, and breast feeding. |
| |
|
* PS/no MS vs.
no PS or MS
|
3.4 (2.0-5.9) |
|
| |
|
* Household cigs/day:
0
1-19
20-39
³ 40
|
1.0
2.5 (1.3-4.7)
4.0 (2.4-6.6)
7.6 (4.0-14.3)
|
|
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure.
TABLE 4.2
COGNITION IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Design (n) |
Outcome |
Tobacco Exposure Comparison1,2 |
Comments |
Location |
Ages at Follow-up |
Assessment |
Exposure Group |
Results |
|
Rantakallio (1983)
Finland |
Prospective
(1763 prenatally exposed, 1781 controls) |
School ability in theoretical subjects |
•MS during
pregnancy:
<10 cig/day vs. 0
>10 cig/day vs. 0 |
Change in score:
-1.8%
-2.5% ^^^ |
MS adjusted for sex, maternal age, parental height, SES and
family size. PS also adjusted for prenatal exposure and maternal education. |
| |
14 year olds |
|
*Any vs. no PS |
Inverse association |
|
Bauman et al.
(1989)
United States (North Carolina) |
Prospective
(973)
8th graders |
California Achievement Test |
*Cig/day smoked
by family:
0
1-19
20-39
>40 |
Mean total score:
618.8
610.0
606.8
602.9 ^ |
Non-smoking children only (confirmed by breath CO). Adjusted
for age, sex, parental education, some psych characteristics. No control for SES, prenatal
exposure. |
Bauman et al.
(1991)
California |
Prospective
(1,500-2,800)
5,10,16 year olds |
PPVT
RAVEN |
*Any vs. no parental smoking at age:
5
10
16 |
Score difference:
PPVT RAVEN
-0.06 -0.14
-1.55^^^ -0.89^
-0.92 |
Up to 30% had missing values for parental smoking. Father's
smoking interpolated at ages 5 and 16. Adjusted for age, sex, race, birth weight, SES,
income, parental education, prenatal exposure, and (in 16-year-olds) active smoking.
Dose-response seen with PPVT scores in 10-year-olds. |
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure; bullet (•) denotes on-ETS exposure; PPVT
- Peabody Picture Vocabulary Test; RAVEN - Raven Colored Progressive Matrices Test,; MDI -
Mental Development Index of the Bayley Scales of Infant Development; GCI - General
Cognitive Index of the McCarthy Scales of Children's Abilities; HOME - Home Observation
for Measurement of the Environment.
2 ns = not significant (p>0.05), ^p<0.05, ^^p<0.01, ^^^p<0.001,
n = study size.
TABLE 4.2 (continued)
COGNITION IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year) |
Design (n) |
Outcome |
Tobacco Exposure Comparison1,2 |
Comments |
Location |
Ages at Follow-up |
Assessment |
Exposure Group |
Results |
|
Baghurst et al.et al.
(1992)
Port Pirie, Australia |
Prospective
(548)
2 and 4 year olds |
Bayley
(at 2 years)
McCarthy
(at 4 years) |
*Any vs. no maternal postnatal smoking |
Score difference:
Bayley MDI -0.55
McCarthy
GCI -0.45
verbal -0.17
perceptual -0.67
quantitative 0.21 |
Adjusted for SES, maternal IQ, and HOME score. No control for
prenatal exposure. Adjustment caused score differences to drop 65-90% and lose statistical
significance. |
| Eskenazi and Trupin (1995) California |
Prospective
(2,124)
Five year olds |
PPVT RAVEN |
•No smoke exposure |
Mean score: PPVT RAVEN
50.7 10.7 |
Adusted for parents’ education, socioeconomic status,
race, birth order, preschool attendance, and other factors. |
| |
|
|
*Maternal ETS during pregnancy |
51.9 10.8 |
|
| |
|
|
•MS during pregnancy only |
52.5^ 11.3^ |
|
| |
|
|
*MS after pregnancy only |
49.9 10.4 |
|
| |
|
|
*MS during and after pregnancy |
50.8 10.6 |
|
| |
|
|
*Current cig/day smoked by mother: 1 - 9
10 - 19
³ 20 |
Score difference from children of non-smoking mothers PPVT
RAVEN
-1.5^ -0.5^
-1.3 -0.3
-1.3 -0.6^ |
Adjusted for above factors as well as prenatal exposure |
TABLE 4.3
BEHAVIOR IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year)
Location |
Design (n)
Ages at Follow-up |
Outcome Assessment |
Tobacco Exposure
Comparison1 |
Results |
Comments1 |
Denson et al. (1975)
Saskatchewan |
Retrospective
(20 cases,
40 controls)
5-15 year olds |
Hyperactivity |
•MS during pregnancy
*PS during pregnancy
*Current MS
*Current PS |
Parents of cases smoked more cig/day than parents of
controls. p<0.05 only for MS. |
Matched by age,sex, and minimally by SES, no other adjustment
for potential confounders. ORs could not be calculated from data presented. |
Weitzman et al.et al. (1992)
US National Longitudinal |
Prospective
(2,256)
4-11 year olds |
Behavior Problem Index >14 (rating by mother) |
MS in cig/day:
•Pregnancy only:
<20 vs. 0
>20 vs. 0 |
OR (95% CI):
1.6 (1.0-2.5)
0.4 (0.1-1.6) |
Only 19 women in high-dose pregnancy only category thus
estimate unstable. |
| Survey of Youth |
|
|
*Post-preg only:
<20 vs. 0
>20 vs. 0 |
1.2 (0.9-1.7)
2.0 (1.3-3.1) |
Adjusted for age, sex, race, birth weight, health, HOME, |
| |
|
|
*Both:
<20 vs. 0
>20 vs. 0 |
1.4 (1.1-1.8)
1.5 (1.1-2.2) |
income, and maternal education, intelligence, self-esteem,
marital status, alcohol use in pregnancy, employment. |
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure; HOME - Home Observation for Measurement of the
Environment-Short Form, n - study size.
TABLE 4.3 (continued)
BEHAVIOR IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year)
Location |
Design (n)
Ages at Follow-up |
Outcome Assessment |
Tobacco Exposure
Comparison1 |
Results |
Comments |
Eskenazi and Trupin (1995)
California |
Prospective
(2,124)
Five year olds |
Rated "active" by mother |
•No smoke exposure |
OR (95% CI) Unadjusted Adjusted
1.0 1.0 |
Adjusted for parents’ education, socioecon-
omic status, race, birth |
| |
|
|
*Maternal ETS
during pregnancy |
1.6 (0.7, 3.3) 1.5 (0.7, 3.1) |
order, preschool attendance, and other |
| |
|
|
•MS during
pregnancy only |
1.1 (0.6, 2.0) 1.0 (0.5, 1.9) |
factors. |
| |
|
|
*MS after
pregnancy only |
1.4 (0.8, 2.7) 1.2 (0.6, 2.2) |
|
| |
|
|
*MS during and
after pregnancy |
1.6 (1.2, 2.1) 1.2 (0.9, 1.7) |
|
| |
|
|
*Current cig/day
smoked by mother:1 - 9
10 - 19
³ 20 |
OR (95% CI) Unadjusted Adjusted
1.2 (0.7, 1.9) 1.0 (0.6, 1.7)
1.5 (0.9, 2.3) 1.1 (0.8, 2.0)
1.8 (1.2, 2.6) 1.6 (0.9, 2.8) |
Adjusted for above factors as well as prenatal exposure |
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure.
TABLE 4.4
HEIGHT GROWTH IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year)
Location |
Design (n)
Ages at Follow-up |
Source/Amount of Tobacco Exposure1 |
Height Difference
in cm |
Comments |
Rona et al. (1981)
United Kingdom |
Cross-section
(4,961)
5-11 year olds |
*Number of people
smoking >5 cig/day at
home |
Inverse association
(p<0.05) |
Adjusted for age, sex, parental heights, # sibs, SES, birth
weight. No control for prenatal exposure. |
Rona et al. (1985)
United Kingdom |
Cross-section
(5,903)
5-11 year olds |
*Every 10 cig/day smoked
at home by parents |
-0.2 (p<0.01) |
Adjusted for age, sex, location, parental heights, # sibs,
prenatal exposure, birth weight. |
Chinn & Rona (1991)
United Kingdom |
Cross-section
(11,224)
5-11 year olds |
*Total cig/day smoked at
home by parents |
No significant association |
Adjusted for same covariates as above, plus SES, ethnicity,
school meals. |
Rantakallio (1983)
Finland |
(1,763 prenatally exposed,
1,781 controls) |
•MS during pregnancy:
<10 cig/day vs. 0
>10 cig/day vs. 0 |
-0.6
-0.9 (p<0.05) |
MS adjusted for sex, maternal age, parental height, SES and
family size. PS also adjusted for prenatal |
| |
14 year olds |
*Any vs. no PS |
Inverse association (ns) |
exposure and maternal education. |
Berkey et al.(1984);
Ferris et al. (1985)United States |
Longitudinal cohort
(9,273)
6-11 year olds |
Current cig/day:
•MS <10 vs. 0
>10 vs. 0 |
-0.5
-0.7 (p<0.001) |
Adjusted for age, sex, location, parental education, gas
cooking. No control for parental height, |
| |
|
•PS >10 vs. 0
>10 vs. 0 |
-0.04
-0.1 (ns) |
prenatal exposure, birth weight. |
| |
|
|
No association between MS or PS and rate of growth |
|
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure; n - study size.
TABLE 4.4 (continued)
HEIGHT GROWTH IN CHILDREN
STUDIES THAT ASSESSED SOME SOURCE OF POSTNATAL ETS EXPOSURE
Authors (year)
Location |
Design (n)
Ages at Follow-up |
Source/Amount of Tobacco Exposure1 |
Height Difference
in cm |
Comments |
Eskenazi and Trupin (1995)
California |
Prospective
(2,622)
Five year olds |
*Maternal ETS during
pregnancy |
Model I Model II 0.5 (-0.5, 1.4) 0.4 (-0.5,
1.3) |
Model I adjusted for race, sex, birth order, and maternal
education, age, height, and body mass |
| |
|
•MS during pregnancy only |
-0.3 (-1.1, 0.5) -0.01 (-0.8, 0.8) |
index. |
| |
|
*MS after pregnancy only |
0.5 (-0.3, 1.3) 0.5 (-0.3, 1.3) |
Model II adjusted for the above factors and birth |
| |
|
*MS during and after pregnancy |
-0.5 (-0.9, -0.1) -0.02 (-0.4, 0.4) |
weight and gestational age. |
1 Abbreviations: MS - maternal smoking; PS - paternal smoking; asterisk (*)
denotes proxy measurement for ETS exposure;
bullet (•) denotes non-ETS exposure; n - study size.
|
