Abstract
PATHOPHYSIOLOGY RELATIONSHIP OF PARENTAL SMOKING TO WHEEZING AND NONWHEEZING LOWER RESPIRATORY TRACT ILLNESSES IN INFANCY Wright AL, Holberg C. J Pediatr. 1991;118:207-214. Purpose of the Study This study was designed to establish the impact of parental smoking on lower respiratory tract illness. Study Population A large cohort of infants was followed up prospectively from birth. Methods Illnesses were diagnosed by physicians using the agreed-on criteria and parental smoking histories were obtained by questionnaire. Lower respiratory tract illnesses were differentiated into wheezing and nonwheezing episodes. The age of the first illness was determined in relationship to smoking by parents. Findings The odds of having a lower respiratory tract illness were significantly higher in children whose mothers smoked (odds ratio 1.52) and were higher if mother smoked a pack of cigarettes or more a day and if the child stayed at home rather than attending day care (odds ratio 2.8; confidence interval 1.43 to 5.5). Logistic regression indicated that the lower respiratory tract illness rate was significantly increased both in children exposed to heavy maternal smoke (greater than one pack per day) in the absence of day care. It was also elevated in those who used day care but were not exposed to maternal smoking of a pack or more per day. The relationship of maternal smoking to lower respiratory tract illness rate was evident for both wheezing and nonwheezing infants. Maternal smoking of a pack or more per day was also related to an early age onset of the first lower respiratory illness in both wheezing (P < .05) and nonwheezing (P < .002) illnesses.
Published Version
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