目的:本研究的目的是评估孕妇孕期吸烟(MSDP)和个人吸烟对死亡率和预期寿命的个体和综合影响。
方法:一项基于英国生物银行的前瞻性队列研究,中位随访时间为12.47年。
方法:本研究采用多变量Cox回归,根据母亲和/或个人吸烟状况和吸烟包年(0、1-20、21-30、>30),确定所有原因和特定疾病的相对死亡风险。此外,这项研究估计了两种暴露之间的加性相互作用。使用估计的特定年龄死亡率进行生命表分析以预测预期寿命。
结果:结果表明,MSDP提高了全因死亡率(HR=1.12,95%CI:1.09-1.15)和肿瘤死亡率(HR=1.10,95%CI:1.06-1.12)的风险,循环(HR=1.13,95%CI:1.06-1.19),呼吸系统疾病(HR=1.27,95%CI:1.16-1.40)和消化系统疾病(HR=1.22,95%CI:1.08-1.38)。值得注意的是,在母亲和个人吸烟之间观察到乘法和加法相互作用,所有原因死亡率的相互作用相对超额风险(RERI)值,肿瘤,循环,呼吸系统疾病分别为0.21、0.22、0.16和0.76。这项研究还发现,当产妇吸烟和个人吸烟的包年增加相结合时,预期寿命会缩短。
结论:在英国生物银行的这项队列研究中,MSDP与全因死亡率风险增加和预期寿命缩短有关。这表明在怀孕期间戒烟可能对两代人都有健康和长寿的好处。
OBJECTIVE: The aim of this study was to evaluate the individual and combined effects of maternal smoking during pregnancy (MSDP) and personal smoking on mortality and life expectancy.
METHODS: A prospective cohort study based on the UK Biobank, with a median follow-up of 12.47 years.
METHODS: This study employed multivariate Cox regression to determine the relative risks of mortality from all causes and specific diseases according to maternal and/or personal smoking status and pack-years of smoking (0, 1-20, 21-30, >30). Additionally, this study estimated the additive interaction between the two exposures. Life table analyses were performed using the estimated age-specific mortality rates to forecast life expectancy.
RESULTS: Results indicated that MSDP elevated the risk of all-cause mortality (HR = 1.12, 95% CI: 1.09-1.15) and mortality due to neoplasms (HR = 1.10, 95% CI: 1.06-1.12), circulatory (HR = 1.13, 95% CI: 1.06-1.19), respiratory (HR = 1.27, 95% CI: 1.16-1.40) and digestive system diseases (HR = 1.22, 95% CI: 1.08-1.38). Notably, both multiplicative and additive interactions were observed between maternal and personal smoking, with Relative Excess Risk due to Interaction (RERI) values for mortality from all causes, neoplasms, circulatory, and respiratory diseases being 0.21, 0.22, 0.16, and 0.76, respectively. This study also found a trend towards shorter gained life expectancy when maternal smoking and increasing pack-years of personal smoking were combined.
CONCLUSIONS: In this cohort study of UK Biobank, MSDP was associated with an increased risk of all-cause mortality and reduced life expectancy, suggesting that quitting smoking during pregnancy might have health and longevity benefits for both generations.