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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 |
||
| 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 |
|||
| 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) |
|||||
| 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 |
|||
| 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) |
Design (n) |
Outcome Assessment |
Tobacco Exposure |
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) |
Design (n) |
Outcome Assessment |
Tobacco Exposure |
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) |
Design (n) |
Source/Amount of Tobacco Exposure1 |
Height Difference |
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) |
Design (n) |
Source/Amount of Tobacco Exposure1 |
Height Difference |
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.