Newman RB, Momirova V, Dombrowski MP, Schatz M, Wise R, Landon M, Rouse DJ, Lindheimer M, Caritis SN, Sheffield J, Miodovnik M, Wapner RJ, Varner MW, O'Sullivan MJ, Conway DL
The Effect of Active and Passive Household Cigarette Smoke Exposure on Pregnant Women with Asthma. [JOURNAL ARTICLE]
Chest 2009 Oct 9.
BACKGROUND: To estimate the effect of active and passive household cigarette smoke exposure on asthma severity, obstetric and neonatal outcomes in pregnant women with asthma.
METHODS: Secondary observational analysis of pregnant women with mild and moderate-severe asthma enrolled in a prospective observational cohort study of asthma in pregnancy and a randomized clinical trial (RCT) comparing inhaled beclomethasone and oral theophylline. A baseline questionnaire detailing smoking history and passive household smoke exposure was given to each patient. Smoking status was confirmed in the RCT using cotinine levels. Asthma severity, obstetric outcomes and neonatal outcomes were collected and analyzed with respect to self-reported tobacco smoke exposure. Kruskal-Wallis and Pearson Chi square statistics were used to test for significance.
RESULTS: 2210 women were enrolled: 1812 in the observational study and 398 in the RCT. Four hundred and eight (18%) women reported current active smoking. Of the non-smokers, 790 (36%) women reported passive household smoke exposure. Active smoking was associated with an increased number of total symptomatic days (p < 0.001) and nights of sleep disturbance (p < 0.001). Among the newborns of active smokers there was a greater risk of small for gestational age (SGA) < 10 percentile (p < 0.001) and a lower mean birth weight (p < 0.001). There were no differences in symptom exacerbation or outcome between non-smokers with and without passive household cigarette smoke exposure.
CONCLUSIONS: Among pregnant women with asthma, active, but not passive smoking is associated with increased asthma symptoms and fetal growth abnormalities.
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