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Tobacco exposure in utero and childhood asthma and wheeze - a register-based cohort study
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet; Neuropediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet; Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
Department of Psychological and Brain Sciences, Indiana University, Bloomington, United States of America.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-6851-3297
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, no Suppl. 63Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Previous studies have found associations between smoking during pregnancy (SDP) and childhood asthma/wheeze. Although nicotine has been suggested as a causal agent, the mechanism is unclear. In Sweden, oral moist snuff (snus) is a common form of tobacco, with high nicotine levels, but no combustion.

Aim: To estimate the association between tobacco use in pregnancy, both smoking and snus, and asthma/wheeze in the child, to examine the role of nicotine.

Methods: Our cohort included 897 975 children, born in Sweden 2005-2012. Information on SDP and snus use came from the Medical Birth Registry. We based the asthma/wheeze outcome on diagnoses and drugs from national health registers, as incident asthma at age 0-7 yrs and prevalent asthma at ages 2-6 yrs.

Results: For the association of SDP and asthma/wheeze, we saw a pattern with higher hazard ratios around 5 and 18 months of age (Figure 1). Snus did not show the same pattern. Prevalent asthma, showed the strongest association with SDP at age 2 yrs (adjOR=1.22 95% CI: 1.17-1.28). The corresponding estimates for snus was adjOR=1.06 (95% CI: 0.96-1.18).

Conclusion: We saw an association between SDP and asthma at early age, but the association with snus was much weaker. The results suggest that nicotine is not a causal agent in the SDP – asthma association.

Place, publisher, year, edition, pages
European Respiratory Society , 2019. Vol. 54, no Suppl. 63
Keywords [en]
Children, Smoking, Environment
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-79827DOI: 10.1183/13993003.congress-2019.OA4968ISI: 000507372400399OAI: oai:DiVA.org:oru-79827DiVA, id: diva2:1392117
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, Spain, September 28 - October 2, 2019
Available from: 2020-02-06 Created: 2020-02-06 Last updated: 2020-02-06Bibliographically approved

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