Am. J. Respir. Crit. Care Med., Volume 162, Number 6, December 2000, 2097-2104

Effects of In Utero and Environmental Tobacco Smoke Exposure on Lung Function in Boys and Girls with and without Asthma

YU-FEN LI, FRANK D. GILLILAND, KIROS BERHANE, ROB MCCONNELL, W. JAMES GAUDERMAN, EDWARD B. RAPPAPORT, and JOHN M. PETERS

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California

To investigate whether the effects of in utero exposure to maternal smoking and environmental tobacco smoke (ETS) exposure on lung function vary by sex or asthma status, we examined medical history and tobacco smoke exposure data for 5,263 participants in the Children's Health Study. At study enrollment, parents or guardians of each subject completed a questionnaire, and lung function was measured spirometrically with maximum forced expiratory flow-volume maneuvers. To assess the in utero effects of maternal smoking and ETS exposure on lung function, we used regression splines that accounted for the nonlinear relationship between pulmonary function, height, and age. In utero exposure to maternal smoking was independently associated with deficits in lung function that were larger for children with asthma. Boys and girls with a history of in utero exposure to maternal smoking showed deficits in maximum midexpiratory flow (MMEF) and a decrease in the FEV₁/FVC ratio. As compared with children without asthma, boys with asthma had significantly larger deficits from in utero exposure in FVC, MMEF, and FEV₁/FVC, and girls with asthma had larger decreases in FEV₁/FVC. The effect of ETS exposure varied by children's gender and asthma status. Deficits in flows associated with current ETS exposure were present in children with and without asthma but were significant only among children without asthma. Past ETS exposure was associated with reduced FEV₁, MMEF, and FEV₁/FVC among boys with asthma. In contrast, past ETS exposure was associated with decreased flow rates in girls without asthma. In summary, both in utero exposure to maternal smoking and ETS exposure were associated with persistent deficits in lung function. The effects of in utero exposure were greatest among children with asthma.

This article has been cited by other articles:

				M. Wenten, Y.-F. Li, P.-C. Lin, W. J. Gauderman, K. Berhane, E. Avol, and F. D. Gilliland In Utero Smoke Exposure, Glutathione S-Transferase P1 Haplotypes, and Respiratory Illness-Related Absence Among Schoolchildren Pediatrics, May 1, 2009; 123(5): 1344 - 1351. [Abstract] [Full Text] [PDF]

				J. Chang and Z. Mosenifar Differentiating COPD From Asthma in Clinical Practice J Intensive Care Med, September 1, 2007; 22(5): 300 - 309. [Abstract] [PDF]

				R. T. Cohen, G. J. Canino, H. R. Bird, S. Shen, B. A. Rosner, and J. C. Celedon Area of Residence, Birthplace, and Asthma in Puerto Rican Children Chest, May 1, 2007; 131(5): 1331 - 1338. [Abstract] [Full Text] [PDF]

				S. T. Sigurdarson and J. N. Kline School Proximity to Concentrated Animal Feeding Operations and Prevalence of Asthma in Students Chest, June 1, 2006; 129(6): 1486 - 1491. [Abstract] [Full Text] [PDF]

				H. Moshammer, G. Hoek, H. Luttmann-Gibson, M. A. Neuberger, T. Antova, U. Gehring, F. Hruba, S. Pattenden, P. Rudnai, H. Slachtova, et al. Parental Smoking and Lung Function in Children: An International Study Am. J. Respir. Crit. Care Med., June 1, 2006; 173(11): 1255 - 1263. [Abstract] [Full Text] [PDF]

				D. S. Postma, D. A. Meyers, H. Jongepier, T. D. Howard, G. H. Koppelman, and E. R. Bleecker Genomewide Screen for Pulmonary Function in 200 Families Ascertained for Asthma Am. J. Respir. Crit. Care Med., August 15, 2005; 172(4): 446 - 452. [Abstract] [Full Text] [PDF]

				H. J. A. M. Schonberger, E. Dompeling, J. A. Knottnerus, T. Maas, J. W. M. Muris, C. van Weel, and C. P. van Schayck The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma Eur. Respir. J., April 1, 2005; 25(4): 660 - 670. [Abstract] [Full Text] [PDF]

				J. P. Bradley, L. B. Bacharier, J. Bonfiglio, K. B. Schechtman, R. Strunk, G. Storch, and M. Castro Severity of Respiratory Syncytial Virus Bronchiolitis Is Affected by Cigarette Smoke Exposure and Atopy Pediatrics, January 1, 2005; 115(1): e7 - e14. [Abstract] [Full Text] [PDF]

				R. I. Harik-Khan, D. C. Muller, and R. A. Wise Racial Difference in Lung Function in African-American and White Children: Effect of Anthropometric, Socioeconomic, Nutritional, and Environmental Factors Am. J. Epidemiol., November 1, 2004; 160(9): 893 - 900. [Abstract] [Full Text] [PDF]

				R. L. Miller, R. Garfinkel, M. Horton, D. Camann, F. P. Perera, R. M. Whyatt, and P. L. Kinney Polycyclic Aromatic Hydrocarbons, Environmental Tobacco Smoke, and Respiratory Symptoms in an Inner-city Birth Cohort Chest, October 1, 2004; 126(4): 1071 - 1078. [Abstract] [Full Text] [PDF]

				D. A. Meyers, M. J. Larj, and L. Lange Genetics of Asthma and COPD: Similar Results for Different Phenotypes Chest, August 1, 2004; 126(2_suppl_1): 105S - 110S. [Abstract] [Full Text] [PDF]

				M. Rizzi, M. Sergi, A. Andreoli, M. Pecis, C. Bruschi, and F. Fanfulla Environmental Tobacco Smoke May Induce Early Lung Damage in Healthy Male Adolescents Chest, April 1, 2004; 125(4): 1387 - 1393. [Abstract] [Full Text] [PDF]

				R. S. Chapman, W. C. Hadden, and S. A. Perlin Influences of Asthma and Household Environment on Lung Function in Children and Adolescents: The Third National Health and Nutrition Examination Survey Am. J. Epidemiol., July 15, 2003; 158(2): 175 - 189. [Abstract] [Full Text] [PDF]

				I. Annesi-Maesano, N. Agabiti, R. Pistelli, M-F. Couilliot, and F. Forastiere Subpopulations at increased risk of adverse health outcomes from air pollution Eur. Respir. J., May 1, 2003; 21(40_suppl): 57S - 63s. [Abstract] [Full Text] [PDF]

				F. D. Gilliland, K. Berhane, Y.-F. Li, E. B. Rappaport, and J. M. Peters Effects of Early Onset Asthma and In Utero Exposure to Maternal Smoking on Childhood Lung Function Am. J. Respir. Crit. Care Med., March 15, 2003; 167(6): 917 - 924. [Abstract] [Full Text] [PDF]

				M. B. Bracken, K. Belanger, W. O. Cookson, E. Triche, D. C. Christiani, and B. P. Leaderer Genetic and Perinatal Risk Factors for Asthma Onset and Severity: A Review and Theoretical Analysis Epidemiol. Rev., December 1, 2002; 24(2): 176 - 189. [Full Text] [PDF]

				G. G. Apostol, D. R. Jacobs Jr., A. W. Tsai, R. S. Crow, O. D. Williams, M. C. Townsend, and W. S. Beckett Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40: The Coronary Artery Risk Development in Young Adults Study Am. J. Respir. Crit. Care Med., July 15, 2002; 166(2): 166 - 172. [Abstract] [Full Text] [PDF]

				E. L. AVOL, W. J. GAUDERMAN, S. M. TAN, S. J. LONDON, and J. M. PETERS Respiratory Effects of Relocating to Areas of Differing Air Pollution Levels Am. J. Respir. Crit. Care Med., December 1, 2001; 164(11): 2067 - 2072. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2000 Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1581 - 1594. [Full Text] [PDF]