上海市女性二手烟暴露对新生儿不良出生结局的归因分析
Evaluating Newborn's Adverse Birth Outcomes Attributable to Maternal Secondhand Smoke Exposure in Shanghai
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摘要:
目的 通过人群归因健康效应评价方法，定量评估上海市女性二手烟暴露所致不良出生结局的发生情况，为孕产保健政策的制定提供依据。
方法 应用2013年上海市慢性病及其危险因素监测的育龄妇女二手烟暴露数据，结合文献发表的二手烟暴露导致不良出生结局的相对危险度，测算上海市女性二手烟暴露所致不良出生结局的人群归因危险度百分比与归因病例数。
结果 上海市育龄期女性二手烟暴露率达41.67%，其中上海户籍为42.15%，非上海市户籍为39.58%，且均随年龄增长而呈现上升趋势。二手烟暴露导致的早产、低体重、出生窒息和出生缺陷婴儿数分别有2337人、1424人、1146人和637人。沪籍和非沪籍产妇的早产儿、低出生体重儿、出生窒息儿和出生缺陷儿的二手烟归因百分比分别为26.11%、25.40%、45.63%、26.58%和26.58%、25.83%、46.14%、27.23%。
结论 上海市女性二手烟暴露形势严峻，归因于二手烟暴露的不良出生结局发生例数众多。若能有效避免二手烟暴露，上海将至少减少超过四分之一的不良出生结局。
Abstract:Objective To quantitatively evaluate adverse birth outcomes attributable to maternal secondhand smoke exposure in Shanghai residents based on population attributable health effect evaluation method, and to provide scientific evidence for making maternal healthcare policy.
Methods Secondhand smoke exposure data from 2013 Shanghai Non-communicable Disease and Behavioral Risk Factor Surveillance System and relative risk of secondhand smoke exposure from published literatures were used to calculate population attributable risk percent and number of cases with adverse birth outcomes attributable to secondhand smoke exposure.
Results The prevalence rate of secondhand smoke exposure among women of childbearing age in Shanghai was 41.67%, in which 42.15% were registered Shanghai residents and 39.58% were non-registered Shanghai residents, and the prevalence rates of the two groups were increasing with age. The numbers of premature birth, low birth weight, birth asphyxia, and birth defects attributable to secondhand smoke exposure were 2337, 1424, 1146, and 637, respectively. The four indicators for registered Shanghai mothers were 26.11%, 25.40%, 45.63%, and 26.58%, respectively; and the indicators for non-registered Shanghai mothers were 26.58%, 25.83%, 46.14%, and 27.23%, respectively.
Conclusion A high prevalence of secondhand smoke exposure is identified among women of childbearing age in Shanghai. There are a large number of adverse birth outcomes attributable to secondhand smoke exposure. If secondhand smoke exposure is avoided effectively, more than a quarter of adverse birth outcomes will be reduced.
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