ML Tang

Abstract

Objective: To investigate the relationship between environmental tobacco smoke (ETS) exposure during prenatal and early childhood period and developmental delay among Hong Kong Chinese toddlers. Methods: A case-control study was carried out on 392 children with newly diagnosed developmental delay and 393 controls with normal development. A self-administered questionnaire was used to collect household smoking history. The main outcome measures were the adjusted odds ratios for developmental delay in different ETS exposures during prenatal and postnatal period. Results: Before adjustment, household ETS appeared to be associated with elevated rates of developmental delay among toddlers, before and after birth (crude ORs = 1.53 [95%CI 1.13-2.07] & 1.44 [95%CI 1.06-1.96] respectively). The main contribution was from paternal smoking (crude ORs = 1.73 [95%CI 1.24-2.42] & 1.90 [95%CI 1.34-2.68] respectively). However, these associations became non-significant statistically when the child's gender and socioeconomic factors of the family were adjusted (adjusted ORs = 1.18 [95%CI 0.86-1.63] & 1.23 [95%CI 0.88-1.73] respectively). Conclusion: There is some evidence of an association between environmental tobacco smoke in both prenatal and early childhood period and developmental delay among Hong Kong Chinese toddlers. However, this association appears to be confounded by gender of the child and socioeconomic factors. However, since home is the most significant ETS exposure location for toddlers, educational efforts for family members about reducing their children's ETS exposure are essential.

目的：調查香港幼兒發育遲緩與胎兒期及兒童早期吸入二手煙的關係。方法：對 392 例新診斷發育遲緩兒童和 393 例正常發育兒童進行病例對照研究。用一份自己完成的問卷收集家居吸煙史。主要的衡量指標是比較兩組發育遲緩的調整後的比數比（OR）。結果：調整前，幼兒發育遲緩發生率升高與出生前後暴露於家居二手煙環境呈相關（分別為 OR=1.53，95% 可信區間 1.13-2.07 以及 OR=1.44，95% 可信區間 1.06-1.96）。主要是由父親吸煙所致（分別為 OR=1.73，95% 可信區間 1.24-2.42 以及 OR=1.90，95% 可信區間 1.34-2.68）。然而，當對兒童性別及社會經濟學因素進行調整後，這些相關性便沒有統計學顯著性。（調整後分別為 OR=1.18，95%可信區間 0.86-1.63 以及 OR=1.23，95% 可信區間 0.88-1.73）。結論：有證據顯示香港幼兒發育遲緩與胎兒期及兒童早期吸入二手煙有關。但是，這種相關性受到性別和社會經濟學因素的影響而變得不清晰。然而，由於家居環境是幼兒主要接觸二手煙的環境，有必要對家庭成員進行減少兒童吸入二手煙的教育。