BackgroundFetal exposure to tobacco smoking throughout pregnancy is associated with wheezing in infancy. We investigated the influence of in utero smoking exposure on lung ventilation homogeneity and the relationship between lung ventilation inhomogeneity at 7 weeks of age and wheezing in the first year of life.MethodsMaternal smoking was defined as self‐reported smoking of tobacco or validated by exhaled (e)CO > 6 ppm. Lung function data from healthy infants (age 5–9 weeks) born to asthmatic mothers and parent‐reported respiratory questionnaire data aged 12 months were collected in the Breathing for Life Trial (BLT) birth cohort. Tidal breathing analysis and SF6‐based Multiple Breath Washout testing were performed in quiet sleep. Descriptive statistics and regression analysis were used to assess associations.ResultsData were collected on 423 participants. Infants born to women who self‐reported smoking during pregnancy (n = 42) had higher lung clearance index (LCI) than those born to nonsmoking mothers (7.90 vs. 7.64; p = .030). Adjusted regression analyzes revealed interactions between self‐reported smoking and LCI (RR: 1.98, 95% CI: 1.07–3.63, 0.028, for each unit increase in LCI) and between eCO > 6 ppm and LCI (RR: 2.25, 95% CI: 1.13–4.50, 0.022) for the risk of wheeze in the first year of life.ConclusionIn utero tobacco smoke exposure induces lung ventilation inhomogeneities. Furthermore, an interaction between smoke exposure and lung ventilation inhomogeneities increases the risk of having a wheeze in the first year of life.

中文翻译：

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子宫内吸烟会引起肺清除指数的变化并改变婴儿喘息的风险

背景 胎儿在整个怀孕期间接触吸烟与婴儿期喘息有关。我们研究了子宫内吸烟暴露对肺通气均匀性的影响以及 7 周龄肺通气不均匀性与出生第一年喘息之间的关系。 e)CO > 6 ppm。在生命呼吸试验 (BLT) 出生队列中收集了哮喘母亲所生健康婴儿（5-9 周龄）的肺功能数据以及父母报告的 12 个月龄呼吸问卷数据。潮汐呼吸分析和 SF6‐基于多次呼吸冲洗测试是在安静睡眠中进行的。使用描述性统计和回归分析来评估关联性。结果收集了 423 名参与者的数据。自述在怀孕期间吸烟的妇女所生的婴儿（n= 42）比不吸烟母亲所生的孩子具有更高的肺清除指数（LCI）（7.90 vs. 7.64；p= .030)。调整后的回归分析揭示了自我报告吸烟与 LCI 之间的相互作用（RR：1.98，95% CI：1.07-3.63，0.028，LCI 每增加一个单位）以及 eCO > 6 ppm 与 LCI 之间的相互作用（RR：2.25，95% CI） : 1.13–4.50, 0.022) 出生第一年喘息的风险。 结论 子宫内烟草烟雾暴露会导致肺通气不均匀。此外，烟雾暴露和肺通气不均匀性之间的相互作用会增加出生后第一年出现喘息的风险。