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January 2004, Vol 94, No. 1 | American Journal of Public Health 136-140
© 2004 American Public Health Association


RESEARCH AND PRACTICE

Maternal Smoking in Pregnancy, Fetal Development, and Childhood Asthma

Jouni J. K. Jaakkola, MD, DSc, PhD and Mika Gissler, PhD

Jouni J. K. Jaakkola is with the Institute of Occupational Health, The University of Birmingham, Birmingham, United Kingdom, and the Department of Public Health, University of Helsinki, Finland. Mika Gissler is with the National Research and Development Centre for Welfare and Health, Helsinki.

Correspondence: Requests for reprints should be sent to Jouni J. K. Jaakkola, MD, DSc, PhD, Institute of Occupational Health, The University of Birmingham, Edgbaston, Birmingham B15 2TT UK (e-mail: j.jaakkola{at}bham.ac.uk).

Objectives. We examined the relationships among maternal smoking in pregnancy, fetal development, and the risk of asthma in childhood.

Methods. We conducted a population-based cohort study, where all 58 841 singleton births were followed for 7 years using nationwide registries.

Results. Maternal smoking increased the risk of asthma (adjusted odds ratio = 1.35; 95% confidence interval = 1.13, 1.62 for high exposure). Low birthweight and preterm delivery increased the risk of asthma at the age of 7, whereas being small for gestational age did not.

Conclusions. Maternal smoking in pregnancy increases the risk of asthma during the first 7 years of life, and only a small fraction of the effect seems to be mediated through fetal growth.




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