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Luo Z.-C.,University of Montreal | Luo Z.-C.,Key Laboratory of Childrens Environmental Health | Julien P.,Laval University | Wei S.-Q.,University of Montreal | And 3 more authors.
American Journal of Obstetrics and Gynecology

Objective Self-reported tobacco smoking in pregnancy has been consistently associated with a decreased risk of developing preeclampsia, but the evidence has been limited and inconsistent for previous and passive smokers. Misclassifications and inaccuracies of self-reported tobacco exposure may disguise the true relationship. This study aimed to assess the association of gestational hypertension and preeclampsia with maternal smoking status as ascertained by plasma cotinine. Study Design This was a prospective study of 605 pregnant women without chronic hypertension. Maternal smoking status at 24-26 weeks' gestation was defined by plasma cotinine: >3.0 ng/mL "current smokers," 0.20-3.00 ng/mL "previous and passive smokers," and <0.20 ng/mL "nonsmokers." Results Compared to nonsmokers, the risk of developing preeclampsia did not change significantly for current smokers, but increased significantly (adjusted odds ratio, 6.06; 95% confidence interval, 2.32-15.85; P <.001) for previous and passive smokers. There were no significant differences in the risk of developing gestational hypertension only. Conclusion Previous and passive smoking may increase the risk of preeclampsia. Avoidance of exposure to environmental tobacco smoke in pregnancy may decrease the risk of preeclampsia. Source

Li F.,Shanghai JiaoTong University | Li F.,Key Laboratory of Childrens Environmental Health | Zhou Y.,East China Normal University | Li S.,Shanghai JiaoTong University | And 14 more authors.
BMC Public Health

Background: Several studies conducted during the past two decades suggested increasing trend of childhood allergic diseases in China. However, few studies have provided detailed description of geographic variation and explored risk factors of these diseases. This study investigated the pattern and risk factors of asthma, allergic rhinitis and eczema in eight metropolitan cities in China. Methods. We conducted a cross-sectional survey during November-December 2005 in eight metropolitan cities in China. A total of 23791 children aged 6-13 years participated in this survey. Questions from the standard questionnaire of the International Study of Asthma and Allergies in Children (ISAAC) were used to examine the pattern of current asthma, allergic rhinitis and eczema. Logistic regression analyses were performed to assess the risk factors for childhood allergies. Results: The average prevalence of childhood asthma, allergic rhinitis and eczema across the eight cities was 33% (95% Confidence interval (CI): 31%, 36%), 98% (95% CI: 94%, 102%) and 55% (95% CI: 52%, 58%), respectively. Factors related to lifestyle, mental health and socio-economic status were found to be associated with the prevalence of childhood allergies. These risk factors were unevenly distributed across cities and disproportionately affected the local prevalence. Conclusions: There was apparent geographic variation of childhood allergies in China. Socio-environmental factors had strong impacts on the prevalence of childhood allergies; but these impacts differed across regions. Thus public health policies should specifically target at the local risk factors for each individual area. © 2011 Li et al; licensee BioMed Central Ltd. Source

Li F.,Shanghai JiaoTong University | Li F.,Key Laboratory of Childrens Environmental Health | Zhou Y.-C.,East China Normal University | Tong S.-L.,Queensland University of Technology | And 14 more authors.
World Journal of Pediatrics

Background: Rapid changes in socioeconomic environment and their diverse patterns in China raise a question: how socio-environmental factors affect childhood asthma in China. We performed a multilevel analysis based on a 2005 national survey to understand the association between environmental factors and asthma, and to provide insights on developing prevention strategies. Methods: A multi-center, cross-sectional survey was conducted in 2018 school-aged children chosen from eight Chinese cities. Children of 6-13 years old were chosen randomly from schools of 39 centers in 8 cities. The multilevel analysis was made to assess both individual-level and city-level risk factors. The effect of gross domestic product (GDP) was further investigated by analysis of the factors. Results: Analysis of city-level environmental factors showed that GDP [adjusted odds ratio (OR)=1.88], particulate matter with aerodynamic diameter ≤10 μm (PM10) (adjusted OR=1.37), and average humidity (adjusted OR=1.33) were strong risk factors. Further analysis of the factors decomposed GDP into two major factors, the first represented by urban construction, energy consumption, nitrogen dioxide concentration, and the second represented by health-system coverage. This suggested that the negative effects of GDP outweighed its positive effects on asthma. Conclusions: The prevalence of childhood asthma varies significantly in the eight Chinese cities. Socioenvironmental factors such as GDP, PM10 and average humidity are strong risk factors controlling individual attributes, suggesting that balance is needed between public health and economic development in China. © 2013 Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg. Source

Li Y.,Shanghai JiaoTong University | Li Y.,Key Laboratory of Childrens Environmental Health | Jiang Y.,Key Laboratory of Childrens Environmental Health | Jiang Y.,Shanghai JiaoTong University | And 5 more authors.

Objective: The objective of this study was to investigate the relationship between prenatal and postnatal risk factors and the prevalence of allergic rhinitis (AR) in Chinese children of specific ages. Study Design: This study was a cross-sectional survey. Students from 8 metropolitan cities in China were studied in November and December, 2005. There were 20,803 elementary-school Chinese children (49.6% boys, mean age, 9.19 years) enrolled. Questions from the standard questionnaire of the International Study of Asthma and Allergies in Children were completed to enable us to examine the pattern of current AR. The potential confounders and pre-and postnatal risk factors were analyzed using logistic regression. Results: The overall prevalence of AR was found in this study to be 9.8%. After adjusting for several likely confounders, there was a higher likelihood of AR in school-aged children who were not exclusively breastfed in the first 4 months of their lives (odds ratio [OR]: 1.28; 95% confidence interval [CI]: 1.16-1.41), children who were born post-term (OR: 1.34; 95% CI: 1.12- 1.60), children delivered by cesarean section (OR: 1.07; 95% CI: 1.00-1.19), or children born to mothers who experienced depressive symptoms during the pre- and postnatal periods (OR: 1.28; 95% CI: 1.15-1.42). Conclusions: AR in school-aged children was found to be associated with pre- and postnatal events. These findings indicate that strategies to reduce exposure to risk factors during pre- and postnatal periods for childhood allergies might be warranted. © 2015 Li et al. Source

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