关键词: 孕前, 父亲烟草暴露, 儿童智力, 队列研究

Abstract: Objective To explore the effect of paternal exposure to cigarette smoke prior to pregnancy on children's intelligence at 6 years old, so as to provide epidemiological evidence for prenatal and postnatal care services. Methods A total of 530 mother-child pairs were included in this study from the Shanghai-Minhang Birth Cohort Study (S-MBCS) established in 2012. Information on paternal exposure to cigarette smoke 3 months prior to pregnancy was obtained through a structured questionnaire at the first antenatal checkup. Intelligence of children at 6 years old was assessed using the Simplified Chinese Version of (the Wechsler Intelligence Scale for Children, Fourth Edition,WISC-Ⅳ). Multivariate linear regression model was used to analyze the effect of paternal cigarette smoke exposure prior to pregnancy on children's intelligence at 6 years old. Results After adjusting for covariates, paternal exposure to cigarette smoke prior to pregnancy was associated with a decrease of 2.83 points (95%CI:-5.51 to -0.16) of children's Full-Scale Intelligence Quotient (FSIQ). The effect of paternal smoking (OR=3.15, 95%CI:-6.32 to 0.03) was slightly stronger than that of paternal exposure to second-hand smoking (OR=2.62, 95%CI:-5.54 to 0.30). The effect of paternal smoking prior to pregnancy on children's FSIQ and Perceptual Reasoning Index (PRI) showed statistically significant dose-effect relationships (P_{for trend}<0.05). Children whose fathers smoked more than 5 cigarettes per day prior to pregnancy had a FSIQ decrease of 6.57 points (95%CI:-10.88 to -2.26) and a PRI decrease of 5.83 points (95%CI:-10.61 to -1.05). Besides, the sex and gestational weeks of children showed significant interactions with paternal exposure to cigarette smoke prior to pregnancy in the effects on children's intelligence (P_{for interaction}<0.05). The effects of paternal exposure to cigarette smoke prior to pregnancy on the intelligence of girls, or of children with less than 39 gestational weeks, were stronger. Conclusions Paternal exposure to cigarette smoke 3 months prior to pregnancy was associated with decreased children's intelligence at 6 years old. Our findings suggest that pre-pregnancy health guidance should strengthen the propaganda of husband's tobacco control before pregnancy, and both husband and wife should jointly assume the responsibility for prenatal and postnatal care.

Key words: prior to pregnancy, paternal exposure to cigarette smoke, children's intelligence, cohort study