Recent studies have suggested that prenatal exposure to environmental tobacco smoke may lead to lower lung function in infants. The authors examined the relation of maternal smoking during pregnancy to persistent deficits in the lung function of older children. Subjects were 8,863 nonsmoking white children aged 8–12 years from 22 North American communities. Information on maternal smoking was provided by the child's mother. Pulmonary function testing of the children was conducted at school in 1988–1991. Children whose mothers smoked during pregnancy, whether or not they still smoked in the year prior to the study, had significantly lower lung function than did children whose mothers did not smoke in either period. On average, forced expiratory flow between 65 and 75 percent of forced vital capacity (FEF_66–75%), forced expiratory flow between 25 and 75 percent of forced vital capacity (FEF_25–75%), and forced expiratory volume in ¾ of a second (FEV_{0 75}) were 5.7%, 4.9%, and 1.7% lower, respectively, for children whose mothers smoked during pregnancy. After adjusting for maternal smoking during pregnancy, the authors found that current maternal smoking was not associated with significant differences on any lung function measure. These results show a persistent deficit in lung function associated with maternal smoking during pregnancy that is not explained by current maternal smoking alone. The strongest effects were observed with pulmonary function measures of flow in the small airways. The authors conclude that the effects of exposure to tobacco smoking by the mother during pregnancy and/or environmental tobacco smoke exposure in the first few years of life persist into childhood and may affect the pulmonary function attained throughout the child's life.

The association of exposure to environmental tobacco smoke (ETS) at home with asthma and several measures of wheeze was examined among 11,534 children aged 8 to 11 yr in 24 communities in the United States and Canada in 1988 through 1990. Information on the child's respiratory symptoms in the past year and history of exposure to ETS was provided by the child's mother on a questionnaire. After adjusting for potential confounders, children currently exposed to ETS were at greater risk of wheezing with colds (odds ratio [OR] = 1.7; 95% confidence interval [95% CI], 1.4 to 1.9), going to a hospital emergency room for wheeze (OR = 1.6; 95% CI, 1.2 to 2.2), and having persistent wheeze (OR = 1.4; 95% CI, 1.1 to 1.8). The relative odds of these symptoms increased with exposure level, and there was no evidence of a difference in the association with smoking by mother, father, or other adults. In contrast to wheeze symptoms, active doctor-diagnosed asthma and asthma medication use were not significantly associated with ETS exposure at home, possibly reflecting underdiagnosis of asthma, reporting bias, or smoking cessation by parents whose child is labeled asthmatic. We conclude that exposure to ETS is associated with wheezing symptoms, medical therapy for wheezing, and wheezing-related emergency department visits in U.S. and Canadian children.

Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia

Objective To evaluate regional variation in the incidence of end‐stage renal disease (ESRD) in Indigenous Australians, and to examine the proximity to ESRD treatment facilities of Indigenous patients...