Study On The Relationship Between Passive Smoke Exposure And Gestational Diabetes Mellitus In Non-smoking Pregnant Women

Objective:To discuss the relationship between exposure of passive smoking and risk of GDM in non-smoking pregnanct women.Methods:From December 2015 to May 2016,all pregnant women with GDM who received prenatal examination in the outpatient department of Obstetrics of Anqing First People’s Hospital,Huaining County Hospital and Taihu County Hospital were selected as case group.At the same time,pregnant women（excluding GDM and pre pregnancy diabetes）were selected as control group.The age,education level,height,weight before pregnancy,marital status,family income per capita,occupation,family history of diabetes mellitus,pregnancy times,night shift,stress,pre-pregnancy exercise,sleep quality,passive smoking and so on were investigated.Epidata3.1 software was used to build the database and SPSS21.0 software was used to analyze the data.Univariate analysis was used to compare the counting data between groups byχ² test and t test.Unconditional logistic regression model was used to evaluate the relationship between passive smoking（including exposure or not,average exposure time,daily smoking expenditure of smokers）and the incidence of gestational diabetes mellitus.odds ratio（OR）was used to evaluate the relationship between passive smoking and gestational diabetes mellitus.The intensity associated with the 95%confidence interval（confidence interval,CI）is estimated.Results:（1）995 eligible pregnant women were collected,of which 319 were GDM pregnant women and 32.1%were non-smoking pregnant women.（2）By logisti regression analysis of single factor and multiple factors,six risk factors of pregnant women’s age,pre-pregnancy body mass index（BMI）,passive smoking,family per capita monthly income,pre-pregnancy exercise and sleep quality were included in the model.OR（95%CI）values were 1.22（1.16-1.29）,1.16（1.06-1.27）,1.60（1.09-2.33）,1.18（1.18）..00 to 1.40),0.81（0.68 to 0.96）,0.81（0.66 to 0.99）.（3）the total exposure rate of passive smoking among non-smoking pregnant women was 78.3%（779/995）during pregnancy.Compared with pregnant women without passive smoking exposure,pregnant women in passive smoking exposure group had lower education level and previous pregnancy history,and there was significant difference between the two groups（P<0.05）.Among them,579（58.2%）were pregnant women who smoked passively at home,93（9.3%）were pregnant women who smoked passively at work,107（10.8%）were pregnant women who smoked passively at home and at work,685 pregnant women were exposed to family passive smoking before pregnancy,684pregnant women were exposed to family passive smoking during pregnancy,and 200 pregnant women were exposed to family passive smoking during pregnancy.During pregnancy,there are workplace passive smoking exposures.（4）Before and after correcting the confounding factors,it was suggested that the total exposure to passive smoking in non-smoking pregnant women was significantly correlated with GDM,and the OR（95%CI）values before and after correcting were1.41（1.01-1.98）and 1.60（1.09-2.33）,respectively.Compared with smokers,family passive smoking was significantly correlated with GDM,with OR（95%CI）values of 1.48（1.06-2.05）and1.59（1.13-2.24）before and after correction.No correlation between workplace passive smoking exposure and GDM was found.The relationship between family passive smoking exposure time,daily smoking consumption of family members and the incidence of GDM was further analyzed.The results showed that after adjusting for other confounding factors,the exposure time of passive smoking and the number of smoking cigarettes per day of family members were correlated with GDM,and with the increase of exposure time and the number of smoking cigarettes,the risk of GDM in non-smoking pregnant women increased(P _trend<0.01).Conclusions:（1）The incidence of GDM among non-smoking pregnant women（32.1%）and the exposure rate of passive smoking among non-smoking pregnant women（78.3%）who be collected are at a high level.（2）Older pregnant women,higher BMI before pregnancy,family economic status,passive smoking exposure may be risk factors for GDM;sleep quality and pre-pregnancy exercise may be protective factors for GDM.（3）The main place of passive smoking for non-smoking pregnant women is family.There is a significant correlation between passive smoking exposure and GDM during pregnancy.Passive smoking may be an important risk factor for GDM.With the increase of exposure time of passive smoking in family and the number of daily smoking expenditures of smokers,the risk of GDM increases gradually.It is suggested that the relevant departments should strengthen the health education and promotion of pregnant women in this region,raise the health awareness of pregnant women,fully understand the harm of passive smoking exposure to mothers and children,actively dissuade and actively avoid,and reduce the occurrence of adverse pregnancy outcomes.