Dr Gibby Koshy MBBS, MTropPaed, DPH, MPH, MPhil
Hospital, institution: Liverpool School of Tropical Medicine
Planned completion year: 2010-2011
Name project: Pregnancy smoking exposure and childhood and birth outcomes and asthma epidemiology in Merseyside.
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Introduction and background
Maternal smoking during pregnancy has detrimental effects for both the mother and fetus increasing the risk of both intrauterine growth retardation, obstetric complications and other adverse health effects (1-4). It is associated not only with reduced birth weight but also with an increased risk of sudden infant death syndrome and has been shown to increase the risks for diabetes, obesity, criminal behaviour and substance abuse in adults (5). About 30 % of men and women smoke in the United kingdom and heavy smokers mostly belong to the age group of 20 to 40 years (6). Among women smoking prevalence was highest in the North West of England (32%)(7). Greater efforts are required to promote smoking reduction in these women. There are about 4 million births per year in the UK and as 20% of women smoke during their pregnancy, this equates to as many as 800000 infants annually exposed in utero to cigarette smoke (8).Maternal smoking in pregnancy has also been associated with asthma and obesity in children born to mothers who smoke.
Childhood asthma is a disease with major public health importance in developed countries. Childhood asthma is one of the important causes of impaired quality of life, hospital admission and increased mortality across a wide spectrum of age, socio economic status and geographical locations (9). The UK has one of the highest prevalence estimates for hospital admission or increased mortality from asthma, (10). There is evidence that the prevalence of asthma has increased nationally in the UK and locally in Merseyside during the decade of the 1990s (11). The Merseyside respiratory health surveys were first undertaken because of the effects of airborne dust pollution on asthma risk among children attending primary schools and living around the Sefton Dock area. As a consequence of these activities, the changes in parent-reported childhood asthma prevalence in Merseyside have been assessed in consecutive cross-sectional surveys undertaken in Liverpool and Wallasey primary schools in 1991, 1993, 1998 and 2006.
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Aims and objectives
- To describe the prevalence of pregnancy smoking and birth and childhood outcomes.
- To determine the combined dose response effects of pregnancy cigarette smoke exposure on childhood stature, overweight and obesity.
- To assess trends and cigarette exposure dose response effects on the sex ratio.
- To describe secular changes in respiratory morbidity and asthma in children and their parents from lower socio-economic areas of Merseyside between 1991-2006.
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