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[目的]通过人群归因健康效应评价方法,定量评估上海市女性二手烟暴露所致不良出生结局的发生情况,为孕产保健政策的制定提供依据。[方法]应用2013年上海市慢性病及其危险因素监测的育龄妇女二手烟暴露数据,结合文献发表的二手烟暴露导致不良出生结局的相对危险度,测算上海市女性二手烟暴露所致不良出生结局的人群归因危险度百分比与归因病例数。[结果]上海市育龄期女性二手烟暴露率达41.67%,其中上海户籍为42.15%,非上海市户籍为39.58%,且均随年龄增长而呈现上升趋势。二手烟暴露导致的早产、低体重、出生窒息和出生缺陷婴儿数分别有2 337人、1 424人、1 146人和637人。沪籍和非沪籍产妇的早产儿、低出生体重儿、出生窒息儿和出生缺陷儿的二手烟归因百分比分别为26.11%、25.40%、45.63%、26.58%和26.58%、25.83%、46.14%、27.23%。[结论]上海市女性二手烟暴露形势严峻,归因于二手烟暴露的不良出生结局发生例数众多。若能有效避免二手烟暴露,上海将至少减少超过四分之一的不良出生结局。
[Objective] To quantitatively evaluate the incidence of unhealthy births caused by secondhand smoke exposure in Shanghai by population attribution health effects evaluation method, and provide the basis for the formulation of maternity health care policy. [Methods] According to the data of second-hand smoke exposure of women of childbearing age in Shanghai in 2013 with chronic diseases and their risk factors, the relative risk of adverse birth outcomes caused by exposure to second-hand smoke published in literatures was used to estimate the adverse birth outcomes of second-hand smoke exposure in Shanghai Of the population attributable risk percentage and attributable cases. [Results] The exposure rate of second-hand smoke to women of child-bearing age was 41.67% in Shanghai. Among them, the household registration in Shanghai was 42.15% and the non-Shanghai household registration was 39.58%, both showing an upward trend with age. Prenatal, low birth weight, births asphyxia and birth defects caused by secondhand smoke exposure were 2 337, 1 424, 1 146 and 637, respectively. The percentages of secondhand smoke in preterm infants, low birth weight infants, infants with birth asphyxia and birth defects of Shanghai and non-Shanghai maternity women were 26.11%, 25.40%, 45.63%, 26.58% and 26.58%, 25.83% and 46.14 respectively %, 27.23%. [Conclusion] The situation of secondhand smoke exposure in Shanghai is severe, which is attributed to the large number of adverse birth outcomes of secondhand smoke exposure. If it can effectively prevent exposure to secondhand smoke, Shanghai will reduce its adverse birth outcomes by at least a quarter.