Yorifuji, Takashi Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University ORCID Kaken ID publons researchmap
Tsukahara, Hirokazu Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Doi, Hiroyuki Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Kawasaki disease is the leading cause of acquired childhood heart disease in most developed countries, but the etiology of the disease is unknown. An aberrant immune response to some environmental triggers may play a role and involuntary exposure to tobacco smoke can alter immune functions. We thus prospectively examined the association between early childhood exposure to maternal smoking and the incidence of Kawasaki disease. We used a large, nationwide population-based longitudinal survey ongoing since 2010 and restricted participants to a total of 38,444 children for whom information on maternal smoking was available. Maternal smoking status was ascertained at 6months of age, and responses to questions about hospital admission for Kawasaki disease between the ages of 6 and 30months were used as outcome. We conducted binomial log-linear regression analyses adjusting for children's, parental, and residential factors with children of non-smoking mothers as our reference group. Maternal smoking increased the risk of admission, in particular for the period between 6 and 18months of age, in a dose-dependent manner. Compared with children of non-smoking mothers, the children of mothers who smoked had a risk ratio of 1.83 (95% confidence interval: 1.06, 3.35) for hospital admissions between 6 and 30months of age and a risk ratio of 2.69 (95% confidence interval: 1.56, 4.64) for hospital admissions between 6 and 18months of age. Early childhood exposure to maternal smoking may increase the risk of Kawasaki disease hospitalizations in childhood.
Early childhood exposure
Mucocutaneous lymph node syndrome;
Science of The Total Environment
|Web of Science KeyUT|
Takashi Yorifuji, Hirokazu Tsukahara, Hiroyuki Doi, Early childhood exposure to maternal smoking and Kawasaki Disease: A longitudinal survey in Japan, Science of The Total Environment, Volume 655, 2019, Pages 141-146, ISSN 0048-9697, https://doi.org/10.1016/j.scitotenv.2018.11.194.