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Maternal smoking and child psychological problems: disentangling causal and noncausal effects.
- Source :
-
Pediatrics [Pediatrics] 2010 Jul; Vol. 126 (1), pp. e57-65. Date of Electronic Publication: 2010 Jun 29. - Publication Year :
- 2010
-
Abstract
- Objective: To explore associations of maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms.<br />Patients and Methods: Maternal smoking and child psychological problems were explored in 2 birth cohorts in Pelotas, Brazil (n = 509, random subsample), and the Avon Longitudinal Study of Parents and Children (ALSPAC) in Britain (n = 6735). Four approaches for exploring causal mechanisms were applied: (1) cross-population comparisons between a high-income and a middle-income country; (2) multiple adjustment for socioeconomic and parental psychological factors; (3) maternal-paternal comparisons as a test of putative intrauterine effects; and (4) searching for specific effects on different behavioral subscales.<br />Results: Socioeconomic patterning of maternal prenatal smoking was stronger in the ALSPAC compared with the Pelotas cohort. Despite this difference in a key confounder, consistency in observed associations was found between these cohorts. In both cohorts, unadjusted maternal smoking was associated with greater offspring hyperactivity, conduct/externalizing problems, and peer problems but not with emotional/internalizing problems. After adjusting for confounders and paternal prenatal smoking, only the association with conduct/externalizing problems persisted in both cohorts (conduct problems in the ALSPAC cohort, odds ratio [OR]: 1.24 [95% confidence interval (CI): 1.07-1.46], P = .005; externalizing problems in the Pelotas cohort, OR: 1.82 [95% CI: 1.19-2.78], P = .005; ORs reflect ordinal odds ratios of maternal smokers having offspring with higher scores). Maternal smoking associations were stronger than paternal smoking associations, although statistical evidence that these associations differed was weak in 1 cohort.<br />Conclusion: Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems.
- Subjects :
- Causality
Child
Child Behavior psychology
Child Behavior Disorders etiology
Child Behavior Disorders psychology
Child, Preschool
Cohort Studies
Confidence Intervals
Developmental Disabilities epidemiology
Developmental Disabilities etiology
Developmental Disabilities physiopathology
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Maternal Behavior
Maternal Exposure adverse effects
Maternal Exposure statistics & numerical data
Multivariate Analysis
Odds Ratio
Paternal Exposure adverse effects
Paternal Exposure statistics & numerical data
Pregnancy
Prenatal Care
Prenatal Exposure Delayed Effects psychology
Risk Assessment
Severity of Illness Index
Smoking adverse effects
Socioeconomic Factors
United Kingdom epidemiology
Attitude to Health
Child Behavior Disorders epidemiology
Prenatal Exposure Delayed Effects epidemiology
Smoking epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 126
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 20587678
- Full Text :
- https://doi.org/10.1542/peds.2009-2754