TY - JOUR
T1 - Maternal cigarette use during pregnancy and school readiness
T2 - An analysis of preschool age children in São Paulo, Brazil
AU - Molino, Andrea R.
AU - Fidalgo, Thiago M.
AU - Ribeiro, Marcos V.
AU - Mariano, Marília
AU - Martins, Silvia S.
AU - Caetano, Sheila C.
AU - Surkan, Pamela J.
N1 - Funding Information:
This work was supported by the Brazilian National Council of Research ( CNPq ) grant number 466688/2014-8 to conduct the baseline epidemiological study, and by the São Paulo Research Foundation (FAPESP) grant number 2016/10120-1 to conduct the school evaluation (P.I. Caetano). One of our authors (M.M.) received a scholarship from FAPESP. The project was also partially funded by the Columbia President's Global Innovation Fund - UR008509 (P.I. Martins). One of our authors (A.R.M.) received funding from the Johns Hopkins Center for Global Health Global Health Established Field Placements ( GHEFP ) Award.
Funding Information:
This work was supported by the Brazilian National Council of Research (CNPq) grant number 466688/2014-8 to conduct the baseline epidemiological study, and by the S?o Paulo Research Foundation (FAPESP) grant number 2016/10120-1 to conduct the school evaluation (P.I. Caetano). One of our authors (M.M.) received a scholarship from FAPESP. The project was also partially funded by the Columbia President's Global Innovation Fund - UR008509 (P.I. Martins). One of our authors (A.R.M.) received funding from the Johns Hopkins Center for Global Health Global Health Established Field Placements (GHEFP) Award.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/9
Y1 - 2020/9
N2 - Background: Barriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR). Aims: To examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. Study design: We used the Brazilian Preschool Mental Health Study, a cross-sectional, epidemiological study of preschool-age children in Embu das Artes, São Paulo. SR was assessed using the Engle Scale of Child Development (ESCD). We restricted analyses to biological mothers, who represented 81.9% (n = 591) of the total 722 with ESCD data. Logistic regression models, adjusting for birth and child characteristics (year of preschool, sex, race, history of head trauma, coma, convulsions or epilepsy), sociodemographic factors and school environment, were used to estimate odds ratios and 95% confidence intervals. Results: Prenatal smoking was negatively associated with SR. Children of mothers who smoked during pregnancy were more likely to be in the lowest ESCD quartile (aOR = 1.26, 95%CI: [1.02–1.55]) compared to those of non-smoking mothers, and each cigarette resulted in additional risk (aOR = 1.03, 95%CI:[1.01–1.05]). Children of heavy smokers had worse ESCD scores compared to children of non-smokers (aOR = 1.69, 95%CI:[1.18–2.44]), as well as when compared to children of moderate and non-smokers combined (aOR = 1.77, 95%CI:[1.22–2.57]). This relationship was not seen when comparing children of moderate smokers to children of non-smokers. Inferences were robust when examining very heavy smoking. Conclusion: Maternal tobacco use during pregnancy may affect child SR. Additional studies in other populations are needed to corroborate these results.
AB - Background: Barriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR). Aims: To examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. Study design: We used the Brazilian Preschool Mental Health Study, a cross-sectional, epidemiological study of preschool-age children in Embu das Artes, São Paulo. SR was assessed using the Engle Scale of Child Development (ESCD). We restricted analyses to biological mothers, who represented 81.9% (n = 591) of the total 722 with ESCD data. Logistic regression models, adjusting for birth and child characteristics (year of preschool, sex, race, history of head trauma, coma, convulsions or epilepsy), sociodemographic factors and school environment, were used to estimate odds ratios and 95% confidence intervals. Results: Prenatal smoking was negatively associated with SR. Children of mothers who smoked during pregnancy were more likely to be in the lowest ESCD quartile (aOR = 1.26, 95%CI: [1.02–1.55]) compared to those of non-smoking mothers, and each cigarette resulted in additional risk (aOR = 1.03, 95%CI:[1.01–1.05]). Children of heavy smokers had worse ESCD scores compared to children of non-smokers (aOR = 1.69, 95%CI:[1.18–2.44]), as well as when compared to children of moderate and non-smokers combined (aOR = 1.77, 95%CI:[1.22–2.57]). This relationship was not seen when comparing children of moderate smokers to children of non-smokers. Inferences were robust when examining very heavy smoking. Conclusion: Maternal tobacco use during pregnancy may affect child SR. Additional studies in other populations are needed to corroborate these results.
KW - Brazil
KW - Early childhood development
KW - Epidemiology
KW - Prenatal tobacco exposure
KW - School readiness
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U2 - 10.1016/j.earlhumdev.2020.105103
DO - 10.1016/j.earlhumdev.2020.105103
M3 - Article
C2 - 32615518
AN - SCOPUS:85087024571
SN - 0378-3782
VL - 148
JO - Early Human Development
JF - Early Human Development
M1 - 105103
ER -