Abstract
OBJECTIVE: To explore associations of maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms. 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) crosspopulation comparisons between a high-income and a middleincome 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. 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. CONCLUSION: Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems.
| Original language | English (US) |
|---|---|
| Journal | Pediatrics |
| Volume | 126 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 2010 |
| Externally published | Yes |
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Keywords
- ALSPAC
- Behavioral problems
- Child
- Developmental origins
- Pelotas
- Prenatal smoking
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Maternal smoking and child psychological problems : Disentangling causal and noncausal effects. / Brion, Marie Jo; Victora, Cesar; Matijasevich, Alicia; Horta, Bernardo; Anselmi, Luciana; Steer, Colin; Menezes, Ana Maria B; Lawlor, Debbie A.; Smith, George Davey.
In: Pediatrics, Vol. 126, No. 1, 07.2010.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Maternal smoking and child psychological problems
T2 - Disentangling causal and noncausal effects
AU - Brion, Marie Jo
AU - Victora, Cesar
AU - Matijasevich, Alicia
AU - Horta, Bernardo
AU - Anselmi, Luciana
AU - Steer, Colin
AU - Menezes, Ana Maria B
AU - Lawlor, Debbie A.
AU - Smith, George Davey
PY - 2010/7
Y1 - 2010/7
N2 - OBJECTIVE: To explore associations of maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms. 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) crosspopulation comparisons between a high-income and a middleincome 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. 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. CONCLUSION: Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems.
AB - OBJECTIVE: To explore associations of maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms. 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) crosspopulation comparisons between a high-income and a middleincome 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. 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. CONCLUSION: Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems.
KW - ALSPAC
KW - Behavioral problems
KW - Child
KW - Developmental origins
KW - Pelotas
KW - Prenatal smoking
UR - http://www.scopus.com/inward/record.url?scp=77954363540&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954363540&partnerID=8YFLogxK
U2 - 10.1542/peds.2009-2754
DO - 10.1542/peds.2009-2754
M3 - Article
C2 - 20587678
AN - SCOPUS:77954363540
VL - 126
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 1
ER -