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Duko B, Bedaso A, Dachew BA, Newnham E, Gebremedhin AT, Tessema G, Einarsdottir K, Alati R, Pereira G. The effect of maternal prenatal tobacco smoking on offspring academic achievement: A systematic review and meta-analysis. Addict Behav 2024; 153:107985. [PMID: 38367506 DOI: 10.1016/j.addbeh.2024.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Previous epidemiological studies examining the prospective association between maternal prenatal tobacco smoking and offspring academic achievement have reported conflicting results. Therefore, this systematic review and meta-analysis was conducted to examine the magnitude and consistency of association reported by those studies. METHODS This systematic review and meta-analysis was guided by the PRISMA protocol. Relevant epidemiological studies on the topic were extracted from four main databases (PubMed/Medline, Embase, PsycINFO, and Scopus). The Newcastle-Ottawa Scale (NOS) was used to appraise the methodological quality of the included studies. We conducted a narrative assessment of the studies that did not report effect estimates. Inverse variance-weighted random effect meta-analysis was used to combine studies reporting effect sizes to estimate pooled adjusted odds ratio with 95% confidence intervals (95% CI). The review was prospectively registered in PROSPERO (CRD42022350901). RESULTS Nineteen observational studies, published between 1973 and 2021 with a total of 1.25 million study participants were included in the final review. Of these, fifteen studies (79 %) reported reduced academic achievement in offspring exposed to maternal prenatal tobacco smoking. The eight primary studies (sample size = 723,877) included in the meta-analysis together suggested a 49 % higher risk of reduced academic achievement in offspring exposed to maternal prenatal tobacco smoking when compared to non-exposed offspring (Pooled odds ratio = 1.49, 95 % CI:1.17-1.91). CONCLUSION Our review found a positive association between maternal prenatal tobacco smoking and offspring reduced academic achievement. However, variation in the adjustment of potential confounders and significant heterogeneity across included studies limited more conclusive inference. Mechanistic studies to identify causal pathways and specific academic impacts are needed to inform targeted developmental programs to assist child learning and academic performance.
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Affiliation(s)
- Bereket Duko
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.
| | - Asres Bedaso
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, New South Wales, Australia
| | - Berihun Assefa Dachew
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Elizabeth Newnham
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA
| | | | - Gizachew Tessema
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Kristjana Einarsdottir
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; School of Health Sciences, University of Iceland, Vatnsmýrarvegur 16, 101 Reykjavík, Iceland
| | - Rosa Alati
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, Qld 4068 Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
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Hærvig KK, Petersen KU, Giwercman A, Hougaard KS, Høyer BB, Lindh C, Ramlau-Hansen CH, Nybo Andersen AM, Toft G, Bonde JP, Tøttenborg SS. Fetal exposure to maternal cigarette smoking and male reproductive function in young adulthood. Eur J Epidemiol 2022; 37:525-538. [PMID: 35476275 DOI: 10.1007/s10654-022-00869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 04/04/2022] [Indexed: 11/03/2022]
Abstract
Maternal smoking during pregnancy constitutes a potential, major risk factor for adult male reproductive function. In the hitherto largest longitudinal cohort, we examined biomarkers of reproductive function according to maternal smoking during the first trimester and investigated whether associations were mitigated by smoking cessation prior to the fetal masculinization programming window. Associations between exposure to maternal smoking and semen characteristics, testicular volume and reproductive hormones were assessed among 984 young men from the Fetal Programming of Semen Quality (FEPOS) cohort. Maternal smoking was assessed through interview data and measured plasma cotinine levels during pregnancy. We applied negative binomial, logistic and linear regression models to estimate differences in outcomes according to levels of maternal smoking. Sons of light smokers (≤ 10 cigarettes/day) had a 19% (95% CI - 29%, - 6%) lower sperm concentration and a 24% (95% CI - 35%, - 11%) lower total sperm count than sons of non-smokers. These estimates were 38% (95% CI - 52%, - 22%) and 33% (95% CI - 51%, - 8%), respectively, for sons of heavy smokers (> 10 cigarettes/day). The latter group also had a 25% (95% CI 1%, 54%) higher follitropin level. Similarly, sons exposed to maternal cotinine levels of > 10 ng/mL had lower sperm concentration and total sperm count. Smoking cessation prior to gestational week seven was not associated with a higher reproductive capacity. We observed substantial and consistent exposure-response associations, providing strong support for the hypothesis that maternal smoking impairs male reproductive function. This association persisted regardless of smoking cessation in early pregnancy.
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Affiliation(s)
- Katia Keglberg Hærvig
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark. .,Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23F, entrance 20F, 1st floor, 2400, Copenhagen, NV, Denmark.
| | - Kajsa Ugelvig Petersen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Karin Sørig Hougaard
- Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Birgit Bjerre Høyer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Regional Development, Region of Southern Denmark, Vejle, Denmark
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | | | - Anne-Marie Nybo Andersen
- Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar Toft
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Derakhshan A, Shu H, Broeren MAC, Lindh CH, Peeters RP, Kortenkamp A, Demeneix B, Bornehag CG, Korevaar TIM. Association of phthalate exposure with thyroid function during pregnancy. ENVIRONMENT INTERNATIONAL 2021; 157:106795. [PMID: 34358912 DOI: 10.1016/j.envint.2021.106795] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/01/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The extent of thyroid disruptive effects of phthalates during pregnancy remains unclear. AIM To investigate the association of maternal urinary phthalates with markers of the thyroid system during early pregnancy. METHODS Urinary concentrations of phthalate metabolites and serum concentrations of thyroid stimulating hormone (TSH), free and total thyroxine (FT4 and TT4) and free and total triiodothyronine (FT3 and TT3) were measured in pregnant women in early pregnancy in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (2007-ongoing), a population-based prospective cohort. RESULTS In the 1,996 included women, higher di-ethyl-hexyl phthalate (DEHP) metabolites were associated with a lower FT4 (β [SE] for the molar sum: -0.13 [0.06], P = 0.03) and a higher TSH/FT4 ratio (0.003 [0.001], P = 0.03). Higher concentrations of di-iso-nonyl phthalate (DINP) metabolites were associated with a lower TT4 (β [SE] for the molar sum: 0.93 [0.44], P = 0.03) as well as with lower TT4/FT4 and TT4/TT3 ratios. Higher metabolites of both dibutyl and butyl-benzyl phthalate (DBP and BBzP) were associated with lower T4/T3 ratio (free and total) and higher FT4/TT4 and FT3/TT3 ratios. A higher diisononyl cyclohexane dicarboxylate (DINCH) metabolite concentration was associated with a higher TT3. CONCLUSIONS These results translate results from experimental studies suggesting that exposure to phthalates may interfere with the thyroid system during pregnancy. This is also true for compounds that have been introduced to replace known disruptive phthalates. Further experimental studies should take into account the human evidence to better investigate the potential underlying mechanisms of thyroid disruption by phthalates.
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Affiliation(s)
- Arash Derakhshan
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Huan Shu
- Department of Health Sciences, Karlstad University, 651 88 Karlstad, Sweden
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run 4600, the Netherlands
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, 22363 Lund, Sweden
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Andreas Kortenkamp
- Division of Environmental Sciences, College of Health, Medicine and Life Sciences, Brunel University, London, Uxbridge, UK
| | - Barbara Demeneix
- Laboratoire d'Evolution des Régulations Endocriniennes, CNRS/Muséum National d'Histoire Naturelle, 57 Rue Cuvier, 75005 Paris, France
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, 651 88 Karlstad, Sweden; Icahn School of Medicine at Mount Sinai, New York City, NY 10029-6574, USA
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands.
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Minatoya M, Araki A, Itoh S, Yamazaki K, Kobayashi S, Miyashita C, Sasaki S, Kishi R. Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children's Health. Environ Health Prev Med 2019; 24:74. [PMID: 31812162 PMCID: PMC6898952 DOI: 10.1186/s12199-019-0834-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. Methods This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children’s Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22–0.51 ng/ml (low-passive smoker), 0.52–11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). Results Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. Conclusion Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.
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Affiliation(s)
- Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.,Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Seiko Sasaki
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.
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Sourander A, Sucksdorff M, Chudal R, Surcel HM, Hinkka-Yli-Salomäki S, Gyllenberg D, Cheslack-Postava K, Brown AS. Prenatal Cotinine Levels and ADHD Among Offspring. Pediatrics 2019; 143:e20183144. [PMID: 30804074 PMCID: PMC6398365 DOI: 10.1542/peds.2018-3144] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES An association between maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder (ADHD) has been shown across several studies based on self-reports. No previous studies have investigated the association of nicotine exposure measured by cotinine levels during pregnancy and offspring ADHD. METHODS In this population-based study, 1079 patients born between 1998 and 1999 and diagnosed with ADHD according to the International Classification of Diseases and 1079 matched controls were identified from Finnish nationwide registers. Maternal cotinine levels were measured by using quantitative immunoassays from maternal serum specimens collected during the first and second trimesters of pregnancy and archived in the national biobank. RESULTS There was a significant association between increasing log-transformed maternal cotinine levels and offspring ADHD. The odds ratio was 1.09 (95% confidence interval [CI] 1.06-1.12) when adjusting for maternal socioeconomic status, maternal age, maternal psychopathology, paternal age, paternal psychopathology, and child's birth weight for gestational age. In the categorical analyses with cotinine levels in 3 groups, heavy nicotine exposure (cotinine level >50 ng/mL) was associated with offspring ADHD, with an odds ratio of 2.21 (95% CI 1.63-2.99) in the adjusted analyses. Analyses by deciles of cotinine levels revealed that the adjusted odds for offspring ADHD in the highest decile was 3.34 (95% CI 2.02-5.52). CONCLUSIONS The study reveals an association with and a dose-response relationship between nicotine exposure during pregnancy and offspring ADHD. Future studies incorporating maternal smoking and environmental, genetic, and epigenetic factors are warranted.
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Affiliation(s)
- Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland;
- Departments of Child Psychiatry and
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Minna Sucksdorff
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Pediatric and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Heljä-Marja Surcel
- Faculty of Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland
| | | | - David Gyllenberg
- Department of Child Psychiatry, University of Turku, Turku, Finland
- National Institutes of Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; and
| | - Keely Cheslack-Postava
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Alan S Brown
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Kristjansson AL, Thorisdottir IE, Steingrimsdottir T, Allegrante JP, Lilly CL, Sigfusdottir ID. Maternal smoking during pregnancy and scholastic achievement in childhood: evidence from the LIFECOURSE cohort study. Eur J Public Health 2018; 27:850-855. [PMID: 28957474 PMCID: PMC5881721 DOI: 10.1093/eurpub/ckx074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Research on the impact of maternal smoking during pregnancy (MSDP) on scholastic achievement in the offspring has shown conflicting findings. The objective of this study was to assess the impact of MSDP on scholastic achievement in a birth cohort of children in 4th, 7th and 10th grades. Methods We analysed data from the LIFECOURSE study, a cohort study of risk and protective factors in all children born in Reykjavik, Iceland, in the year 2000 (N = 1151, girls = 49.3%). Retrospective registry data for 2014–2015 were merged with prospective survey data that were collected in April 2016. Data on MSDP were assessed during regular antenatal visits at the end of the first trimester. Standardized academic achievement scores were obtained from official school transcripts. Data were analysed using OLS regressions that were entered in three hierarchical blocks. Results Children of mothers who smoked tobacco during the first trimester consistently revealed between 5% and 7% lower scores on standardized academic achievement in 4th, 7th and 10th grade (∼6–8 points on a normally distributed 120 point scale) than those of mothers who had not smoked tobacco during this period (P < 0.05). These findings held after controlling for several factors associated with the time of birth (e.g. birth weight, maternal age at birth, birth order, parental cohabitation and household income), as well as the year of scholastic assessment (parental cohabitation, household income and parental education). Conclusions Maternal smoking during pregnancy was negatively related to scholastic achievement in the offspring during 4th, 7th and 10th grade.
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Affiliation(s)
- Alfgeir L Kristjansson
- Department of Social and Behavioural Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA.,Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland
| | - Ingibjorg E Thorisdottir
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Thora Steingrimsdottir
- Department of Obstetrics and Gynecology, Landspitali University Hospital and University of Iceland, Reykjavik, Iceland
| | - John P Allegrante
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behaviour Studies, Teachers College, Columbia University, New York, NY, USA.,Department of Sociomedical sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christa L Lilly
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Inga D Sigfusdottir
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behaviour Studies, Teachers College, Columbia University, New York, NY, USA
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Sutin AR, Flynn HA, Terracciano A. Maternal cigarette smoking during pregnancy and the trajectory of externalizing and internalizing symptoms across childhood: Similarities and differences across parent, teacher, and self reports. J Psychiatr Res 2017; 91:145-148. [PMID: 28359941 PMCID: PMC5647462 DOI: 10.1016/j.jpsychires.2017.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/02/2017] [Accepted: 03/02/2017] [Indexed: 11/25/2022]
Abstract
Maternal smoking during pregnancy (MSDP) has been associated with symptoms of externalizing (e.g., hyperactivity) and internalizing (e.g., emotional) disorders in childhood. The present research addresses two new questions about the nature of this relation: (1) Do the associations between MSDP and externalizing and internalizing symptoms vary by who reports the symptoms? and (2) Is MSDP associated with changes in symptomatology across childhood? We address these questions with two cohorts from the Longitudinal Study of Australian Children (LSAC). Parents and teachers completed the Strengths and Difficulties Questionnaire up to six times every two years between child ages 4 and 14 in the older cohort (N = 3841) and up to four times between child ages 4 and 10 in the younger cohort (N = 3714); the study children also completed the same questionnaire up to three times starting at age 10. Across the two cohorts, MSDP was associated with more externalizing symptoms as reported by parents, teachers, and self. MSDP was also associated with increases in externalizing symptoms across childhood when teachers assessed the symptoms but not when parents assessed them. Finally, MSDP was not consistently associated with the average level of internalizing symptoms, but it was associated with increases in these symptoms across childhood. The present research indicates a robust association between MSDP and the average level of externalizing symptoms in childhood regardless of who reports the symptoms. It also indicates that whether MSDP is associated with the trajectory of externalizing symptomatology depends on who reports on the symptoms.
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