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Maternal smoking during pregnancy and children's cognitive and physical development: a causal risk factor?

Stephen E Gilman1, Hannah Gardener, Stephen L Buka

  • 1Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. sgilman@hsph.harvard.edu

American Journal of Epidemiology
|July 26, 2008
PubMed

Insights

Maternal smoking during pregnancy may impact birth weight and childhood obesity. However, most other developmental effects, like intelligence and asthma, appear linked to shared family factors, not smoking itself.

Area of Science:

  • Pediatrics
  • Developmental Psychology
  • Public Health

Background:

  • Maternal smoking during pregnancy is debated for its effects on child development.
  • Some studies link smoking to adverse outcomes, while others suggest these links are spurious.

Purpose of the Study:

  • To investigate the relationship between maternal smoking during pregnancy and 14 child developmental outcomes from birth to age 7.
  • To control for measured and unmeasured confounding factors.

Main Methods:

  • Utilized data from the Collaborative Perinatal Project (1959-1974; n = 52,919).
  • Employed conditional fixed-effects models among siblings to account for unmeasured confounders.
  • Adjusted for potential confounders measured contemporaneously with maternal smoking.

Main Results:

  • Maternal smoking of >=20 cigarettes daily was associated with an 85.63g lower birth weight.
  • Smoking was linked to 2.73 times higher odds of being overweight at age 7.
  • Associations with 12 other outcomes (Apgar score, intelligence, academic achievement, conduct problems, asthma) were eliminated after controlling for confounders.

Conclusions:

  • The hypothesized effects of maternal smoking on most child developmental outcomes are not present or are indistinguishable from familial factors.
  • Familial factors associated with maternal smoking may explain previously observed adverse developmental associations.

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