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Smoking cessation in pregnancy and the risk of child behavioural problems: a longitudinal prospective cohort study
Monique Robinson1, Neil J McLean, Wendy H Oddy
1Telethon Institute for Child Health Research, West Perth, WA 6872, Australia.
Insights
Maternal smoking during pregnancy negatively impacts child behavior, increasing risks for behavioral problems. Quitting smoking early in pregnancy, however, is associated with better child behavioral outcomes.
Area of Science:
- Developmental Psychology
- Public Health
- Obstetrics
Background:
- Pregnancy smoking is a significant public health concern.
- Understanding its long-term effects on child behavior is crucial.
Purpose of the Study:
- To investigate the impact of maternal smoking during pregnancy on child and adolescent behavioral development.
- To compare outcomes between continuing smokers, early quitters, and never-smokers.
Main Methods:
- Utilized data from the Western Australian Pregnancy Cohort (Raine) Study (n=2900).
- Assessed smoking at 18 weeks gestation and child behavior using the Child Behaviour Checklist (CBCL) from ages 2 to 14.
- Controlled for sociodemographic and alcohol exposure confounders.
Main Results:
- Maternal smoking during pregnancy led to higher CBCL scores (internalizing and externalizing behaviors) and increased risk of behavioral problems.
- Children of mothers who quit smoking by 18 weeks gestation showed significantly better behavioral outcomes than continuing smokers and even never-smokers.
Conclusions:
- The inability or decision not to quit smoking during pregnancy is a strong predictor of adverse child behavioral outcomes.
- Further research is needed to understand the psychosocial factors influencing smoking cessation in pregnancy.
Background:
The aim of this study was to examine the influence of smoking in pregnancy on child and adolescent behavioural development, in comparison with mothers who ceased smoking in the first 18 weeks of pregnancy and with those who never smoked, in a large prospective pregnancy cohort.
Methods:
The Western Australian Pregnancy Cohort (Raine) Study provided comprehensive data from 2900 pregnancies. Smoking was assessed at 18 weeks gestation, and children were followed up at ages 1, 2, 3, 5, 8, 10 and 14 years. The Child Behaviour Checklist (CBCL) was used to measure problem child behaviour with continuous z-scores and clinical cut points at ages 2, 5, 8, 10 and 14 years. Potential confounders included maternal and family sociodemographic characteristics and alcohol exposure.
Results:
After adjusting for confounders, children of light smokers who quit smoking by 18 weeks gestation had significantly lower CBCL total z-scores, indicative of better behaviour, than children of women who never smoked, children of heavy smokers who quit and continuing smokers. Maternal smoking during pregnancy resulted in higher CBCL total, internalising and externalising scores and a higher risk of clinically meaningful behaviour problems in children from ages 2 to 14.
Conclusion:
The maternal decision not to quit smoking, or the inability to quit smoking, during pregnancy appears to be a particularly strong marker for poor behavioural outcomes in children. There is a need for a greater understanding of the psychosocial characteristics associated with the decision and ability to quit smoking in pregnancy.
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