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Published on: August 25, 2014
Prenatal tobacco exposure, birthweight, and offspring psychopathology
Ardesheer Talati1, Priya J Wickramaratne2, Rikke Wesselhoeft3
1Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Sackler Institute for Developmental Psychobiology, Columbia University, New York, NY, USA.
Insights
Prenatal tobacco exposure (PTE) is linked to lower birthweight and increased risk of disruptive behavior and substance use disorders in offspring. Birthweight did not explain these long-term mental health effects.
Area of Science:
- Perinatal mental health
- Developmental psychology
- Reproductive health
Background:
- Prenatal tobacco exposure (PTE) is associated with adverse offspring mental health, but underlying mechanisms are not fully understood.
- Birthweight is an early indicator of fetal development and may mediate the effects of PTE on later psychopathology.
Purpose of the Study:
- To investigate whether birthweight mediates the association between prenatal tobacco exposure and offspring psychopathology.
- To examine the long-term mental health consequences of PTE in offspring.
Main Methods:
- Analysis of 238 offspring from a family depression study with prenatal smoking histories and adult psychiatric assessments.
- Exposure defined as maternal smoking of ≥10 cigarettes daily/nearly daily.
- Clinical interviews and best-estimate diagnostic procedures, blind to exposure, assessed psychiatric problems.
Main Results:
- PTE was associated with significantly lower birthweight (0.7lb reduction, p=0.0002).
- PTE increased rates of disruptive behavior disorders in males (OR=2.66) and trended towards increased substance use disorders in females (OR=2.23).
- PTE decreased rates of mood disorders in males (OR=0.42); birthweight did not mediate these associations.
Conclusions:
- Birthweight does not mediate the link between prenatal tobacco exposure and offspring psychopathology.
- Maternal smoking during pregnancy has lasting adverse effects on offspring mental health, independent of birthweight.
- Smoking cessation interventions for pregnant women are crucial for mitigating both immediate (birthweight) and long-term (mental health) adverse outcomes.
Abstract:
Although prenatal tobacco exposure (PTE) is associated with several adverse offspring mental health outcomes, mechanisms remain unclear. We test whether associations between PTE and offspring psychopathology are explained by birthweight, one of the earliest-occurring outcomes of PTE. The analysis focuses on 238 offspring from a family study of depression with (1) collected prenatal histories and (2) at least one clinical interview in adulthood to assess psychiatric problems. Exposure was categorized by maternal smoking of ≥10 cigarettes daily/nearly daily; diagnostic outcomes were confirmed by clinicians using the best-estimate procedure, blind to exposure. After adjusting for potential confounders, PTE was associated with 0.7lb(9%) lower birthweight (p=0.0002), increased rates of disruptive behavior disorders [males: OR=2.66(1.15,6.16), and (trend) substance use disorders [females: OR=2.23(0.98,5.09)], and decreased rates of mood disorders (males: OR=0.42(0.17,0.98)]. Birthweight was not independently associated with diagnoses and did not mediate the association between exposure and psychopathology. Maternal smoking has long-term adverse consequences for offspring. Although birthweight cannot be manipulated, smoking is a modifiable risk factor. Thus, cessation efforts focused on pregnant women may not only improve maternal wellbeing, but also mitigate adverse proximal (e.g., birthweight) and long-term (psychopathology) outcomes in offspring.
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