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Increase in child behavior problems resulting from maternal smoking during pregnancy
J F Orlebeke1, D L Knol, F C Verhulst
1Department of Physiological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
Insights
Maternal smoking during pregnancy is linked to externalizing behavior problems, like aggression, in 3-year-old children. This effect was observed independently of birth weight in a study of twin pairs.
Area of Science:
- Developmental Psychology
- Public Health
- Genetics (Twin Studies)
Background:
- Maternal smoking during pregnancy is a known risk factor for adverse child outcomes.
- Previous research has explored links between prenatal smoke exposure and behavioral issues, often focusing on birth weight as a mediator.
- The specific impact on different types of behavioral problems and its independence from birth weight requires further investigation.
Purpose of the Study:
- To investigate the effect of maternal smoking during pregnancy on behavioral problems in offspring at 3 years of age.
- To determine if this effect is mediated by lower birth weight.
- To analyze the impact on both externalizing and internalizing behaviors.
Main Methods:
- Utilized the Child Behavior Checklist for ages 2-3 years (CBCL/2-3) to assess behavioral problems in 1,377 healthy twin pairs.
- Collected pre- and perinatal data, including maternal smoking habits (never, sometimes, regularly) during pregnancy.
- Analyzed effects on CBCL total and subscale scores, adjusting for confounding factors like birth weight, socioeconomic status, maternal age, and feeding method.
Main Results:
- Maternal smoking significantly affected externalizing behavior problems (oppositional, aggressive, overactive) in both first- and second-born twins.
- No significant effect was found on internalizing behavior problems (withdrawn, depressed, anxious).
- The association between maternal smoking and externalizing behaviors was independent of birth weight and consistent across genders.
Conclusions:
- Maternal smoking during pregnancy is associated with an increased risk of externalizing behavior problems, particularly aggression, in young children.
- The findings suggest a direct effect of maternal smoking on child behavior, not solely mediated by birth weight.
- Further research is warranted to understand the causal mechanisms linking prenatal smoke exposure to externalizing behaviors.
Abstract:
In this article, the authors investigated the effect of maternal smoking during pregnancy on behavioral problems, which were not mediated by lower birth weight, in offspring at 3 y of age. The authors used the Child Behavior Checklist for ages 2-3 y (CBCL/2-3; Achenbach, Edelbrock and Howell) to assess behavioral problems in 1,377 2- to 3-y-old healthy twin pairs. Soon after the birth of twins, the authors collected pre- and perinatal information, including smoking habits of the mother during pregnancy. The question "Did you smoke during pregnancy?" could be answered by choosing one of three possible options: (1) never, (2) sometimes, or (3) regularly. The authors analyzed the effect of maternal smoking on the Child Behavioral Checklist total score and on several subscale scores for first- and second-born twins separately, and they adjusted for the possible confounding effects of birth weight, socioeconomic status, maternal age, and having been breast- or bottle-fed. There was a significant effect of maternal smoking on so-called externalizing behavior problems (oppositional, aggressive, overactive), but not on internalizing behavior problems (withdrawn, depressed, anxious), in both first- and second-born twins. The authors primarily attributed the enhanced externalizing problems to increased aggression. Although boys had higher externalizing (and aggression) scores than girls, the effect of maternal smoking was the same for boys and girls. The authors also discuss whether maternal smoking causes externalizing behavior problems.