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Maternal smoking during pregnancy and the risk of conduct disorder in boys
L S Wakschlag1, B B Lahey, R Loeber
1Department of Psychiatry, University of Chicago, Il, USA. laurie@yoda.bsd.uchicago.edu
Insights
Maternal smoking during pregnancy significantly increases the risk of conduct disorder in sons. This association remains strong even after accounting for other risk factors, highlighting smoking as a key predictor of behavioral problems.
Area of Science:
- Developmental Psychology
- Neuroscience
- Public Health
Background:
- Prenatal nicotine exposure linked to adverse offspring outcomes.
- Previous studies suggest links between maternal smoking and child behavior problems.
- Need to control for confounding factors in human studies.
Purpose of the Study:
- Determine if maternal smoking during pregnancy is associated with severe offspring behavior problems.
- Investigate the link between smoking and behavior problems qualifying for DSM-III-R diagnosis.
- Control for a broad range of correlates of maternal smoking.
Main Methods:
- Longitudinal study of 177 clinic-referred boys (ages 7-12).
- Annual structured diagnostic interviews over 6 years.
- Logistic regression analyses controlling for multiple risk factors.
Main Results:
- Mothers smoking >0.5 packs/day had higher odds of child conduct disorder (OR=4.4, P=0.001).
- Association remained significant after controlling for socioeconomic status, parental factors, and substance abuse.
- Maternal smoking identified as a robust independent risk factor.
Conclusions:
- Maternal smoking during pregnancy is a significant independent risk factor for conduct disorder in male offspring.
- Potential direct adverse effects on fetal development or a marker for unmeasured maternal characteristics.
- Highlights the importance of smoking cessation during pregnancy for child behavioral health.
Background:
Previous animal and human studies have indicated that prenatal exposure to nicotine is associated with adverse reproductive outcomes, including altered neural structure and functioning, cognitive deficits, and behavior problems in the offspring. Our study extends previous research on humans by controlling a broad range of correlates of maternal smoking during pregnancy to determine if smoking is associated with behavior problems in the offspring severe enough to qualify for DSM-III-R diagnosis.
Methods:
Subjects were 177 clinic-referred boys, ages 7 to 12 years at the time of the first assessment, who underwent longitudinal assessment for 6 years using annual structured diagnostic interviews. Correlates of maternal smoking during pregnancy and previously identified demographic, parental, perinatal, and family risk factors for the disruptive behavior disorders were controlled in logistic regression analyses.
Results:
Mothers who smoked more than half a pack of cigarettes daily during pregnancy were significantly more likely to have a child with conduct disorder (odds ratio, 4.4; P = .001) than mothers who did not smoke during pregnancy. This association was statistically significant when controlling for socioeconomic status, maternal age, parental antisocial personality, substance abuse during pregnancy, and maladaptive parenting.
Conclusions:
Maternal smoking during pregnancy appears to be a robust independent risk factor for conduct disorder in male offspring. Maternal smoking during pregnancy may have direct adverse effects on the developing fetus or be a marker for a heretofore unmeasured characteristic of mothers that is of etiologic significance conduct disorder.