妊娠中の母親の喫煙と小児および青年期の学習障害との関連：傾向スコアマッチング分析

The evidence on the associations between maternal smoking during pregnancy and long-term neurodevelopmental outcomes in offspring, particularly learning disabilities, remains insufficient. This study aimed to evaluate the association between maternal smoking during pregnancy and learning disabilities (LDs) in children and adolescents.

This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) cycles 1999-2004. Maternal smoking status during pregnancy was obtained from self-reported questionnaires and classified as smoking or non-smoking. The primary outcome, learning disabilities (LDs), was determined based on parental response to the question: 'Has a doctor or other health professional ever told you that your child has a learning disability?'. Multiple analytic techniques, including multivariable logistic regression, propensity score matching (PSM), doubly robust estimation, inverse probability weighting (IPW), standardized mortality ratio weighting (SMRW), and stratified analyses, were used to evaluate the robustness of our findings.

There were 5835 participants in all, of whom 848 had mothers who smoked during pregnancy and 4987 had mothers who did not. The prevalence of LD was 18.9% (160/848) in the smoking group compared with 9.5% (474/4987) in the non-smoking group. After PSM, 1666 matched individuals were identified. The IPW model indicated that maternal smoking during pregnancy was significantly associated with LDs in offspring (AOR=1.94; 95% CI: 1.59-2.37). Consistent results were confirmed by multivariable logistic regression, doubly robust estimation, SMRW, and stratified analyses.

Maternal smoking during pregnancy was positively associated with LDs among US children and adolescents. It is necessary to conduct further prospective studies to better understand this relationship.