A Clinical Trial of Change in Maternal Smoking and Its Effect on Birth Weight

Sexton, Mary; Hebel, J. Richard

doi:10.1001/jama.1984.03340310025013

Cited by 382 publications

(84 citation statements)

References 14 publications

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“…Adverse maternal and fetal health outcomes associated with smoking in pregnancy are well-established [12, 19, 38, 46, 54]. While smoking in pregnancy is decreasing in many countries, these reductions are not uniform.…”

Section: Introductionmentioning

confidence: 99%

Maternal smoking and offspring inattention and hyperactivity: results from a cross-national European survey

Kovess

Keyes

Hamilton

et al. 2014

Eur Child Adolesc Psychiatry

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In utero exposure to tobacco smoke is associated with adverse neonatal outcomes; the association with later childhood mental health outcomes remains controversial. We used a strategy involving comparison of maternal and paternal smoking reports in a sample pooling data from six diverse European countries. Data were drawn from mother (N = 4,517) and teacher (N = 4,611) reported attention deficit and hyperactivity disorder (ADHD) symptoms in school children aged 6–11 in Turkey, Romania, Bulgaria, Lithuania, Germany, and the Netherlands, surveyed in 2010. Mothers report on self and husband’s smoking patterns during the pregnancy period. Logistic regression used with control covariates including demographics, maternal distress, live births, region, and post-pregnancy smoking. In unadjusted models, maternal prenatal smoking was associated with probable ADHD based on mother [Odds Ratio (OR) = 1.82, 95 % Confidence Interval (CI) 1.45–2.29], teacher (OR = 1.69, 95 % CI 1.33–2.14) and mother plus teacher (OR = 1.49, 95 % CI 1.03–2.17) report. Paternal prenatal smoking was similarly associated with probable ADHD in unadjusted models. When controlled for relevant confounders, maternal prenatal smoking remained a risk factor for offspring probable ADHD based on mother report (OR = 1.44, 95 % CI 1.06–1.96), whereas the effect of paternal prenatal smoking diminished (e.g., mother report: OR = 1.17, 95 % CI 0.92–1.49). Drawing on data from a diverse set of countries across Europe, we document that the association between maternal smoking and offspring ADHD is stronger than that of paternal smoking during the pregnancy period and offspring ADHD. To the extent that confounding is shared between parents, these results reflect a potential intrauterine influence of smoking on ADHD in children.

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Section: Introductionmentioning

confidence: 99%

Maternal smoking and offspring inattention and hyperactivity: results from a cross-national European survey

Kovess

Keyes

Hamilton

et al. 2014

Eur Child Adolesc Psychiatry

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show abstract

“…Exposure to maternal smoking during pregnancy is a well-recognized cause of fetal growth restriction, preterm birth, and oral clefts [1-4]. In childhood, cognitive deficits and problem behaviors such as attention deficit, impulsivity, and conduct problems [5,6] have been associated with maternal smoking during pregnancy; less frequently reported associations include child short stature, obesity, hyperlipidemia, and elevated blood pressure [7-10].…”

Section: Introductionmentioning

confidence: 99%

Exposure to parental smoking and child growth and development: a cohort study

2013

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BackgroundStudies on adverse childhood health and development outcomes associated with parental smoking have shown inconsistent results. Using a cohort of Belarusian children, we examined differences in cognition, behaviors, growth, adiposity, and blood pressure at 6.5 years according to prenatal and postnatal exposure to parental smoking.MethodsUsing cluster-adjusted multivariable regression, effects of exposure to prenatal smoking were examined by comparing (1) children whose mothers smoked during pregnancy with those of mothers who smoked neither during nor after pregnancy and (2) children whose mothers smoked during and after pregnancy with those whose mothers smoked after pregnancy only; effects of postnatal smoking were examined by comparing (1) children whose mothers smoked after pregnancy only with those of mothers who smoked neither during nor after pregnancy and (2) children whose fathers smoked with those whose fathers did not smoke among children of non-smoking mothers after adjusting for a wide range of socioeconomic and family characteristics.ResultsAfter adjusting for confounders, children exposed vs unexposed to prenatal maternal smoking had no differences in mean IQ, teacher-rated behavioral problems, adiposity, or blood pressure. Children exposed to maternal postnatal smoking had slightly increased behavioral problems [0.9, 95% CI: 0.6, 1.2 for total difficulties], higher body mass index [0.2, 95% CI: 0.1, 0.3], greater total skinfold thickness [0.4, 95% CI: 0.04, 0.71], and higher odds of overweight or obesity [1.4, 95% CI; 1.1, 1.7]. Similar magnitudes of association were observed with postnatal paternal smoking.ConclusionsNo adverse cognitive, behavioral and developmental outcomes were associated with exposure to maternal prenatal smoking. Observed associations with postnatal smoking of both parents may reflect residual confounding by genetic and family environmental factors.

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“…In addition, smoking during pregnancy is a known adverse health-related behavior. The association between the risk of LBW and maternal smoking during pregnancy is well established [35,36,37,38,39,40,41], suggesting an increased risk of LBW in the offspring of smokers. Smoking during pregnancy is also strongly associated with SES, indicating a higher prevalence of smokers during pregnancy in the lower social class [35,42].…”

Section: Introductionmentioning

confidence: 99%

Anthropometric and Health-Related Behavioral Factors in the Explanation of Social Inequalities in Low Birth Weight in Children with Prenatal Alcohol Exposure

Pfinder

2014

IJERPH

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There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral factors to the explanation of social inequalities. A total of 2,159 participants with parental self-reported moderate to regular PAE (enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents) were examined. At similar levels of PAE, the risk of LBW was significantly increased in subjects with a low socioeconomic status (SES) (adjusted odds ratio (OR) 2.78, 95% confidence interval (CI) 1.59, 4.86) and middle SES (adjusted OR 2.04, 95% CI 1.28, 3.24). Maternal height, maternal body mass index (BMI) and smoking during pregnancy mediated the association. The mediating effect of maternal height was 12.5% to 33.7%. Maternal BMI explained 7.9% of the socioeconomic difference in LBW between the high and low SES groups in children with PAE. The mediating effect of smoking during pregnancy was 17.3% to 31.5%. Maternal height, maternal BMI and smoking during pregnancy together explained 24.4% to 60.1% of the socioeconomic differences in LBW in children with PAE. A large proportion of the socioeconomic differences in LBW in children with PAE can be attributed to anthropometric and health-related behavioral factors.

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A Clinical Trial of Change in Maternal Smoking and Its Effect on Birth Weight

Cited by 382 publications

References 14 publications

Maternal smoking and offspring inattention and hyperactivity: results from a cross-national European survey

Maternal smoking and offspring inattention and hyperactivity: results from a cross-national European survey

Exposure to parental smoking and child growth and development: a cohort study

Anthropometric and Health-Related Behavioral Factors in the Explanation of Social Inequalities in Low Birth Weight in Children with Prenatal Alcohol Exposure

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