Child Behavior Problems Increased by Maternal Smoking During Pregnancy

Abstract

We investigated the effects of maternal smoking during pregnancy on behavioral problems (i.e., not mediated by low birth weight) in 3-y-old offspring. We assessed behavioral problems in 1377 2- to 3-y-old twin pairs (registered in the Netherlands Twin Register) with the Child Behavior Checklist for ages 2-3 y (CBCL/2-3) from Achenbach, Edelbrock, and Howell. Two to 3 y earlier (i.e., soon after the birth of the twins) we collected information about the smoking habits (i.e., "never," "sometimes," and "regularly") of the mother during pregnancy. We analyzed the effect of maternal smoking on the CBCL total score and on several subscale scores for first- and second-born twins separately, and we adjusted for the possible confounding effects of birth weight, socioeconomic status, maternal age, and type of feeding (i.e., breast or bottle fed). There was a significant effect of maternal smoking on so-called "externalizing" behavioral problems (e.g., oppositional, aggressive, overactive), but not on "internalizing" behavioral problems (e.g., withdrawn, depressed, anxious), in both first- and second-born twins. The enhanced "externalizing" problems were attributed predominantly to increased aggression. Although boys have higher externalizing and aggression scores than girls, the effect of maternal smoking was the same for boys and girls.

Neurocognitive elements of antisocial behavior: Relevance of an orbitofrontal cortex account

“…Similar results were found for obstetrical complications (Arseneault, Tremblay, Boulerice, & Saucier, 2002). Maternal smoking during pregnancy has been related to externalizing disorder problems (i.e., CD, ADHD, and ODD) in childhood (Breslau & Chilcoat, 2000;Orlebeke, Knol, & Verhulst, 1999;Weissman, Wickramaratne, & Kandel, 2000), and into adulthood (Rasanen et al, 1999), as well as poor neurocognitive function in children (Eskenazi & Castorina, 2000). Maternal smoking during pregnancy was also related to number of conduct symptoms in the parents, which suggests a complex intergenerational transmission process (Zoccolillo, 2000).…”

Direct and Passive Prenatal Nicotine Exposure and the Development of Externalizing Psychopathology

“…Behavioral effects have been reported to increase linearly with the number of cigarettes smoked during pregnancy [8]. These associations appear specific to externalizing psychopathology, with no increased risk for internalizing outcomes among exposed children [9,1].…”

“…This adversity is expressed across the lifespan, and includes conditions such as aggression in preschool [1], attention deficit/hyperactivity disorder (ADHD) in childhood [2][3][4], conduct disorder (CD) and delinquency in adolescence [5,6] and criminality in adulthood [7]. Behavioral effects have been reported to increase linearly with the number of cigarettes smoked during pregnancy [8].…”

Prenatal Exposure to Maternal Cigarette Smoking and the Adolescent Cerebral Cortex

“…Several studies also revealed an increased incidence of externalizing disorders in general (Breslau and Chilcoat, 2000), and attention-deficit hyperactivity (Milberger et al, 1998) and conduct (Wakschlag et al, 1997;Weissman et al, 1999) disorders in particular. Some studies also observed an association between PEMCS and criminal behavior in adulthood (Brennan et al, 1999;Räsänen et al, 1999), and higher rates of aggression in children and adults (Orlebeke et al, 1999;Räsänen et al, 1999). Finally, PEMCS may increase the probability of experimenting with cigarette smoking in childhood (Cornelius et al, 2000) and of developing cigarette smoking addiction in adolescence (Kandel et al, 1994;Kandel and Udry, 1999;Weissman et al, 1999;Buka et al, 2003).…”