Exposure to tobacco smoke in utero or during early childhood and risk of hypomania: Prospective birth cohort study

Abstract

Objectives Using data from a prospective birth cohort, we aimed to test for an association between exposure to tobacco smoke in utero or during early development and the experience of hypomania assessed in young adulthood.Methods We used data on 2,957 participants from a large birth cohort (Avon Longitudinal Study of Parents and Children, ALSPAC). The primary outcome of interest was hypomania, and the secondary outcome was 'hypomania plus previous psychotic experiences (PE)'. Maternally-reported smoking during pregnancy, paternal smoking and exposure to environmental tobacco smoke (ETS) in childhood were the exposures of interest. Multivariable logistic regression was used and estimates of association were adjusted for socio-economic, lifestyle and obstetric factors.Results There was weak evidence of an association between exposure to maternal smoking in utero and lifetime hypomania. However, there was a strong association of maternal smoking during pregnancy within the sub-group of individuals with hypomania who had also experienced psychotic symptoms (OR = 3·45, 95%CI 1·49=7·98, P = 0·004). There was no association between paternal smoking, or exposure to ETS during childhood, and hypomania outcomes. ConclusionsExposure to smoking in utero may be a risk factor for more severe forms of psychopathology on the mood-psychosis spectrum, rather than DSM-defined bipolar disorder.

Health outcomes of smoking during pregnancy and the postpartum period: an umbrella review

“…Firstly, although systematic reviews are accepted as the highest in the evidence hierarchy [76,77], the focus on systematic reviews alone meant some health conditions were not covered. Some original studies have indicated the impact of SDP on other infant-related conditions, such as diabetes [78], hypomania [79], otitis [80] and pervasive development disorder [81], which were not assessed in a systematic review, and as a result were not included in this study. Furthermore, SDP has been shown to be related to the smoking uptake of the offspring [82,83].…”

The effects of polygenic risk for psychiatric disorders and smoking behaviour on psychotic experiences in UK Biobank

“…However, it is still unclear whether these findings are false positives resulting from a lack of power in relatively small samples. Maternal smoking during pregnancy is associated with psychotic experiences in offspring 19 . However within-family studies suggest that once familial factors are taken into account, maternal smoking during pregnancy has no effect on the risk of psychotic experiences 20 .…”

Association Between Maternal Smoking During Pregnancy and Severe Mental Illness in Offspring

“…[1][2][3] In particular, recent studies have provided novel evidence of associations between SDP and offspring bipolar disorder, 4 schizophrenia, 5 and related outcomes. 6 These associations raise the possibility that SDP exposure has c ausal teratogenic eff ects on the risk of severe mental illness (SMI). 7 Because nicotine and carbon monoxide cross the placenta and may directly and indirectly (eg, via hypoxia) affect fetal neurodevelopment, 8 this hypothesis is biologically plausible.…”