Investigating the Association Between Exposure to Second Hand Smoke in utero and Developmental Coordination Disorder

Abstract

Background: Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are highly comorbid in children. There is evidence linking second hand smoke (SHS) exposure in utero to ADHD; however, it's relation to DCD is unknown. The purpose of this study was to examine the effect of SHS exposure in utero in children with and without DCD.Methods: This study was a cross-sectional examination of 122 children from the District School Board of Niagara (72 males, 50 females, Mage = 12.9 years) who were part of a larger, prospective cohort study. Participants were assessed for motor proficiency and intelligence and were screened for symptoms of ADHD using the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, the Kaufman Brief Intelligence Inventory, 2nd edition, and the Conners' Parent Rating Scales-Revised: Short Form, respectively. Parent questionnaires were used to determine SHS exposure in utero as either yes or no. Multinomial logistic regression was used to examine the relationship between SHS exposure and DCD risk.Results: Children exposed to SHS in utero were significantly more likely to be at high risk for DCD than children who were not (OR = 3.33, p = 0.004), and children exposed to SHS in utero were more likely to be at moderate risk for DCD in the presence (OR = 3.57, p = 0.025) or absence of ADHD (OR = 2.38, p = 0.042). However, statistical adjustment for birth weight, socioeconomic status, age, and sex reduced this effect to non-significance in the moderate risk group.Conclusion: Results suggest exposure to SHS during pregnancy increases the chances of a child developing high risk DCD. While SHS exposure may increase DCD risk with and without ADHD, this effect may be explained by covariates and confounding factors. Further study is needed to examine the mechanisms linking SHS exposure in utero to motor coordination problems in children.

Mothers’ prenatal tobacco smoke exposure is positively associated with the occurrence of developmental coordination disorder among children aged 3–6 years: A cross-sectional study in a rural area of Shanghai, China

“…Previous studies indicated that the association between high prevalence of DCD in children and mothers' prenatal tobacco exposure was confounded by social, economic factors, as well as perinatal risk factors including preterm birth, lower birthweight, gender of children, age of children, etc 8,10,19 . In order to address this, we adjusted the potential confounding factors mentioned above, ascertained by directed acyclic graphs (DAGs) 16,20 , and logistic regression analysis with covariable adjustment demonstrated that children still had higher risk of DCD occurrence if their mother was exposed to tobacco smoke prenatally, with OR=3.68 and OR=1.63 for FHS and SHS exposure, respectively. Potential mechanisms underlying this association include intrauterine hypoxia, and direct toxic effects of nicotine 35 .…”

“…It has been well established that maternal smoking is a significant risk factor for attention deficit hyperactivity disorder (ADHD), which has an almost 50% overlap with DCD 13 , but the association of maternal smoking during pregnancy and DCD among children is equivocal 14,15 . A study with 122 children from Canada indicated that children exposed to secondhand smoke in utero have 3 times increased risk of DCD 16 , while another study with 744 children in Auckland, New Zealand, demonstrated that children whose mothers smoke during pregnancy have an increased risk of DCD in comparison with children whose mothers are non-smokers 17 . However, two other studies (420 children investigated in Menorca Island, Spain, and 3207 children studied in Great Britain) find no association between prenatal smoking exposure in mothers and DCD in children 18,19 .…”

Early factors associated with risk of developmental coordination disorder in very preterm children: A prospective area‐based cohort study in Italy

“…While males are generally found at higher risk, 1,[4][5][6][7] a recent review states that this applies to the general paediatric population only. 16 Associations were reported between DCD and pregnancy exposures, such as active 4,[17][18][19] and passive 20,21 maternal smoking, and with medical conditions including threatened abortion before 20 weeks, 22 infection/inflammation, 23,24 fetal distress during labour 22,25 and intrauterine growth restriction, 4,26 although this latter was not always confirmed 14 or explored 22 in subsequent studies.…”

Prenatal second-hand smoke exposure and the risk of suspected developmental coordination disorder in preschoolers: A nationwide retrospective cohort study in China

“…A single center study ( N = 8,586) in Shanghai, China, found that the occurrence of DCD among children was positively associated with prenatal SHS exposure among mothers (OR = 1.77; 95% CI: 1.47–2.14) ( 24 ). Furthermore, a cross-sectional examination of 122 children in Niagara, Ontario, Canada, suggested that exposure to SHS during pregnancy increases the risk of DCD in children ( 23 ).…”

“…Children with DCD are characterized by significantly impaired function in motor coordination; however, the etiology of the disorder is still largely unclear. An earlier study with a small sample ( N = 122) ( 23 ), as well as another study involved 8,586 children in Shanghai, China, looking at maternal exposure to first- and second-hand smoking ( 24 ), both reported a lower risk of DCD in children whose mothers were not exposed to tobacco smoke during pregnancy. Nevertheless, there is no large-scale specific research on the relationship between prenatal SHS and DCD to confirm the impact of prenatal SHS exposure on off-spring neurodevelopment.…”