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

Abstract

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.

Maternal cigarette smoking during pregnancy and the trajectory of externalizing and internalizing symptoms across childhood: Similarities and differences across parent, teacher, and self reports

“…The most consistent results were found between MSDP and the mean-level of externalizing behavior: Compared to the children of mothers who had not smoked during pregnancy, the children of mothers who had smoked during pregnancy were, on average, more hyperactive and had more difficulties with their peers and with their behavior as rated by parents, teachers, and the children themselves. These results support previous findings that MSDP is associated with symptoms of ADHD and other externalizing disorders (Hutchinson et al ., 2010, Kovess et al ., 2015, Zhu et al ., 2014) and indicate that the results do not depend on who reports the symptomatology; similar differences emerged from three respondents who had access to information about the child across different settings.…”

“…There is consistent evidence that children of mothers who smoked during pregnancy have more symptoms of attention deficit hyperactivity disorder (ADHD) (Kovess et al ., 2015, Melchior et al ., 2015) and are more likely to receive a diagnosis of ADHD (Zhu et al ., 2014) than children of mothers who did not smoke during pregnancy. MSDP has likewise been associated with other externalizing behaviors, such as symptoms of conduct disorders (Hutchinson et al ., 2010).…”

Evidence-Based Practices During Pregnancy and Midwifery Approach

“…(2015) tarafından Avrupa da beş ülke de (Tür-kiye, Romanya, Bulgaristan, Litvanya, Almanya ve Hollanda'da) hiperaktivite ve dikkat bozukluğu olan 6-11 yaş arası çocuklarda, annelerin rapor ettiği 4.517 ve öğretmenlerin rapor ettiği 4.611 çocuk dahil edilerek bir çalışma yapılmıştır. 70 Çalışmada annelerin gebelik döneminde sigara içmesi ile, ço-cuklardaki hiperaktivite ve dikkat bozukluğu arasındaki ilişki incelenmiş ve çalışmanın sonucunda çocuklardaki hiperaktivite ve dikkat bozukluğu ile annenin gebelik döneminde sigara kullanımı arasında potansiyel bir ilişki olduğu belirtilmiştir. Gebelikte sigara kullanımının değerlendiril-mesi ve pasif içiciliğin saptanması (güçlü öneri, zayıf kalite kanıt düzeyi), Gebelikte sigara kullanımının bırakılması için psiko-sosyal destek süreci (güçlü öneri, orta kalitede kanıt düzeyi), Gebelikte sigara kullanımının bırakılmasını desteklemek için nikotin replasman terapisinin (NRT) kullanımı veya kullanılmaması konusunda bir tavsiye yapılamayacağı (uygulanmasını öner-mez, orta kalitede kanıt düzeyi), bupropion veya vareniklin gibi farmakolojik ajanların kullanılma-sının önerilmemesi (güçlü öneri, kanıt değeri yok), Gelecekteki çalışmalarda, gebelikte sigara bı-rakılması için kullanılan farmakolojik ajanların, gü-venirliğinin, etkinliğinin ve bağımlılık yapma etkisinin incelenmesi ( güçlü öneri, kanıt değeri yok), Gebe kadınlara, eşlerine ve diğer hane halkı üyelerine pasif içiciliğe maruz kalmanın riskleri ve evde pasif içiciliği azaltma stratejileri konusunda bilgi verilmesidir (güçlü öneri, zayıf kalitede kanıt düzeyi).…”

Maternal smoking during pregnancy and offspring personality in childhood and adulthood

“…MSDP, for example, has been linked to attention‐deficit/hyperactivity disorder (ADHD), internalizing symptoms, and conduct disorders. Children exposed to nicotine during prenatal development have more attention deficits at age 5 (Melchior et al, ), have more symptoms of ADHD at age 8 (Kovess et al, ), and are at greater risk of a clinical diagnosis of ADHD by adolescence (Biederman, Monuteaux, Faraone, & Mick, ) than children who did not have prenatal exposure to nicotine. Compared to mothers who did not smoke during pregnancy, children of mothers who did smoke also exhibit more symptoms of anxiety and depression (McCrory & Layte, ), although not all find this relation (Melchior et al, ).…”