Mother's environmental tobacco smoke exposure during pregnancy and externalizing behavior problems in children

Abstract

Background While the impact of active maternal smoking during pregnancy on child health has been well investigated, the association between maternal passive smoking, or environmental tobacco smoke (ETS), or second-hand smoke, and behavioral development of offspring is less clear. This study examines the association between maternal ETS exposure during pregnancy and child behavior problems. Methods Cross-sectional data of 646 mother–child pairs from the Jintan China Cohort Study were used in the analyses. Mother’s exposure to tobacco smoking at home, the workplace, and other places during pregnancy (for the determination of maternal ETS exposure) and children’s behaviors (via Child Behavior Checklist) were assessed when the children were 5–6 years old. Logistic regression models were constructed to examine associations between maternal exposure to ETS during pregnancy and internalizing and externalizing behavior problems, adjusting for potential cofounders including child sex and parental characteristics. Results 37% of mothers reported ETS during pregnancy. Children of mothers exposed to ETS during pregnancy had higher scores for externalizing and total behavior problems, with 25% of children whose mothers were exposed to ETS compared to 16% of children of unexposed mothers. After adjusting for potential confounders, ETS exposure was associated with a higher risk of externalizing behavior problems in offspring of exposed mothers (OR = 2.08, 95% confidence interval [CI] 1.27–3.43). Analysis after multiple imputations and sensitivity analysis further verified the association, but no dose–response relationship was found. ETS exposure, however, was not associated with internalizing or total behavior problems. Conclusion This study suggests that maternal ETS exposure during pregnancy may impact child behavioral development, particularly externalizing behaviors.

Risk Factors for Internalizing and Externalizing Problems in the Preschool Years: Systematic Literature Review Based on the Child Behavior Checklist 1½–5

“…Studies related to substance abuse found that pre-pregnancy risk drinking (Knudsen et al 2014) increased IEP, methamphetamine use during pregnancy increases IEP ) and EP (Twomey et al 2013), tobacco exposure during pregnancy (Liu et al 2013) and maternal smoking during child preschool years increases IEP (Paterson et al 2013). One study reported non-significant results to the effect of methamphetamine exposure during pregnancy in EP (Liles et al 2012).…”

Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence

“…The published literature on the role of tobacco is currently limited by the absence of any measures of secondhand smoke exposure to the mother during pregnancy. This is an important gap, given that (1) secondhand smoke is a different chemical mixture than primary smoke, (2) there is evidence that secondhand smoke exhibits neurodevelopmental toxicity, 61,62 and (3) it is a very common exposure. Given the complexity of tobacco mixtures and the biologic plausibility of impact, future studies should evaluate the role of secondhand exposure and consider biomarker measures of tobacco; these measures are objective, quantitative, and integrate all sources of exposure and, although not yet used in this literature due to the preponderance of retrospective designs, could be used when biologic materials have been stored or can be prospectively collected.…”

Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study

“…Pediatric SHSe has been shown to exacerbate asthma symptoms [1,2], and is associated with increased risk of bronchitis, pneumonia and other respiratory infections [3], sudden infant death syndrome [4,5], middle ear disease [6], atopic dermatitis [7], attention deficit hyperactivity disorder [8], externalizing behavior problems [9] and cognitive development delays [10,11]. Despite declines in US smoking prevalence, 50% of US children are routinely exposed to secondhand smoke [12], and over 30% of US children live in homes where a resident or visitor smokes [13].…”