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

Abstract

INTRODUCTION Prenatal tobacco smoke exposure is a potential risk factor for developmental coordination disorder (DCD) in children, but evidence on the relationship between DCD in children and tobacco smoke exposure in women is limited in China. We conducted a cross-sectional study to understand the prevalence of prenatal tobacco smoke exposure among mothers and the prevalence of DCD among children and to explore if mothers' prenatal tobacco smoke exposure is positively associated with the occurrence of DCD among children. METHODS During 2018, we sampled 8586 children aged 3-6 years and their mothers in Songjiang district, Shanghai. DCD in children was identified by MABC-2 screening combined with pediatrician confirmation. Prenatal tobacco smoke exposure among mothers was classified into firsthand smoke (FHS) and secondhand smoke (SHS) exposure. SAS 9.2 software was applied to calculate the prevalence of DCD in children, the prevalence of prenatal FHS and SHS exposure in mothers and to analyze the differences by chi-squared test and logistic regression. RESULTS Among the 8586 women, the prevalence of prenatal FHS and SHS exposure was 0.94% and 20.79%, respectively. The prevalence of DCD in children was 6.65%, which was significantly higher in boys (7.64%) than in girls (5.51%), and children aged 3 years (9.77%) had a higher prevalence of DCD than children aged 4, 5 or 6 years (7.44%, 5.27% and 4.28%, respectively). In comparison with children whose mother was not exposed to prenatal FHS or SHS, the odds of having DCD was higher in children whose mother was exposed to prenatal FHS (OR=4.42; 95% CI: 2.62-7.44) and SHS (OR=1.77; 95% CI: 1.47-2.14), even after adjustment for potential confounders. CONCLUSIONS The occurrence of DCD among children is positively associated with prenatal tobacco smoke exposure among the mothers. It is crucial to implement tobacco control measures to decrease the prevalence of smoking among pregnant women and SHS exposure at home as well as in the work environment.

The Influence of Various Smoking Categories on The Risk of Gestational Hypertension and Pre-Eclampsia

“…There are significant discrepancies in the relationship between smoking and the development of PIH [10][11][12][13]. Establishing these relationships is important because it is estimated that around a quarter of the population in the European Region smokes [14,15], and maternal smoking is the most prevalent preventable cause of pregnancy complications such as neonatal morbidity, low birthweight, and premature delivery [16]. Many studies have shown that smoking during pregnancy (paradoxically) reduces the risk of PE.…”

“…Tobacco smoke contains more than 7000 chemicals, among them various toxic and carcinogenic and cocarcinogenic substances [8,9,11,12,[17][18][19][20]. Smoking has been shown to trigger inflammatory processes and to increase oxidative stress, as well as to reduce placental flows [16,17]. On the other hand, the study by Laule et al indicates that nicotine can have anti-inflammatory effects through the α7-nAChR (acetylcholine receptor subunit) and inhibition of pro-inflammatory cytokine production, which may attenuate hypertension caused by placental ischemia.…”

Association between Maternal Thyroxine and Risk of Fetal Congenital Heart Defects: A Hospital-Based Cohort Study

“…Some risk factors for CHDs [27], such as maternal chronic conditions and habits, history of adverse outcomes in previous pregnancies, and the treatment for gestational thyroid disease, were not collected in the present study. However, we do not think the lack of these factors in the present study would significantly shake the results since the population-attributable fraction of these factors was low (1.2%), the large sample size in the present study had enough power to ensure robust associations, and pregnant women rarely smoke (<1.0%) in Shanghai, China [28]. Finally, although the findings were powered by a large sample of women and the missingness analyses showed consistent results, we acknowledge a potential selection bias induced by a certain percentage of women who were lost to follow-up.…”

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

“…The findings reported in this large-scale population retrospective cohort study are consistent with previous research with smaller sample sizes. 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.…”