Maternal Prenatal Smoking and Autism Spectrum Disorder in Offspring: A California Statewide Cohort and Sibling Study
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We examined associations between maternal smoking and autism spectrum disorder (ASD) in children in a statewide population-based cohort and sibling-comparison design using California birth records (n = 2,015,104) with information on maternal smoking, demographic factors, and pregnancy (2007–2010). ASD cases (n = 11,722) were identified through California Department of Developmental Services records with diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders–IV-TR. We estimated odds ratios for ASD with and without intellectual disability in the full cohort using logistic regression and in a sibling comparison using conditional logistic regression. In the full cohort, the adjusted odds ratio for ASD and maternal smoking 3 months before/during pregnancy compared with nonsmoking was 1.15 (95% confidence interval (CI): 1.04, 1.26), and it was similar in cases with (odds ratio = 1.12, 95% CI: 0.84, 1.49) and without intellectual disability (odds ratio = 1.15, 95% CI: 1.04, 1.27). Heavy prenatal smoking (≥20 cigarettes/day in any trimester) was related to an odds ratio of 1.55 (95% CI: 1.21, 1.98). In the sibling comparison, the odds ratio for heavy smoking was similarly elevated but the confidence interval was wide. Our findings are consistent with an increased risk for ASD in offspring of mothers who smoked ≥20 cigarettes/day during pregnancy; associations with lighter smoking were weaker.
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In a California population-based cohort and sibling-comparison study, the aOR for ASD and maternal smoking 3 months before/during pregnancy compared with nonsmoking was 1.15 (95% CI 1.04-1.26) in the full cohort.
“In the full cohort, the aOR for ASD and maternal smoking 3 months before/during pregnancy compared with nonsmoking was 1.15 (95% CI: 1.04, 1.26)”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [121]
Mothers who smoked heavily during pregnancy (≥20 cigarettes/day in any trimester) had an OR of 1.55 (95% CI 1.21-1.98), indicating a dose-response relationship between maternal prenatal smoking and offspring risk for ASD.
“Mothers that smoked heavily during pregnancy ( ≥ 20 cigarettes/day in any trimester) were found to have an OR of 1.55 (95% CI: 1.21, 1.98) which indicates a dose-response relationship between maternal prenatal smoking and offspring risk for ASD [121].”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [121]
The aOR was similar between cases with intellectual disability (OR = 1.12, 95% CI 0.84-1.49) and without intellectual disability (OR = 1.15, 95% CI 1.04-1.27).
“and was found to be similar between the cases with (OR = 1.12, 95% CI: 0.84, 1.49) and without intellectual disability (OR = 1.15, 95% CI: 1.04, 1.27) [121].”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [121]
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Autism Spectrum Disorders-A Review on The Preventive Aspects
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A sibling study of the prenatal and perinatal risks for cerebral palsy
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Perinatal and maternal factors associated with Autism Spectrum DisorderPreprint
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Perinatal and maternal factors associated with Autism Spectrum Disorder
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- Authors
- von Ehrenstein, O. S., Cui, X., Yan, Q., Aralis, H., & Ritz, B.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-08-24
- Volume
- 190
- Issue
- 5
- Pages
- 728-737
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC8096427
- OpenAlex
- W3080620775
- Cited by
- 52
- References
- 60
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 13 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 2
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Environmental Health Sciences (R21ES022389, R21ES025558)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- maternal smoking, autism spectrum disorder, heavy smoking, intellectual disability, sibling comparison, pregnancy, birth cohort
- MeSH terms
- Autism Spectrum Disorder, California, Child, Female, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Registries, Smoking, Maternal Exposure, Siblings
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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