Maternal smoking during pregnancy and child behaviour problems: The Generation R Study
Abstract
BACKGROUND: Several studies showed that maternal smoking in pregnancy is related to behavioural and emotional disorders in the offspring. It is unclear whether this is a causal association, or can be explained by other smoking-related vulnerability factors for child behavioural problems. METHODS: Within a population-based birth cohort, both mothers and fathers reported on their smoking habits at several time-points during pregnancy. Behavioural problems were measured with the Child Behavior Checklist in 4680 children at the age of 18 months. RESULTS: With adjustment for age and gender only, children of mothers who continued smoking during pregnancy had higher risk of Total Problems [odds ratio (OR) 1.59, 95% confidence interval (CI): 1.21-2.08] and Externalizing problems (OR 1.45, 95% CI: 1.15-1.84), compared with children of mothers who never smoked. Smoking by father when mother did not smoke, was also related to a higher risk of behavioural problems. The statistical association of parental smoking with behavioural problems was strongly confounded by parental characteristics, chiefly socioeconomic status and parental psychopathology; adjustment for these factors accounted entirely for the effect of both maternal and paternal smoking on child behavioural problems. CONCLUSIONS: Maternal smoking during pregnancy, as well as paternal smoking, occurs in the context of other factors that place the child at increased developmental risk, but may not be causally related to the child's behaviour. It is essential to include sufficient information on parental psychiatric symptoms in studies exploring the association between pre-natal cigarette smoke exposure and behavioural disorders.
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- Authors
- Roza, S. J., Verhulst, F. C., Jaddoe, V. W., Steegers, E. A., Mackenbach, J. P., Hofman, A., & Tiemeier, H.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Tiemeier, Henning
- ORCID
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-09-04
- Volume
- 38
- Issue
- 3
- Pages
- 680-689
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2121171601
- Cited by
- 118
- References
- 34
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 12 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 11 · 2014: 5 · 2013: 8 · 2012: 6
- FWCI
- 6.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- ZonMw (100001003)
- Erasmus Universiteit Rotterdam
- Erasmus Medisch Centrum
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- smoking during pregnancy, paternal smoking, child behavior problems, externalizing problems, prenatal cigarette smoke exposure, socioeconomic status, Child Behavior Checklist, Generation R Study, birth cohort
- MeSH terms
- Adult, Child Behavior Disorders, Female, Gestational Age, Humans, Infant, Infant, Newborn, Male, Parents, Pregnancy, Prenatal Exposure Delayed Effects, Surveys and Questionnaires, Smoking, Socioeconomic Factors, Tobacco Smoke Pollution, Confounding Factors, Epidemiologic
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