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Cited by 43Prenatal Substance Exposure EffectsAttention Deficit Hyperactivity DisorderSmoking Behavior and Cessation

Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children’s Health

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Minatoya, Machiko, Araki, Atsuko, Itoh, Sachiko, Yamazaki, Keiko, Kobayashi, Sumitaka, Miyashita, Chihiro, Sasaki, Seiko, Kishi, Reiko·2019·Environmental Health and Preventive Medicine
DOI 10.1186/s12199-019-0834-4PMC PMC6898952
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Abstract

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.

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  • Behavioral problems, particularly attention deficit hyperactivity disorder (ADHD), are significantly increased in children of self-reported pregnant smokers or environmental tobacco smoke exposure.

    “Behavioral problems, particularly attention deficit hyperactivity disorder (ADHD), are significantly increased in children of self-reported pregnant smokers or environmental tobacco smoke exposure [23,24].”

    From Nicotine on the developing brain. (2023) · cites this paper as [24]

    The Results report significantly increased total difficulties and hyperactivity/inattention among children of active smokers. Passive-smoke associations were not statistically significant in the reported group comparisons, so the claim overstates that finding. The study classified prenatal exposure using maternal cotinine levels, not self-reported smoking. (LLM, conf=0.90)

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  • Maternal active smoking (cotinine ≥11.49 ng/mL) during pregnancy is significantly associated with increased risk of total difficulties (OR=1.67).

    “Another study (n = 3,216) analyzing maternal cotinine levels during pregnancy and one’s risk for ADHD found that maternal active smoking (cotinine level ≥ 11.49 ng/mL) during pregnancy was significantly associated with an increased risk of total difficulties (OR = 1.67)”

    From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [67]

  • Maternal low- and high-passive smoking (cotinine 0.22-0.51 and 0.52-11.48 ng/mL) increased risk (OR=1.11, 1.25) but was not statistically significant.

    “while maternal low- and high-passive smoking (cotinine level 0.22–0.51 ng/mL and 0.52–11.48 ng/mL respectively) increased the risk (OR = 1.11, 1.25, respectively) but was not statistically significant”

    From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [67]

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Authors
Minatoya, M., Araki, A., Itoh, S., Yamazaki, K., Kobayashi, S., Miyashita, C., Sasaki, S., & Kishi, R.
Affiliations
Hokkaido University (JP)
Corresponding author
Kishi, Reiko
ORCID
Venue
Environmental Health and Preventive Medicine
Publisher
Springer Science and Business Media LLC
Published
2019-12
Volume
24
Issue
1
Pages
74-74
ISSN
  • 1342-078X (ISSN-L)
  • 1347-4715
DOI
10.1186/s12199-019-0834-4
PMC
PMC6898952
OpenAlex
W2992137676
Cited by
43
References
37
Citations by year
2026: 1 · 2025: 10 · 2024: 10 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 1 · 2014: 1
FWCI
3.90
Type
journal article
Language
en
Open access
Licence
Locations
  • Environmental Health and Preventive Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Hokkaido University Collection of Scholarly and Academic Papers (Hokkaido University) (submittedVersion, cc-by)
  • Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by)
Funders
  • Ministry of Health, Labour and Welfare
  • Japan Society for the Promotion of Science (JP25253050)
  • Ministry of the Environment (5-1454)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
prenatal tobacco exposure, smoking during pregnancy, passive smoking, ADHD symptoms, hyperactivity/inattention, conduct problems, preschool children, sex differences
MeSH terms
Tobacco Smoking, Adult, Attention Deficit Disorder with Hyperactivity, Child, Preschool, Cotinine, Female, Follow-Up Studies, Humans, Japan, Male, Mothers, Pregnancy, Pregnancy Trimester, Third, Prenatal Exposure Delayed Effects, Risk, Sex Factors, Maternal Exposure

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