Prenatal Exposure to Environmental Tobacco Smoke and Hyperactivity Behavior in Chinese Young Children.

Qingmei Lin,Dan-Xia Xian,Guo-Min Wen,Dengli Sun,Chuan-An Wu,Lijun Fan,Xiang-Yu Hou,Yu Jin,Xiao-Na Yin,Hui Jiang,Wei-Qing Chen,Jin Jing

doi:10.3390/ijerph14101132

Abstract

This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models and hierarchical linear models were employed to assess the associations. After adjusting for potential confounders of gender, preterm birth, birth asphyxiation, etc., prenatal ETS exposure was significantly associated with an increased risk of hyperactivity behaviors in young children (OR (95% CI) = 1.51 (1.28–1.77); β (95% CI) = 0.017 (0.013–0.020)). Along with increases in children’s prenatal ETS exposure dose (measured by daily ETS exposure duration, daily cigarette consumption by household members, and overall score of prenatal ETS exposure), the children were also increasingly more likely to exhibit hyperactivity behaviors. Furthermore, children whose mothers had prenatal ETS exposure in any one or more of the pregnancy trimesters were more likely to exhibit hyperactivity behaviors as compared with those born to non-exposure mothers (all p < 0.05). Overall, prenatal ETS exposure could be associated with a detrimental impact on offspring’s hyperactivity behaviors, and public health efforts are needed to reduce prenatal ETS exposure.

Highlights

Hyperactivity behaviors are the main clinical manifestation of attention-deficit hyperactivity disorder and belong to one of the most common neurobehavioral conditions in preschool and school children [1,2], which are likely to disrupt their academic achievements, social relationship establishment, and occupational functioning [3]
Between the children with and without hyperactivity behaviors, significant differences were observed in terms of child gender, preterm birth, birth asphyxia, fetal growth restriction, family income per month, parent’s educational level, and parental age at childbirth; other characteristics were quite comparable, including child age, low birth weight, single child, delivery mode, and parental marital status
In order to find out the critical sensitive periods during maternal pregnancy, our study explored the impact of trimester-specific environmental tobacco smoke (ETS) exposure on child behaviors, and observed that children whose mothers had prenatal ETS exposure in any one or more of the pregnancy trimesters were more likely to have hyperactivity behaviors when compared with those born to non-exposed mothers

Summary

Introduction

Hyperactivity behaviors are the main clinical manifestation of attention-deficit hyperactivity disorder and belong to one of the most common neurobehavioral conditions in preschool and school children [1,2], which are likely to disrupt their academic achievements, social relationship establishment, and occupational functioning [3]. The cause of hyperactivity behaviors remains unclear, but a series of prior epidemiological evidence have identified a relationship between them with prenatal exposure to harmful environmental factors, among which the impact of maternal active smoking on offspring behaviors is quite well-established [4,5,6]. Linnet et al reported that smoking in pregnancy increased the prevalence of hyperkinetic disorder by threefold [7]. Public Health 2017, 14, 1132; doi:10.3390/ijerph14101132 www.mdpi.com/journal/ijerph

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