Abstract
AimExplore associations between smoking in pregnancy and psychiatric symptoms in the adolescent offspring.Design/subjectsA prospective population based follow-up of 84 adolescents at 14 years of age, of whom 32 of the mothers reported smoking during pregnancy.Main outcome measuresThe Achenbach System of Empirically Based Assessment (ASEBA), ADHD-Rating Scale IV, Autism Spectrum Screening Questionnaire (ASSQ), Children's Global Assessment Scale (CGAS), estimated IQ based on four subscales of WISC-III.ResultsAdolescents who were born by smokers had significantly more rule-breaking and aggressive behaviour, externalizing and total problems on the ASEBA than adolescents of non-smokers (p < 0.01), when reported by mothers, fathers and teachers. ADHD symptoms were reported more frequently (p < 0.05), and mothers also reported more internalizing symptoms (p < 0.05) and social problems (p < 0.001). The ASSQ sum score was higher (p < 0.001), and overall function as measured by the CGAS was lower (p < 0.01) for the smoking-exposed group. Associations were still present after controlling for possible confounding factors.ConclusionAdolescents exposed to prenatal smoking had higher scores for both externalizing and internalizing psychiatric symptoms, which could not be explained by a broad range of possible psychosocial confounders. Thus, smoking in pregnancy may be a marker for increased risk of psychiatric symptoms in the offspring.
Highlights
Smoking during pregnancy is well known to have negative effects on the growth and development of the unborn child [1]
Autism Spectrum Screening Questionnaire (ASSQ) [14], with 27 items rated 0–1–2, and Children’s Global Assessment Scale (CGAS) [15], measuring the child’s overall functioning from zero to 100, were rated by a child psychiatrist based on separate interviews with the adolescent and the parents
Adolescents who were born by smokers had significantly more rule-breaking and aggressive behaviour, symptoms of ADHD, social problems and higher sum score on the ASSQ than adolescents of non-smokers
Summary
Smoking during pregnancy is well known to have negative effects on the growth and development of the unborn child [1]. Associations have been reported between prenatal smoking exposure and symptoms of ADHD, these results are less consistent [7,8,9]. Reports on internalizing symptoms such as anxiety and depression are fewer. These studies suggest a weak association with prenatal smoking exposure which, may be confounded by psychosocial factors [4,5]. There is one report on increased risk of autism associated with smoking exposure in utero [10]. In most studies, smoking during pregnancy is measured retrospectively, and information on psychiatric symptoms in the offspring is often collected from the mothers only
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