Maternal smoking during pregnancy and children's cognitive and physical development: a causal risk factor?

Full Abstract

There remains considerable debate regarding the effects of maternal smoking during pregnancy on children's growth and development. Evidence that exposure to maternal smoking during pregnancy is associated with numerous adverse outcomes is contradicted by research suggesting that these associations are spurious. The authors investigated the relation between maternal smoking during pregnancy and 14 developmental outcomes of children from birth through age 7 years, using data from the Collaborative Perinatal Project (1959-1974; n = 52,919). In addition to adjusting for potential confounders measured contemporaneously with maternal smoking, the authors fitted conditional fixed-effects models among siblings that controlled for unmeasured confounders. Results from the conditional analyses indicated a birth weight difference of -85.63 g associated with smoking of >or=20 cigarettes daily during pregnancy (95% confidence interval: -131.91, -39.34) and 2.73 times' higher odds of being overweight at age 7 years (95% confidence interval: 1.30, 5.71). However, the associations between maternal smoking and 12 other outcomes studied (including Apgar score, intelligence, academic achievement, conduct problems, and asthma) were entirely eliminated after adjustment for measured and unmeasured confounders. The authors conclude that the hypothesized effects of maternal smoking during pregnancy on these outcomes either are not present or are not distinguishable from a broader range of familial factors associated with maternal smoking.

Author information

Author/s: Gilman, Stephen E (SE); Gardener, Hannah (H); Buka, Stephen L (SL);

Affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. sgilman(-atsign-)hsph.harvard.edu

Grants: P50 CA084719 (Agency:NCI NIH HHS) ; P50 CA084719-10 (Agency:NCI NIH HHS) ; T32 MH017119-22 (Agency:NIMH NIH HHS) ; T32 MH17119 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: American journal of epidemiology (Am J Epidemiol), published in United States. (Language: eng)

Reference: 2008-Sep; vol 168 (issue 5) : pp 522-31

Dates: Created 2008/08/25; Completed 2008/10/31; Revised 2009/09/02;

PMID: 18653646, status: MEDLINE (last retrieval date: 9/4/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.