Maternal smoking during pregnancy and severe antisocial behavior in offspring: a review.
OBJECTIVE
Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question.


METHODS
We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework.


RESULTS
The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions.


CONCLUSIONS
Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.
Wakschlag
Lauren S
LS
Department of Psychiatry, University of Chicago, Chicago, IL 60637, USA. laurie@yoda.bsd.uchicago.edu
Pickett
Kate E
KE
Cook
Edwin
E
Benowitz
Neal L
NL
Leventhal
Bennett L
BL
D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000453:epidemiology / Q000209:etiology*; D015984:Causality; D002648:Child; D019955:Conduct Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data*; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology