title: Maternal smoking during pregnancy and child behaviour problems: the Generation R Study.
abstract: BACKGROUND
  Several studies showed that maternal smoking in pregnancy is related to behavioural and emotional disorders in the offspring. It is unclear whether this is a causal association, or can be explained by other smoking-related vulnerability factors for child behavioural problems.
  
  
  METHODS
  Within a population-based birth cohort, both mothers and fathers reported on their smoking habits at several time-points during pregnancy. Behavioural problems were measured with the Child Behavior Checklist in 4680 children at the age of 18 months.
  
  
  RESULTS
  With adjustment for age and gender only, children of mothers who continued smoking during pregnancy had higher risk of Total Problems [odds ratio (OR) 1.59, 95% confidence interval (CI): 1.21-2.08] and Externalizing problems (OR 1.45, 95% CI: 1.15-1.84), compared with children of mothers who never smoked. Smoking by father when mother did not smoke, was also related to a higher risk of behavioural problems. The statistical association of parental smoking with behavioural problems was strongly confounded by parental characteristics, chiefly socioeconomic status and parental psychopathology; adjustment for these factors accounted entirely for the effect of both maternal and paternal smoking on child behavioural problems.
  
  
  CONCLUSIONS
  Maternal smoking during pregnancy, as well as paternal smoking, occurs in the context of other factors that place the child at increased developmental risk, but may not be causally related to the child's behaviour. It is essential to include sufficient information on parental psychiatric symptoms in studies exploring the association between pre-natal cigarette smoke exposure and behavioural disorders.
authors.affiliation: The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: Sabine J
authors.initials: SJ
authors.lastname: Roza
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000328:Adult; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000523:psychology; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution