Childhood hardship, maternal smoking, and birth outcomes: a prospective cohort study.
OBJECTIVE
To determine the association between type, chronicity, and severity of childhood hardships and smoking status during pregnancy, preterm birth (PTB), and low birth weight (LBW).


METHODS
Prospective cohort study.


METHODS
The National Child Development Study, a nationally representative study of births in Great Britain in 1958.


METHODS
Four thousand eight-hundred sixty-five women with at least 1 singleton live birth.


METHODS
Hardship during childhood, indicated by several variables, including financial/structural hardship, lack of parental interest in education, family dysfunction, violence/mental health issues, and family structure.


METHODS
Smoking in pregnancy, LBW, and PTB.


RESULTS
A consistent and graded association was seen between all types of childhood hardships and smoking status during pregnancy (odds ratio [OR] for 4 or more hardships, 2.02; 95% confidence interval [CI], 1.58-2.58; P < .001 for all comparisons). Most hardships were also associated with risk of LBW and PTB, with associations between number of hardships and both outcomes persisting after controlling for smoking status and adult social class (for LBW, OR, 1.51; 95% CI, 1.10-2.06; for PTB, OR, 1.44; 95% CI, 1.08-1.92).


CONCLUSIONS
Childhood hardships have an enduring impact on future pregnancy outcomes, in part through their association with smoking during pregnancy and adult socioeconomic position.
Tulane University, New Orleans, Louisiana, USA. harville@tulane.edu
Emily W
EW
Harville
Renée
R
Boynton-Jarrett
Chris
C
Power
Elina
E
Hyppönen
D000328:Adult; D002648:Child; D017579:Domestic Violence; D005195:Family Relations; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008137:Longitudinal Studies; D009035:Mothers; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*; D012923:Social Class; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology