title: Separating Family-Level and Direct Exposure Effects of Smoking During Pregnancy on Offspring Externalizing Symptoms: Bridging the Behavior Genetic and Behavior Teratologic Divide.
abstract: Maternal smoking during pregnancy (MSDP) has been robustly associated with externalizing problems and their developmental precursors in offspring in studies using behavioral teratologic designs (Wakschlag et al., Am J Public Health 92(6):966-974, 2002; Espy et al., Dev Psychol 47(1):153-169, 2011). In contrast, the use of behavior genetic approaches has shown that the effects commonly attributed to MSDP can be explained by family-level variables (D'Onofrio et al., Dev Psychopathol 20(01):139-164, 2008). Reconciling these conflicting findings requires integration of these study designs. We utilize longitudinal data on a preschool proband and his/her sibling from the Midwest Infant Development Study-Preschool (MIDS-P) to test for teratologic and family level effects of MSDP. We find considerable variation in prenatal smoking patterns both within and across pregnancies within families, indicating that binary smoking measures are not sufficiently capturing exposure. Structural equation models indicate that both conduct disorder and oppositional defiant disorder symptoms showed unique effects of MSDP over and above family level effects. Blending high quality exposure measurement with a within-family design suggests that it is premature to foreclose the possibility of a teratologic effect of MSDP on externalizing problems. Implications and recommendations for future studies are discussed.
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA. restabrook@northwestern.edu.
authors.forename: Ryne
authors.identifier: 0000-0002-0053-2010
authors.initials: R
authors.lastname: Estabrook
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA.|Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Suena H
authors.initials: SH
authors.lastname: Massey
authors.affiliation: Department of Psychology, University of Arizona, Tucson, AZ, USA.
authors.forename: Caron A C
authors.initials: CA
authors.lastname: Clark
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Burns
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Mustanski
authors.affiliation: Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Edwin H
authors.initials: EH
authors.lastname: Cook
authors.affiliation: Department of Psychology, Illinois College, Jacksonville, IL, USA.
authors.forename: T Caitlin
authors.initials: TC
authors.lastname: O'Brien
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Makowski
authors.affiliation: Departments of Psychology and Psychiatry, University of Arizona, Tucson, AZ, USA.|Office for Research & Economic Development, University of Nebraska-Lincoln, Lincoln, NE, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Espy
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair Street, 19th Floor, Chicago, IL, 60611, USA.|Institute for Policy Research, Northwestern University, Evanston, IL, USA.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Wakschlag
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000235:genetics*; D005190:Family; D005260:Female; D005824:Genetics, Behavioral; D006801:Humans; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000235:genetics*; D012907:Smoking / Q000009:adverse effects*; D018600:Teratology
keywords: Child development; Externalizing disorders; Maternal smoking during pregnancy; Multivariate Analyses; Within-family designs