Prenatal tobacco exposure, birthweight, and offspring psychopathology.
Although prenatal tobacco exposure (PTE) is associated with several adverse offspring mental health outcomes, mechanisms remain unclear. We test whether associations between PTE and offspring psychopathology are explained by birthweight, one of the earliest-occurring outcomes of PTE. The analysis focuses on 238 offspring from a family study of depression with (1) collected prenatal histories and (2) at least one clinical interview in adulthood to assess psychiatric problems. Exposure was categorized by maternal smoking of ≥10 cigarettes daily/nearly daily; diagnostic outcomes were confirmed by clinicians using the best-estimate procedure, blind to exposure. After adjusting for potential confounders, PTE was associated with 0.7lb(9%) lower birthweight (p=0.0002), increased rates of disruptive behavior disorders [males: OR=2.66(1.15,6.16), and (trend) substance use disorders [females: OR=2.23(0.98,5.09)], and decreased rates of mood disorders (males: OR=0.42(0.17,0.98)]. Birthweight was not independently associated with diagnoses and did not mediate the association between exposure and psychopathology. Maternal smoking has long-term adverse consequences for offspring. Although birthweight cannot be manipulated, smoking is a modifiable risk factor. Thus, cessation efforts focused on pregnant women may not only improve maternal wellbeing, but also mitigate adverse proximal (e.g., birthweight) and long-term (psychopathology) outcomes in offspring.
Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Sackler Institute for Developmental Psychobiology, Columbia University, New York, NY, USA. Electronic address: talatia@nyspi.columbia.edu.
Ardesheer
A
Talati
Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Biostatistics, Mailman School of Public Health of Columbia University, New York, NY, USA. Electronic address: wickramp@nyspi.columbia.edu.
Priya J
PJ
Wickramaratne
University of Southern Denmark, Odense, Denmark. Electronic address: rwesselhoeft@health.sdu.dk.
Rikke
R
Wesselhoeft
Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Departments of Epidemiology and Biostatistics, Mailman School of Public Health of Columbia University, New York, NY, USA; Sackler Institute for Developmental Psychobiology, Columbia University, New York, NY, USA. Electronic address: mmw3@columbia.edu.
Myrna M
MM
Weissman
D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D065886:Neurodevelopmental Disorders / Q000139:chemically induced*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D011599:Psychopathology; D012307:Risk Factors; D000073869:Tobacco Smoking / Q000009:adverse effects*
Birthweight; Externalizing disorders; Gestational exposure; Nicotine