Table 2.
Selected human models of maternal smoking during pregnancy (MSDP).
| Authors and Publication date |
Prospective or Retrospective |
Populations species and size |
Measures | Brief results |
|---|---|---|---|---|
|
Pregnancy and Birth Outcomes | ||||
| Bada et al., (2005) | Prospective – maternal smoking data collected “during pregnancy” | Dyads recruited from the NICHD Neonatal Research Network n = 9637 mother-infant dyads |
Birth weight, intrauterine growth restriction | Maternal smoking associated with lower birth weight and intrauterine growth restriction |
| Conter et al., (1995) | Retrospective – maternal smoking data collected the 3rd or 4th day after delivery | Nationwide multicenter obstetric/pediatric survey in Italy n = 12,987 babies |
Birth weight | Maternal smoking associated with lower birth weight in dose response relationship |
| Davies & Abernethy, (1976) | Prospective – maternal smoking data collected at 36 weeks | Mother giving birth in one of two South Wales towns n = 1159 mothers |
Maternal weight gain, fetal growth | Maternal smoking associated in a dose-response fashion with lower maternal weight gain, and lower birth weights, length, and head circumference |
| D’Onofrio et al., (2003) | Unclear – presumably retrospective | Children of twins from two twin samples | Birth weight | Smoking during pregnancy covaries with offspring birth weight through a direct environmental pathway rather than genetic or shared environmental factors. |
| Knopik et al., (2005) | Retrospective – maternal smoking data collected in mothers of twins aged 11–19 years | Adolescent female twins pairs n = 1936 twin pairs |
DSM-IV ADHD, low birth weight | No evidence for maternal smoking effects on ADHD status when covariates included. Maternal smoking associated with low birth weight. |
| Kyrklund-Blomberg et al., (2005) | Prospective – maternal smoking data collected at first antenatal visit (usually before week 15) | All singleton births in two Swedish hospitals were examined for very preterm birth n = 295 |
Very preterm births (between 22 and 32 weeks) | Dose dependent association between maternal smoking and very preterm birth. |
| Meyer et al., (2004) | Prospective – maternal smoking data collected at first antenatal visit (typically weeks 8–12) | All cases in Swedish Medical Birth Registry between 1983 and 1997 with cleft palate or cleft lip excluding multiple births, immigrants, those with missing smoking data and recurrent cleft births and controls n = 872 with cleft palate, 678 with isolated cleft palate, 1456 with cleft lip and 1175 with isolated cleft lip 10% of 128,688 noncleft births used as controls |
Cleft lip and cleft palate | Cleft palate associated with MSDP using multiple designs, cleft lip associated with MSDP only with case-control design |
| Morales-Suarez-Varela et al., (2006) | Prospective – Maternal smoking data collected at 11–25 weeks of gestation | Mothers and offspring from Danish National Cohort n = 76,768 births |
Congenital malformations using EUROCAT criteria | No association of congenital malformations with maternal smoking, children born to nonsmokers using nicotine substitutes had increased congenital malformations (especially musculoskeletal malformations) |
| Naeye, (1978) | Prospective-“during pregnancy” | Participants in the Collaborative Perinatal Project n = 53,518 pregnancies at 12 hospitals in the United States |
Birth weight, placental health, and length of pregnancy | Maternal smoking associated with lower birth weight, poorer placental health, and shorter pregnancies |
| Suzuki et al., (1980) | Prospective-100ug/kg body weight over 20 minutes during pregnancy | 8 pregnant rhesus monkeys near term | Uterine arterial blood flow | Nicotine decreases uterine arterial blood flow |
|
Infant and Toddler Outcomes | ||||
| Baghurst et al., (1992) | Prospective –maternal smoking data collected at first antenatal visit, 32nd week of gestation, and after birth | Offspring of women enrolled in the Port Pirie Cohort Study n = 548 children followed from birth to 4 years |
Bayley Scales of Infant Development at 2 years and McCarthy Scales of Children’s Abilities at 4 years | No significant association between maternal smoking and neuropsychological development |
| Brook et al., (2000) | Retrospective – maternal smoking data collected to mother’s of 2 year olds | Community sample of 99 toddlers and mothers. 52 smoked during pregnancy, 47 did not smoke during pregnancy | Negativity as measured by impulsivity, risk taking, and rebelliousness | Maternal smoking during pregnancy was associated with negativity |
| Fried and Makin, (1987) | Prospective – maternal smoking data collected in each trimester | Children aged 2–8 days that had participated in the Ottawa Prenatal Prospective Study n = 250 babies |
Brazelton Neonatal Behavioral Assessment Scale | Maternal smoking associated with increased tremors and poorer auditory habituation |
| Gusella and Fried, (1984) | Prospective – maternal smoking data collected in each trimester | Children aged 13 months days that had participated in the Ottawa Prenatal Prospective Study n = 84 offspring |
Bayley Mental and Motor Scales | Maternal smoking associated with decreased motor scores, poorer verbal comprehension, and poorer fine motor skills |
| Key et al., (2006) | Unclear- maternal smoking data collected within 48 hours of birth | Smoking exposed neonates and controls taken from a larger study on early language development n = 8 exposed and 8 unexposed neonates |
Newborn speech discrimination ability measured by event-related potentials | Infants of smoking mothers discriminated fewer syllables and began the discrimination process 150 ms later than matched controls. |
| Law et al., (2003) | Prospective –self report and biomarkers used during pregnancy | 27 nicotine exposed and 29 unexposed infants n = 56 mother offspring pairs |
NICU Network Neurobehavioral Scale within 48 hours of birth | Offspring of mothers who smoked were excitable, showed greater asymmetrical reflexes and more hypertonia than unexposed infants. Exposed infants also had higher scores on the stress abstinence scale in a dose response fashion. |
| Obel et al., (1998) | Prospective – Maternal smoking behavior reported at 16 weeks gestation | Singleton infants without disability n = 1871 |
Babbling abilities at home visit lasting 1–1.5 hours | Trend of dose response relationship between maternal smoking during pregnancy and the likelihood of being a nonbabbling infant was found. |
| Saxton, (1978) | Unclear when assessed | 15 smokers and 17 nonsmokers | Brazelton Neonatal Behavioural Assessment Scale | Prenatally exposed children exhibited decrements to bell, and deficits in inanimate orientation (auditory), animate orientation (auditory), and consolability |
| Childhood outcomes | ||||
| Batstra et al., (2003) | Prospective – maternal smoking data collected during pregnancy | Subsamples of the Groningen Perinatal Project were identified and re-examined at age 5.5 – 11 years n = 1186 singleton births |
Reading spelling and arithmetic and parent and teacher ratings of attention and level of internalizing/externalizing | Children of mothers who smoked showed increased attention problems, externalizing behavior, and did worse on arithmetic and spelling tasks |
| Bauman et al., (1991) | Prospective – maternal smoking data collected “during pregnancy” | 9–11-year old children who participated in the Child Health and Development Studies n = varies between 1745 and 3260 by longitudinal timepoint |
Peabody Picture Vocabulary Test, Raven Coloured Progressive Matrices Test, Goodenough-Jarrios Drawing Test, and Quick test | Offspring of mothers who smoked during pregnancy but quit afterwards did not differ on language and matrices tasks from offspring not exposed to smoking during pregnancy. However, children exposed to both MSDP and smoking after pregnancy scored lower than either group. |
| Brook et al., (2000) | Retrospective – maternal smoking data collected to mother’s of 2 year olds | Community sample of 99 toddlers and mothers. 52 smoked during pregnancy, 47 did not smoke during pregnancy | Negativity as measured by impulsivity, risk taking, and rebelliousness | Maternal smoking during pregnancy was associated with negativity |
| Cornelius et al., (2001) | Prospective – maternal smoking data collected from fourth prenatal month | 10 year old children n = 593 mother/offspring pairs |
Wide Range Assessment of Memory and Learning Screening, Wisconsin Card Sorting Task, Stroop and Trail making Tasks, Pediatric Assessment of Cognitive Efficiency, Grooved Pegboard. | Maternal smoking associated with deficits in verbal learning, design memory, eye hand coordination, flexible problem solving, and increases in impulsivity |
| D’Onofrio et al., (2008) | Mixed- mothers were initially assessed on smoking during pregnancy 4 years after entry into the study; mothers who had a child within these four years would be retrospective whereas those giving birth later would be prospective | Females from the National Longitudinal Survey on Youth and their children n = 11, 192 children form 4886 mothers |
Behavioral Problem Index | Although smoking during pregnancy was associated in a dose response fashion with offspring conduct problems, oppositional defiant problems or attention deficit hyperactivity problems (especially in males), the relationship between conduct problems and oppositional defiant problems were not found when examined in siblings that differed in exposure to prenatal nicotine suggesting the possibility of environmental effects that vary between families confound this relationship. |
| Eskanazi & Trupin, (1995) | Prospective – maternal smoking data collected “during pregnancy” | 5-year old children who participated in the Child Health and Development Studies n = 2,124 |
Peabody Picture Vocabulary Test, Raven Coloured Progressive Matrices Test and a behavioral rating scale | Maternal smoking during pregnancy was not significantly associated with differences on the neurobehavioral assessment |
| Fried et al., (1992a) | Prospective – maternal smoking data collected in each trimester | Children aged 6 years that had been followed in the Ottawa Prenatal Prospective Study n = 135 60-month old children and 137 72-month old children |
McCarthy Scales of Children’s Abilities and Home Observation for Measurement of the Environment (only a subset) | Maternal smoking associated with impaired cognitive and receptive language scores at both 60 and 72 months |
| Fried et al., (1992b) | Prospective – maternal smoking data collected in each trimester | Children aged 6 years that had been followed in the Ottawa Prenatal Prospective Study n = 126 children |
The Gordon Diagnostic System, sustained attention, The Sentence Memory Test, McCarthy Scales of Children’s Abilities, Target Test and Conners Parent Rating Scale | Maternal smoking was associated with poorer performance on memory tasks (in particular those with verbal recall) |
| Knopik et al., (2006) | Retrospective – maternal smoking data collected when offspring were 13–21 years old. | Australian female twin pairs where at least one twin had a history of alcohol abuse or dependence (DSM-IV) and at least one twin had children between ages of 13–21 n = 536 twin mothers (268 pairs) and 922 children |
Child ADHD assessed with items from Diagnostic Interview for Children and Adolescents and Semi-Structured Assessment of the Genetics of Alcoholism | MSDP associated with offspring ADHD but children-of-twin design suggests genetic transmission of risk for ADHD is not fully explained by MSDP |
| Lambe et al., (2006) | Prospective – maternal smoking data collection begun at first antenatal visit | 15 year old males and females n = 400,000 |
Educational achievement: grade point summary score | Maternal smoking associated with increased risk of poor scholastic achievement OR = 1.59 for 1–9 cigarettes daily, OR =1.92 for 10+ cigarettes daily. However, within mother comparisons suggested that siblings not exposed to MSDP also at increased risk for poor school performance. |
| Makin et al., (1991) | Prospective – maternal smoking data collected in each trimester | Children between the ages of 6 and 9 years that had been followed in the Ottawa Prenatal Prospective Study N = 91 children |
Test battery including Sound blending, Pegboard test, Conners parent Questionnaire, Developmental Drawings test. Peabody Picture Vocabulary Test, Wide Range, Achievement Test, and Hand Dominance | Maternal smoking associated with poorer performance on tests of speech and language skills, intelligence, visual/spatial abilities, and maternal rating of behavior |
| Maughan et al., (2004) | Retrospective-maternal smoking data collected one year after twins’ birth | High risk twin pairs at age 5 with 18-month follow-up n = 1116 twin pairs |
Conduct problems on Achenbach instruments | Prenatal smoking associated with children conduct problems at age 5 and 7 years with dose response relationship for light, moderate and heavy smokers. However, once antisocial behavior in both parents, maternal depression, familial disadvantage, and genetic influences were controlled for, the effects of MSDP were substantially reduced. |
| McCartney et al., (1994) | Prospective – assessed in each trimester | Children aged 6–11 years that had participated in the Ottawa Prenatal Prospective Study n = 110 children |
Central auditory processing task (SCAN) | Prenatal exposure associated with poorer performance on SCAN |
| Orlebeke et al, (1999) | Retrospective-maternal smoking data collected shortly after birth | 2–3 year old twin pairs from the Netherlands Twin Register n = 377 twin pairs |
Child Behavior Checklist | Association of MSDP with externalizing (especially aggression) but not internalizing behaviors |
| Sexton et al., (1990) | Prospective-maternal smoking data collected to gain entry into smoking cessation study | 3 year old offspring of mothers who smoked during pregnancy n = 366 offspring |
McCarthy Scales of Children’s Abilities and Minnesota Child Development Inventory (MCDI) | Offspring of mothers who quit smoking showed higher scores on the General Cognitive Index of the McCarthy Scales and MCDI scores compared with offspring of mothers who did not quit smoking |
| Silberg et al., (2003) | Retrospective – maternal smoking data collected when offspring were aged 8–16 years | Twins from the Virginia Twin Study of Adolescent Behavioral Development n = 1413 families |
Conduct disturbance and smoking behavior form the Child and Adolescent Psychiatric assessment | Conduct disorder related to some other variable than smoking during pregnancy |
|
Adolescent & Adult Outcomes | ||||
| Brennan et al., (1999) | Prospective – mother reported smoking behavior in third trimester | Birth cohort of 4169 males at age 34 years | Adult criminal outcomes | Dose response relationship between maternal smoking behavior and arrests for nonviolent and violent crimes (especially persistent criminal behavior. |
| Buka et al., (2003) | Prospective – maternal smoking behavior assessed at each prenatal visit | Offspring from the National Collaborative Perinatal Project n = 1248 |
DSM III nicotine and marijuana dependence | Offspring of mothers who smoked during pregnancy were more likely to develop nicotine but not marijuana dependence compared with unexposed offspring |
| Cornelius et al., (2000) | Prospective – maternal smoking data collected at fourth and seventh prenatal visit and at delivery | Low-SES birth cohort randomly sampled from an urban prenatal clinic n = 589 10-year olds |
Questions about use of tobacco, alcohol and marijuana | Association of MSDP and early tobacco experimentation in preadolescence |
| Fergusson et al (1998) | Retrospective – maternal smoking data collected at birth | 18 year old offspring followed in a longitudinal study n = 1022 children |
Mental health problems measured with Composite International Diagnostic Interview at age 18 | Offspring of mothers who smoked were more likely to have higher psychiatric symptom rates for conduct disorder, alcohol and substance abuse and depression |
| Milberger et al., (1996) | Retrospective – maternal smoking data collected at 4-year follow-up | Siblings of ADHD and non-ADHD probands n = 266 |
DSM III- R | Maternal smoking associated with ADHD, |
| Milberger et al., (1997) | Retrospective – maternal smoking data collected at 4-year follow-up | Siblings of ADHD and non-ADHD probands n = 266 |
DSM III- R | Maternal smoking associated with ADHD, CD, Major Depression and drug abuse |
| Milberger et al., (1998) | Retrospective- Maternal smoking data collected from mothers of ADHD probands and non-ADHD comparison probands (mean age of 13) | High risk-siblings ascertained through probands of ADHD and non-ADHD controls n = 174 siblings of ADHD probands and 129 siblings of non-ADHD probands |
DSM III-R diagnosis of ADHD | Association of MSDP and ADHD. Association also found after controlling for SES, parental IQ, and parental ADHD status |
| Mortensen et al., (2005) | Mixed - maternal smoking data collected during and in first few days after pregnancy | Assessment at mean age of 18.7 n = 3044 singleton males |
Intelligence assessed by Børge Priens Prøve. | Negative association of maternal smoking with intelligence in a dose-response relationship for five levels of maternal smoking. |
| Rasanen et al., (1999) | Unclear – appears to be prospective | Men from a general population cohort n = 5636 |
Criminal records | Maternal smoking associated with violent and persistent (but not nonviolent) offenses. |
| Wakschlag et al., (1997) | Retrospective – maternal smoking data collected when offspring were aged 7–12 years | A longitudinal study of boys referred to one of two university outpatient clinics n = 177 boys |
DSM-III-R using the Diagnostic Interview Schedule | Maternal smoking associated with conduct disorder |
| Wakschlag et al., (2001) | Retrospective-maternal smoking data collected when offspring were 2.5–5.5 years old | Preschoolers referred to Preschool Behavior Problems Clinic and controls n = 79 referred to clinic and 52 controls recruited from a general pediatric clinic |
DSM-IV symptoms of ODD and CD assessed using K-SADS | Disruptive behavior disorder symptoms were associated with prenatal exposure to cigarettes |
| Weissman et al., (1999) | Retrospective – maternal smoking data collected when offspring were between 6 and 23 years old | Mother offspring pairs selected for presence or absence of lifetime history of major depression in parents N = 147 offspring whose mothers reported either never smoking during pregnancy (97) or 10+ cigarettes daily during pregnancy (50) |
Schedule for Affective Disorders and Schizophrenia-Lifetime version (SADS-LA) and Peabody Picture Vocabulary Test (PPVT) | Male offspring of mothers who smoked during pregnancy had more than a 3-fold increased lifetime risk of conduct disorder, female offspring of mothers who smoked during pregnancy had a more than 5-fold increased risk of drug abuse/dependence |