Wakschlag Lauren S, Pickett Kate E, Kasza Kristen E, Loeber Rolf
Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, IL 60608, USA.
J Am Acad Child Adolesc Psychiatry. 2006 Apr;45(4):461-7. doi: 10.1097/01.chi.0000198597.53572.3e.
Prenatal smoking is robustly associated with increased risk of conduct problems in offspring. Observational studies that provide detailed phenotypic description are critical for generating testable hypotheses about underlying processes through which the effects of prenatal smoking may operate. To this end, we use a developmental framework to examine the association of exposure with (1) oppositional defiant disorder and attention-deficit/hyperactivity disorder in young boys and (2) the pattern of delinquent behavior at adolescence.
Using diagnostic measures and repeated measures of delinquency, we compare exposed and nonexposed boys from the youngest cohort of the Pittsburgh Youth Study (N = 448).
Exposed boys were significantly more likely to (1) develop oppositional defiant disorder and comorbid oppositional defiant disorder-attention-deficit/hyperactivity disorder but not attention-deficit/hyperactivity disorder alone and (2) to have an earlier onset of significant delinquent behavior.
The early emergence and developmental coherence of exposure-related conduct problems is striking and is consistent with a behavioral teratological model. Phenotypically, exposure-related conduct problems appear to be characterized by socially resistant and impulsively aggressive behavior. Whether prenatal smoking plays an etiological role in or is a risk marker for the development of conduct problems, exposed offspring are at increased risk of an early-starter pathway to conduct problems.
产前吸烟与后代出现行为问题的风险增加密切相关。提供详细表型描述的观察性研究对于生成关于产前吸烟影响可能起作用的潜在过程的可检验假设至关重要。为此，我们使用一个发育框架来研究暴露与以下方面的关联：（1）年幼儿童中的对立违抗障碍和注意力缺陷多动障碍；（2）青少年期的犯罪行为模式。
我们使用诊断措施和对犯罪行为的重复测量，比较了匹兹堡青年研究中最年轻队列的暴露组和非暴露组男孩（N = 448）。
暴露组男孩更有可能：（1）患上对立违抗障碍以及共病对立违抗障碍 - 注意力缺陷多动障碍，但单独患上注意力缺陷多动障碍的可能性不大；（2）更早出现显著的犯罪行为。
与暴露相关的行为问题的早期出现和发展连贯性令人瞩目，且与行为致畸模型一致。从表型上看，与暴露相关的行为问题似乎表现为具有社会抗拒性和冲动攻击性的行为。无论产前吸烟在行为问题的发展中是起病因作用还是风险标志物作用，暴露的后代都有更高的风险走上早期出现行为问题的途径。
