D'Onofrio Brian M, Rickert Martin E, Langström Niklas, Donahue Kelly L, Coyne Claire A, Larsson Henrik, Ellingson Jarrod M, Van Hulle Carol A, Iliadou Anastasia N, Rathouz Paul J, Lahey Benjamin B, Lichtenstein Paul
Department of Psychological and Brain Sciences, Indiana University, Bloomington, 47405, USA.
Arch Gen Psychiatry. 2012 Nov;69(11):1140-50. doi: 10.1001/archgenpsychiatry.2011.2107.
Previous epidemiological, animal, and human cognitive neuroscience research suggests that maternal smoking during pregnancy (SDP) causes increased risk of substance use/problems in offspring.
To determine the extent to which the association between SDP and offspring substance use/problems depends on confounded familial background factors by using a quasi-experimental design.
We used 2 separate samples from the United States and Sweden. The analyses prospectively predicted multiple indices of substance use and problems while controlling for statistical covariates and comparing differentially exposed siblings to minimize confounding.
Offspring of a representative sample of women in the United States (sample 1) and the total Swedish population born during the period from January 1, 1983, to December 31, 1995 (sample 2).
Adolescent offspring of the women in the National Longitudinal Survey of Youth 1979 (n = 6904) and all offspring born in Sweden during the 13-year period (n = 1,187,360).
Self-reported adolescent alcohol, cigarette, and marijuana use and early onset (before 14 years of age) of each substance (sample 1) and substance-related convictions and hospitalizations for an alcohol- or other drug-related problem (sample 2).
The same pattern emerged for each index of substance use/problems across the 2 samples. At the population level, maternal SDP predicted every measure of offspring substance use/problems in both samples, ranging from adolescent alcohol use (hazard ratio HR, 1.32 [95% CI, 1.22-1.43]; HR(high), 1.33 [1.17-1.53]) to a narcotics-related conviction (HR(moderate), 2.23 [2.14-2.31]; HR(high), 2.97 [2.86-3.09]). When comparing differentially exposed siblings to minimize genetic and environmental confounds, however, the association between SDP and each measure of substance use/problems was minimal and not statistically significant.
The association between maternal SDP and offspring substance use/problems is likely due to familial background factors, not a causal influence, because siblings have similar rates of substance use and problems regardless of their specific exposure to SDP.
以往的流行病学、动物及人类认知神经科学研究表明，孕期母亲吸烟（SDP）会增加后代物质使用/问题的风险。
通过使用准实验设计，确定SDP与后代物质使用/问题之间的关联在多大程度上取决于混杂的家族背景因素。
我们使用了来自美国和瑞典的两个独立样本。分析前瞻性地预测了物质使用和问题的多个指标，同时控制统计协变量，并比较暴露情况不同的兄弟姐妹以尽量减少混杂因素。
美国女性代表性样本的后代（样本1）以及1983年1月1日至1995年12月31日期间在瑞典出生的所有人口（样本2）。
1979年全国青少年纵向调查中女性的青春期后代（n = 6904）以及瑞典在这13年期间出生的所有后代（n = 1,187,360）。
自我报告的青少年酒精、香烟和大麻使用情况以及每种物质的早发（14岁之前）情况（样本1），以及与酒精或其他药物相关问题的物质相关定罪和住院情况（样本2）。
两个样本中物质使用/问题的每个指标都呈现出相同的模式。在总体水平上，母亲的SDP预测了两个样本中后代物质使用/问题的各项指标，范围从青少年酒精使用（风险比[HR]（中度），1.32 [95%置信区间，1.22 - 1.43]；HR（高度），1.33 [1.17 - 1.53]）到与麻醉品相关的定罪（HR（中度），2.23 [2.14 - 2.31]；HR（高度），2.97 [2.86 - 3.09]）。然而，当比较暴露情况不同的兄弟姐妹以尽量减少遗传和环境混杂因素时，SDP与物质使用/问题的各项指标之间的关联极小且无统计学意义。
母亲的SDP与后代物质使用/问题之间的关联可能归因于家族背景因素，而非因果影响，因为无论兄弟姐妹对SDP的具体暴露情况如何，他们的物质使用和问题发生率相似。
