Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia.
Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.
J Psychiatr Res. 2021 Oct;142:1-8. doi: 10.1016/j.jpsychires.2021.07.030. Epub 2021 Jul 20.
Emerging epidemiological evidence suggests that offspring born to mothers who smoked tobacco during pregnancy may have elevated risk of developing conduct disorder (CD) symptoms. We examined associations between maternal and paternal tobacco smoking during pregnancy and CD symptoms in offspring at the age of 14 years.
We obtained data from the Raine Study, a multi-generational cohort study based in Western Australia. DSM-oriented scale of the Child Behavior Checklist (CBCL) was used to measure CD symptoms in offspring. Negative binomial regression was used to estimate the rate ratio (risks) (RR) of CD symptoms in offspring. We also produced the E-values to investigate the extent of unmeasured confounding. Paternal smoking during pregnancy was used as a proxy for environmental tobacco smoke exposure.
Complete data were available for 1747 mother-offspring and 1711 father-offspring pairs. After adjusting for potential confounders, we found elevated risks (rates) of CD symptoms in offspring born to mothers smoking tobacco during the first trimester [RR 1.52 (95 % CI: 1.24-1.87)], third trimester [RR 1.36 (95 % CI: 1.09-1.69)] and during both trimesters of pregnancy [RR 1.50 (95 % CI: 1.19-1.90)]. The rates of CD symptoms in offspring increased with the level of exposure to maternal smoking during pregnancy. However, we noted insufficient statistical evidence for an association between paternal smoking during pregnancy and CD symptoms in offspring.
The associations we found for maternal but not paternal smoking may suggest a biological mechanism for intrauterine tobacco exposure on the risk of CD symptoms in offspring. Early interventions assisting pregnant mothers to quit tobacco smoking, or avoid smoking initiation, have potential to contribute health benefits to both mothers and their offspring.
新兴的流行病学证据表明，母亲在怀孕期间吸烟的子女患品行障碍（CD）症状的风险可能会升高。我们研究了母亲和父亲在怀孕期间吸烟与 14 岁子女 CD 症状之间的关联。
我们从澳大利亚西部的一项多代队列研究——Raine 研究中获取数据。使用儿童行为检查表（CBCL）的 DSM 定向量表来衡量子女的 CD 症状。使用负二项回归来估计子女 CD 症状的率比（风险）（RR）。我们还生成了 E 值，以调查未测量混杂因素的程度。父亲在怀孕期间吸烟被用作环境烟草烟雾暴露的替代指标。
我们获得了 1747 对母子和 1711 对父女的完整数据。在调整了潜在混杂因素后，我们发现，子女出生时母亲在妊娠前三个月吸烟[RR 1.52（95%CI：1.24-1.87）]、第三个月[RR 1.36（95%CI：1.09-1.69）]和整个孕期[RR 1.50（95%CI：1.19-1.90）]都有更高的 CD 症状风险。子女 CD 症状的发生率随着母亲怀孕期间吸烟量的增加而增加。然而，我们注意到，父亲在怀孕期间吸烟与子女 CD 症状之间的关联没有足够的统计证据。
我们发现母亲吸烟与子女 CD 症状之间存在关联，但父亲吸烟与子女 CD 症状之间没有关联，这可能表明宫内烟草暴露对子女 CD 症状风险的生物学机制。早期干预措施协助孕妇戒烟或避免吸烟开始，有可能对母亲及其子女的健康都带来益处。
