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Background The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children's behavioural problems is still a matter of controversy. We tested this association using data collected among a sample of children followed from pregnancy to early adolescence (age 11.5 years), accounting for multiple parents’, children's and family characteristics. Methods Data come from 1424 mother-child pairs participating in the EDEN mother-child cohort set up in France. Using repeated measures (3, 5.5, 8 and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children's emotional and behavioural difficulties. Two aspects of maternal smoking were studied: the timing and the level of use (cigarettes/day) during the first trimester of pregnancy. Multinomial regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique. Results Contrary to bivariate analyses, in propensity score-controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioural difficulties. Maternal heavy smoking (≥10cigarettes/day) remained significantly associated with intermediate levels of overall emotional and behavioural difficulties (OR 1.64, 95%CI 1.04-2.58) and conduct problems (OR 3.05 95%CI 1.22-7.61), as well as with high levels of conduct problems symptoms (OR 2.82 95%CI 0.88-9.06) - although the latter did not reach statistical significance. Conclusions The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties appears to be largely explained by women's other characteristics. However, maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics. Key messages • The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties seem largely explained by the family's socio-demographic and behavioural characteristics. • Maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.

Introduction. L’objectif de cette étude était d’identifier les facteurs associés à la qualité de vie des parents d’enfants souffrant de troubles du neurodéveloppement (TND) en utilisant un questionnaire validé de qualité de vie Par-DD-QoL. Méthode. Cette étude quantitative descriptive et analytique a porté sur 130 parents d’enfants atteints de troubles du neurodéveloppement en Île-de-France entre janvier et mai 2019. Résultats. Les facteurs identifiés en analyse multivariée comme améliorant significativement la qualité de vie des parents étaient : le fait d’être en couple et d’être soutenus par leur médecin traitant. Il existait une association significativement défavorable sur la qualité de vie des parents avec les facteurs suivants : le fait d’avoir un enfant atteint de troubles du spectre de l’autisme au sein des différents TND, le délai long jusqu’au diagnostic et le niveau d’études parental élevé. Conclusion. Le soutien des parents par le médecin traitant ainsi que la vie de couple semblent avoir un impact positif sur leur qualité de vie. Cette étude confirme l’importance de l’accompagnement des parents face au TND de leur enfant par le médecin généraliste.

BackgroundSmoking during pregnancy (SDP) is an important source of preventable morbidity and mortality for both mother and child.ObjectivesThe aim of this study was to describe changes in the prevalence of SDP over the last 25 years in developed countries (Human Development Index >0.8 in 2020) and associated social inequalities.Data sourcesA systematic review was conducted based on a search in PubMed, Embase and PsycInfo databases and government sources. Study selection and data extraction: Published studies between January 1995 and March 2020, for which the primary outcome was to assess the national prevalence of SDP and the secondary outcome was to describe related socio‐economic data were included in the analysis. The selected articles had to be written in English, Spanish, French or Italian.SynthesisThe articles were selected after successive reading of the titles, abstracts and full‐length text. An independent double reading with intervention of a third reader in case of disagreement allowed including 35 articles from 14 countries in the analysis.ResultsThe prevalence of SDP differed across the countries studied despite comparable levels of development. After 2015, the prevalence of SDP ranged between 4.2% in Sweden and 16.6% in France. It was associated with socio‐economic factors. The prevalence of SDP slowly decreased over time, but this overall trend masked inequalities within populations. In Canada, France and the United States, the prevalence decreased more rapidly in women of higher socio‐economic status, and inequalities in maternal smoking were more marked in these countries. In the other countries, inequalities tended to decrease but remained significant.ConclusionsDuring pregnancy, that is a period described as a window of opportunity, smoking and social vulnerability factors need to be detected to implement targeted prevention strategies aiming at reducing related social inequalities.