Maternal smoking during pregnancy and academic achievement of offspring over time: A registry data-based cohort study

Kristjánsson, Álfgeir L.; Thomas, Sabena; Lilly, Christa; Þórisdóttir, Ingibjörg Eva; Allegrante, John P.; Sigfúsdóttir, Inga Dóra

doi:10.1016/j.ypmed.2018.05.017

Cited by 42 publications

(23 citation statements)

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“…2 Cigarette smoking during pregnancy leads to many detrimental child health outcomes, including low birth weight, delayed intrauterine development, preterm birth, infant mortality, and long-term developmental delays. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13…”

Section: Introductionmentioning

confidence: 99%

Association of Maternal Cigarette Smoking and Smoking Cessation With Preterm Birth

2019

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IMPORTANCE Cigarette smoking during pregnancy increases the risk of preterm birth, low birth weight, and infant mortality. OBJECTIVE To assess the probability of preterm birth among expectant mothers who smoked cigarettes before pregnancy and quit smoking at the start or during pregnancy. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed information provided on live birth certificates from 2011 through 2017 that were obtained from US states that implemented the 2003 revision of the US live birth certificate. In total, 25 233 503 expectant mothers who delivered live neonates and had known prepregnancy and trimester-specific cigarette smoking frequency were included in the analyses. EXPOSURES Cigarette smoking frequency (1-9, 10-19, and Ն20 cigarettes per day) 3 months prior to pregnancy and for each trimester during pregnancy. MAIN OUTCOMES AND MEASURES Cigarette smoking cessation throughout pregnancy, after the first trimester, after the second trimester, and during the third trimester irrespective of first and second trimester smoking. Probability of preterm birth (<37 weeks' gestation). RESULTS Of 25 233 503 expectant mothers who delivered live neonates between 2011 and 2017, the modal age at delivery was 25 to 29 years; 52.9% were non-Hispanic white, 23.6% were Hispanic, and 14.2% were non-Hispanic black women; 22 600 196 mothers did not smoke during the 3 months prior to pregnancy, and 2 633 307 smoked during the 3 months prior to pregnancy. The proportion of prepregnancy smokers who quit throughout pregnancy was 24.3% in 2011 and 24.6% in 2017. The proportion of prepregnancy smokers who quit during the third trimester was 39.5% in 2011 and 39.7% in 2017. High-frequency cigarette smoking often occurred among expectant mothers who smoked during pregnancy (eg, 46.9% of third-trimester smokers smoked Ն10 cigarettes per day in 2017). The probability of preterm birth decreased more the earlier smoking cessation occurred in pregnancy. For example, the probability of preterm birth was 9.8% (95% CI, 9.7%-10.0%) among 25to 29-year-old, non-Hispanic white, primigravida and primiparous expectant mothers (ie, pregnant for the first time and not yet delivered) who smoked 1 to 9 cigarettes per day prior to pregnancy and maintained this frequency throughout their pregnancy. The probability of preterm birth was 9.0% (95% CI, 8.8%-9.1%) if smoking cessation occurred at the start of the second trimester (an 8.9% relative decrease), and 7.8% (95% CI, 7.7%-8.0%) if cessation occurred at the start of pregnancy (a 20.3% relative decrease). CONCLUSIONS AND RELEVANCE Quitting smoking-and quitting early in pregnancy-was associated with reduced risk of preterm birth even for high-frequency cigarette smokers.

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Section: Introductionmentioning

confidence: 99%

Association of Maternal Cigarette Smoking and Smoking Cessation With Preterm Birth

2019

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“…The majority of participants with CLA records had a mother who smoked during pregnancy, and this exposure was negatively associated with attainment. However, there is debate as to whether maternal smoking during pregnancy is a direct cause of poorer child educational attainment, or is instead a strong marker of socioeconomic disadvantage 37–39…”

Section: Discussionmentioning

confidence: 99%

Early life adversity, contact with children’s social care services and educational outcomes at age 16 years: UK birth cohort study with linkage to national administrative records

et al. 2019

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ObjectivesTo use record linkage of birth cohort and administrative data to study educational outcomes of children who are looked-after (in public care) and in need (social services involvement), and examine the role of early life factors.Setting, designProspective observational study of children from the Avon Longitudinal Study of Parents and Children (ALSPAC), which recruited pregnant women in and around Bristol, UK in the early 1990s. ALSPAC was linked to the annual Children Looked-After (CLA) Data Return and Children In Need (CIN) Census. Educational outcomes at 16 years were obtained through linkage to the National Pupil Database (NPD). These included passing 5+ good GCSEs (grades A*-C, including English and Maths). Covariates included early life adversity and social position.Participants12 868 ALSPAC participants were linked to the NPD. The sample for the main educational outcomes analyses comprised 9545 children from the ALSPAC core sample who had complete education data.ResultsOverall, of the 12 868 ALSPAC participants linked to NPD data, 137 had a CLA record and a further 209 a CIN record during adolescence. These children were more disadvantaged than their peers and had little active study participation beyond infancy. In the main educational outcomes analyses, achievement of 5+ good GCSEs was low in the CLA (OR 0.14, 95% CI 0.05 to 0.35) and CIN (0.11, 0.05 to 0.27) groups relative to their peers. Measured early life factors explained little of this difference.ConclusionsData linkage enabled the study of educational outcomes in children with social services contact. These children had substantially worse educational outcomes relative to their peers, for reasons likely to be multifactorial.

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“…In addition to these detrimental outcomes of exposure to smoking in utero, epidemiological observational evidence links prenatal smoking to increased risks of obesity, behavioral problems, conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and cognitive issues in children. [53][54][55][56][57][58][59] Recent research has revealed a dose-response relationship between maternal cotinine concentrations (indicating nicotine exposure) during pregnancy and presence of ADHD in children. 60 These associations remain even after controlling for confounding factors, such as maternal income and education and maternal and paternal ADHD diagnoses, and are linked to poor health and lower educational attainment.…”

Section: Smoking During Pregnancy Perpetuates Disparitiesmentioning

confidence: 99%

Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach

et al. 2021

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Fourteen percent of US adults use tobacco products. Because many of those who use tobacco are parents and/or caregivers, children are disproportionately exposed to tobacco smoke. People who use tobacco products often become addicted to nicotine, resulting in tobacco dependence, a chronic, relapsing disease. Tobacco use and exposure are more likely to occur in vulnerable and marginalized groups, including those living in poverty. Although some view tobacco use as a personal choice, evidence suggests that structural forces play an important role in tobacco uptake, subsequent nicotine addiction, and perpetuation of use. Viewing tobacco use and tobacco dependence through a structural competency lens promotes recognition of the larger systemic forces perpetuating tobacco use, including deliberate targeting of groups by the tobacco industry, lack of enforcement of age-for-sale laws, inferior access to health insurance and health care, poor access to cessation resources, and economic stress. Each of these forces perpetuates tobacco initiation and use; in turn, tobacco use perpetuates the user’s adverse health and economic conditions. Pediatricians are urged to view family tobacco use as a social determinant of health. In addition to screening adolescents for tobacco use and providing resources and treatment of tobacco dependence, pediatricians are encouraged to systematically screen children for secondhand smoke exposure and support family members who smoke with tobacco cessation. Additionally, pediatricians can address the structural issues perpetuating tobacco use by becoming involved in policy and advocacy initiatives.

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Maternal smoking during pregnancy and academic achievement of offspring over time: A registry data-based cohort study

Cited by 42 publications

References 42 publications

Association of Maternal Cigarette Smoking and Smoking Cessation With Preterm Birth

Association of Maternal Cigarette Smoking and Smoking Cessation With Preterm Birth

Early life adversity, contact with children’s social care services and educational outcomes at age 16 years: UK birth cohort study with linkage to national administrative records

Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach

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