Prenatal Exposure to Environmental Tobacco Smoke and Early Development of Children in Rural Guizhou Province, China

Abstract

Background: There is a substantial body of evidence supporting the association between maternal active smoking during pregnancy and child development, but the association between prenatal exposure to environmental tobacco smoke (ETS) and early child development has not been well documented. This cross-sectional study examines the association between prenatal exposure to ETS and the development of children in their first two years of life. Methods: We interviewed the primary caregivers of 446 children under two years old in rural Guizhou Province, China. Based on self-reported assessments about whether the mother was exposed to ETS during pregnancy, we divided the children into the ETS-exposed group or the non-exposed group. Sociodemographic information was collected through a questionnaire. The cognitive, language, motor, and socioemotional abilities of children were assessed using the Bayley Scales of Infant Development III (BSID-III). A multivariate linear regression model adjusting for confounding variables was used to estimate the association of interest. Results: About 60% of mothers experienced ETS exposure during pregnancy. Cognitive and language scores were lower among children in the ETS-exposed group. When adjusting for characteristics of the child, the mother, the household, and village fixed effects, prenatal exposure to ETS was associated with lower cognition scores (−3.41; 95% confidence interval (CI): −6.39 to −0.42; p = 0.03) and language scores (−3.01; 95% CI: −5.39 to −0.09; p = 0.04). Frequency of prenatal exposure to ETS was also negatively associated with language development (−0.48; 95% CI: −0.87 to −0.09; p = 0.02) before children reached two years old. Conclusions: Prenatal exposure to ETS is negatively associated with the cognitive and language development of rural young children within their first two years of life. The government should take action to raise public awareness about the negative effects of tobacco use, with an emphasis on the protection of pregnant women and their children, in order to carry through comprehensive smoke-free laws in rural areas, while also increasing tobacco taxation.

Maternal health behaviors during pregnancy in rural Northwestern China

“…Although we did not survey rates of active and passive smoking among our sample, previous studies have shown that in rural China, rates of smoking among men are much higher than among women (59% compared to 2%), suggesting that the majority of tobacco exposure in our sample may be due to secondhand smoke [ 21 ]. This is corroborated by past studies which have found that about 60% of rural mothers are exposed to secondhand smoke during pregnancy [ 26 ]. These findings suggest a lack of knowledge regarding the dangers of tobacco exposure during pregnancy, despite the substantial body of literature linking prenatal tobacco exposure to poor outcomes at birth and in childhood [ 7 , 55 , 56 ].…”

“…Given the significant relationship between maternal education and health behaviors, policy makers and practitioners should develop maternal health education campaigns, focusing on nutrition and tobacco exposure during pregnancy, to improve maternal and fetal health in utero. He [26] Román [55] Hernández-Martínez [7] Rodriguez [62] Alcohol consumption Affects child brain development, damages selective brain structures, and increases the risk of growth retardation; Mothers who consumed alcohol during pregnancy were also at elevated risk of experiencing placental abruption…”

“…Although previous studies have filled an important need in describing unhealthy maternal behavior in rural China [25][26][27], there are several gaps in the literature to date. First, current studies are not comprehensive, focusing on only one or a few maternal behaviors and, in some analyses, without much detail or depth.…”

Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba’ah Study

“…The prevalence of prenatal smoking in France and Iceland were considerably higher than the 1.5% and 0.7% of the current cohort that self-reported smoking before and during pregnancy, respectively. In summary, our study revealed that more than a third of pregnant women from the Emirati population were exposed to ETS, which is lower than China (60.5%) [ 33 ] and France (43.0%) [ 31 ], but higher than the United States (23.0%) [ 30 ].…”

DNA Methylation as a Potential Mediator of the Association Between Prenatal Tobacco and Alcohol Exposure and Child Neurodevelopment in a South African Birth Cohort

“…Several studies have investigated the association between PTE and PAE and neurodevelopment and related disorders [51][52][53] . One study (N=446) conducted in a rural region of China in children with an average age of 15 months found that prenatal exposure to tobacco smoke was associated with neurodevelopmental delay in the cognitive and language domains, assessed using the BSID-III 54 . While we did find evidence of an association between PTE and cognitive development, associations with language development were not statistically significant, although it may be difficult to detect language differences as early as 6 months 41,55 .…”