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Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behav

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(CD, ODD, co-morbid ADHD) Smoking. Substance use. Multiple, independent, cross-national samples, robust to measured confounders ... – PowerPoint PPT presentation

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Title: Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behav


1
Meaningful differences in maternal smoking
behaviour during pregnancy Implications for
infant behavioural vulnerability
  • Kate E. Pickett, Callie Wood, Joy Adamson,
    Lalitha DeSouza, Lauren Wakschlag

DEPARTMENT OF HEALTH SCIENCES
2
Maternal smoking and offspring behaviour
  • Consistent association with risk of problem
    behaviour
  • Disruptive behaviour
  • (CD, ODD, co-morbid ADHD)
  • Smoking
  • Substance use
  • Multiple, independent, cross-national samples,
    robust to measured confounders

3
Correlation or causation?
  • Does smoking play an aetiologic role
  • Is smoking a marker for intergenerational
    transmission processes associated with both
  • tendency to smoke
  • risk of offspring with problem behaviour

4
Background work
  • A critical review of epidemiological studies
  • Empirical work
  • Estimate of the population attributable risk
  • Patterns and measurement of maternal smoking
  • Timing of onset of delinquency
  • Early onset of externalizing behaviour problems
    in toddlers
  • Individual and contextual characteristics of
    women who smoke, women who quit, women who never
    smoke

5
Competing Hypotheses
  • Is exposure to cigarette smoke associated with an
    early risk pathway?
  • Does it increase the risk of difficult
    temperament in infants?
  • Is quitting smoking associated with an early
    protective pathway?
  • Does it increase the likelihood of temperamental
    robustness in infants?

6
Study setting
  • Millennium Cohort Study
  • 18,263 mother-infant pairs
  • 9 months old, born 2000-2001
  • Sample selected from a random sample of electoral
    wards, stratified to ensure representation of all
    four UK countries, deprived areas and areas with
    high concentrations of Black and Asian families.

7
Measurement of temperament
  • 14 questions from Carey Infant Temperament Scale
  • 3 dimensions (high scoremore robust)
  • Positive mood
  • Receptivity to novelty
  • Regularity
  • Difficult temperament (scores below sample
    means)
  • Lack of positive emotionality
  • Wariness
  • Irregularity

8
Measurement of smoking etc
  • Smoking
  • Never smoked in pregnancy
  • Gave up during pregnancy
  • Continuous light smoking (lt 10/day)
  • Continuous heavy smoking (10/day)
  • Other factors
  • Birth weight, length of gestation
  • Age
  • Alcohol consumption
  • History of depression
  • History of domestic violence
  • Marital status
  • Poverty
  • Educational attainment
  • Social class
  • Ethnicity

9
Smoking in the MCS
13,038
2,320
2,098
807
10
Temperament by smoking
Overall diff. p.01 Quit vs heavy, plt .001 Never
vs heavy, p0.03
11
Adjusted effects of smoking on difficult
temperament
P0.01
P0.02
P0.01
12
Discussion
  • Martin et al (2006) found better temperament
    among infants of smokers in Finland, but included
    quitters with smokers
  • More attention needs to be paid to characterizing
    differences between pregnancy quitters and
    pregnancy smokers
  • Need to examine development over time and the
    unfolding of early vulnerabilities into problem
    behaviours

13
Adaptive problems related to smoking in the
Family Health and Development Project
Wakschlag LS, Pickett KE, Middlecamp M, Walton L,
Leventhal BLL. Pregnant smokers who quit,
pregnant smokers who cant Does history of
problem behavior make a difference? Social
Science and Medicine 2003562449-2460.
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