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Maternal smoking during pregnancy and physical control and coordination among offspring
  1. Matz Larsson1,2,
  2. Scott M Montgomery3,4,5
  1. 1Department of Respiratory Medicine, Örebro University Hospital, Örebro, Sweden
  2. 2The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3Clinical Epidemiology and Biostatistics Unit, Örebro University Hospital, Örebro, Sweden
  4. 4Department of Primary Care and Public Health, Charing Cross Hospital, Imperial College, London, UK
  5. 5Clinical Epidemiology Unit, Department of Medicine at Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Matz Larsson, Department of Respiratory Medicine, Örebro University Hospital, Örebro SE-701 85, Sweden; matz.larsson{at}


Background To examine if smoking during pregnancy is associated with poorer motor competence among offspring, indicating impaired neurological function. The measures may be less susceptible to socioeconomic confounding than cognition tests.

Methods Data were from 13 207 members of the National Child Development Study, born in Great Britain in 1958. Maternal smoking during pregnancy was recorded prospectively. Tests of physical control and coordination administered by a school doctor at age 11 years were: time to pick up 20 matches (PUM), number of squares marked (NSM) and copying designs (CD). PUM and NSM were tested for left and right hand. Test scores were dependent variables in linear regression analysis, with adjustment for maternal smoking during pregnancy, sex, birth weight standardised for gestational age, breast-feeding, social class, parental education, mother's age, laterality and pubertal development.

Results After adjustment, heavy smoking during pregnancy was statistically significantly associated with PUM (non-dominant hand) and CD, but not NSM; particularly among boys. The regression coefficients (and 95% CI) for PUM (non-dominant hand) are 1.474 (0.47 to 2.48, p=0.004) and 1.203 (0.15 to 2.26, p=0.026) for boys and girls, respectively: higher scores indicate poorer performance. The coefficients for CD are −0.185 (−0.32 to −0.05, p=0.006) for boys and 0.020 (−0.11 to 0.15, p=0.753) for girls: lower scores indicate poorer performance.

Conclusions Smoking during pregnancy is associated with subtly reduced motor competence, particularly on the non-dominant side. Statistically significant effect modification by sex was observed for only one test, providing equivocal evidence of a sex difference.

  • Child development
  • neurology
  • reproductive health
  • smoking and pregnancy
  • socioeconomic

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  • Funding SMM received funding from Economic and Social Research Council grant RES – 596-28-0001 to the International Centre for Life-Course Studies in Society and Health.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.