ARTICLES
Is Prenatal Smoking Associated With a Developmental Pattern of Conduct Problems in Young Boys?

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ABSTRACT

Objective

Prenatal smoking is robustly associated with increased risk of conduct problems in offspring. Observational studies that provide detailed phenotypic description are critical for generating testable hypotheses about underlying processes through which the effects of prenatal smoking may operate. To this end, we use a developmental framework to examine the association of exposure with (1) oppositional defiant disorder and attention-deficit/hyperactivity disorder in young boys and (2) the pattern of delinquent behavior at adolescence.

Method

Using diagnostic measures and repeated measures of delinquency, we compare exposed and nonexposed boys from the youngest cohort of the Pittsburgh Youth Study (N = 448).

Results

Exposed boys were significantly more likely to (1) develop oppositional defiant disorder and comorbid oppositional defiant disorder-attention-deficit/hyperactivity disorder but not attention-deficit/hyperactivity disorder alone and (2) to have an earlier onset of significant delinquent behavior.

Conclusions

The early emergence and developmental coherence of exposure-related conduct problems is striking and is consistent with a behavioral teratological model. Phenotypically, exposure-related conduct problems appear to be characterized by socially resistant and impulsively aggressive behavior. Whether prenatal smoking plays an etiological role in or is a risk marker for the development of conduct problems, exposed offspring are at increased risk of an early-starter pathway to conduct problems.

Section snippets

Participants

The PYS is a representative, school-based sample of boys from the Pittsburgh area, with oversampling for delinquency risk. This sample and procedures are described extensively elsewhere (Loeber et al., 1998). The analytical sample for the present study is based on the youngest cohort of the PYS and consists of the 448 boys with complete information on maternal smoking during pregnancy (89% of the original cohort). There were no significant differences in rates of DBDs, race/ethnicity, or

RESULTS

Characteristics of the mothers and youths in the sample are presented in Table 1. Thirty-seven percent of the mothers smoked regularly during pregnancy (60% of these smoked more than half a pack per day). Slightly more than half of the sample was African American. Exposed boys had higher levels of risk in all domains: Their mothers were more likely to be single parents, have no more than a high school education, have police contact, use frequent physical punishment, and use alcohol and illicit

DISCUSSION

To our knowledge, this is the first study to use a prospective, population-based sample to examine the association of maternal smoking during pregnancy to ODD in young children and to the developmental timing and pattern of delinquency. In the present sample, exposed first-grade boys had more than double the risk of ODD compared with nonexposed boys, with a host of potential confounds controlled. In concert with the pattern of delinquent behavior demonstrated in exposed boys (earlier onset and

REFERENCES (38)

  • Dukic V, Neissner M, Benowitz N, Hans S, Wakschlag L (submitted), Modeling the relationship of cotinine and...
  • M Ernst et al.

    Behavioral and neural consequences of prenatal exposure to nicotine

    J Am Acad Child Adolesc Psychiatry

    (2001)
  • D Fergusson

    Prenatal smoking and antisocial behavior

    Arch Gen Psychiatry

    (1999)
  • C Gibson et al.

    Assessing the relationship between maternal cigarette smoking during pregnancy and age at first police contact

    Justice Q

    (2000)
  • B Lahey et al.

    Attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder and adult antisocial behavior: a life span perspective

  • B Lahey et al.

    Are attention-deficit/hyperactivity disorder and oppositional defiant disorder developmental precursors to conduct disorder?

  • R Loeber et al.

    Antisocial Behavior and Mental Health Problems: Explanatory Factors in Childhood and Adolescence

    (1998)
  • R Loeber et al.

    Developmental pathways in disruptive child behavior

    Dev Psychopathol

    (1993)
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      A recent study by Korhonen et al. (2012) showed maternal prenatal depression to be associated with adolescent boys’ (but not girls) poor psychosocial functioning and with externalizing problems. Maternal smoking during pregnancy is another prenatal event that has consistently been linked with an increased risk of externalizing behaviors such as ADHD and conduct disorder among offspring (Indredavik et al., 2006; Nigg et al., 2007; Stene-Larsen et al., 2009; Schmitz et al., 2006; Wakschlag et al., 2006). Taylor et al. (2017) recently compared the associations of maternal smoking during pregnancy and mother's partner's smoking during pregnancy with offspring depression using four large data sets from the UK, Sweden, Brazil, and Norway.

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    The Pittsburgh Youth Study (PYS) was supported by grants from the National Office of Juvenile Justice and Delinquency Prevention (96-MU-FX-0012) and National Institute of Mental Health (MH 50778) . Manuscript preparation was also supported by National Institute on Drug Abuse grants 1R01 DA015223 to Dr. Wakschlag and 1R03 DA14334 to Dr. Pickett and the Walden and Jean Young Shaw Foundation and the Irving B. Harris Center for Developmental Studies. The vital contributions of Magda Stouthamer-Loeber, Ph.D., to the PYS are gratefully acknowledged. The authors are most appreciative of critical feedback from our colleagues, Bennett Leventhal, M.D., Edwin Cook, Jr., M.D., and Daniel Pine, M.D.

    Portions of this article were presented at the Meetings of the American Public Health Association, Boston, November 2000.

    Disclosure: The authors have no financial relationships to disclose.

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