IJE Advance Access originally published online on June 5, 2007
International Journal of Epidemiology 2007 36(4):825-832; doi:10.1093/ije/dym107
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Maternal smoking habits and cognitive development of children at age 4 years in a population-based birth cohort
1Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigació Mèdica (IMIM). Barcelona, Spain,
2Menorca Health Area, Ib-Salut, Menorca, Spain,
3Department of Personality, Evaluation and Psychological Treatment, University of Barcelona. Barcelona, Spain and
4Department of Experimental and Health Sciences, University of Pompeu Fabra. Barcelona, Spain.
*Corresponding author: Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d’Investigació Mèdica, C. Dr. Aiguader, 88 08003 Barcelona, Spain. E-mail: jjulvez{at}imim.es
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Abstract |
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Background Active maternal smoking during pregnancy has been associated with a higher risk of behavioural disorders in children, but a few cohort studies measuring smoking data prospectively have studied its specific effects on the cognitive abilities of pre-schoolers.
Method A birth cohort was set up in Menorca Island in 1997 within the Asthma Multicenter Infants Cohort Study. A total of 420 (87% of those eligible) children had complete data for final analyses at age 4 years. Interviewer-administered questionnaires were completed by mothers during the third trimester of pregnancy and then every year up to age 4 years of their child. A standardized version of the McCarthy Scales of Children's Abilities (MCSA) was used to evaluate the child's motor and cognitive capabilities. Multivariable regressions were used with MCSA's assessed outcomes adjusting for: home location, maternal alcohol consumption, mother's social class and level of education during pregnancy, parity, marital status, father's education level, child's gender, birth weight and height, breastfeeding duration, passive smoking, school season, age during test administration and evaluator (psychologist).
Results A high global consistency in maternal smoking habits was found (total agreement = 88.7%). Maternal social class and education level were inversely associated with maternal smoking behaviour. Maternal smoking during pregnancy (in cig./day) was associated with a decrease (in points) of children's global cognitive score [ß = –0.60, (95% CI: –1.10; –0.09)]; as well as global cognitive sub-areas like verbal score [ß = –0.59, (95% CI: –1.11; –0.07)]; quantitative score [ß = –0.57, (95% CI: –1.08; –0.06)]; executive function score [ß = –0.71, (95% CI: –1.23; –0.20)]; and working memory score [ß = –0.46, (95% CI: –0.92; –0.01)].
Conclusion Our findings suggest an association with maternal smoking during pregnancy and lowered cognitive development in children at age 4 years.
Keywords Maternal smoking habits, smoking during pregnancy, Paternal smoking habits, Cognitive development, Neurocognitive functions, Pre-school children, Populatin based study, Birth cohort
Accepted 24 April 2007
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