Posted
August, 2008
Prenatal
Exposure to Tobacco Smoke as a Predictor of Dutch Children's
Externalizing and Internalizing Problems at ages 5 to 18 Years
Numerous
studies have tested associations between maternal smoking
during pregnancy and subsequent problems of the offspring.
However, most such studies have assessed a narrow range of
problems at relatively young ages. A team of Dutch researchers
tested relations between prenatal exposure to tobacco smoke
and the CBCL Internalizing and Externalizing scores of a general
population sample of 396 children at ages 5, 10 to 11, and
18 years (Ashford et al., 2008). Because maternal smoking
may be associated with other risk factors, the researchers
used latent growth curve modeling that controlled for maternal
illness before and during pregnancy, pregnancy duration, complications
during pregnancy, child birth weight, and maternal psychopathology,
which was assessed via the Young Adult Self-Report (the predecessor
of the Adult Self-Report). In addition, to control for associations
between different kinds of problems, prediction of Internalizing
scores from maternal smoking was tested with scores for Externalizing,
Social Problems, and Attention problems partialed out. Analogously,
prediction of Externalizing scores from maternal smoking was
tested with scores for Internalizing, Social Problems, and
Attention Problems partialed out. It was found that both Internalizing
and Externalizing scores were similarly elevated among 5-
to 18-year-olds whose mothers smoked during pregnancy. In
other words, the apparent effects of maternal smoking did
not diminish as the children grew older. The authors concluded
that " . . . even after controlling for the co-occurrence
of internalizing and externalizing problems, prenatal exposure
to smoking was related to increased levels of both internalizing
and externalizing problems from ages 5 to 18 years" (p.
785). Effect sizes were in the small to medium ranges. The
authors did not control for postnatal exposure to tobacco
smoke, which may be nearly impossible to control for because
mothers who smoke during pregnancy are also likely to smoke
after their children are born. Nevertheless, the results add
to the evidence for the harmful effects of tobacco smoke on
a variety of problems over a broad age span.
Reference:
Ashford, J., van Lier, P.A.C., Timmermans, M., Cuijpers, P.,
& Koot, H.M. (2008). Prenatal smoking and Internalizing
and Externalizing problems in children studied from childhood
to late adolescence. Journal of the American Academy of
Child and Adolescent Psychiatry, 47, 779-787.
