Prenatal smoking exposure and psychiatric symptoms in adolescence

AIM Explore associations between smoking in pregnancy and psychiatric symptoms in the adolescent offspring. DESIGN/SUBJECTS A prospective population based follow-up of 84 adolescents at 14 years of age, of whom 32 of the mothers reported smoking during pregnancy. MAIN OUTCOME MEASURES The Achenbach System of Empirically Based Assessment (ASEBA), ADHD-Rating Scale IV, Autism Spectrum Screening Questionnaire (ASSQ), Children's Global Assessment Scale (CGAS), estimated IQ based on four subscales of WISC-III. RESULTS Adolescents who were born by smokers had significantly more rule-breaking and aggressive behaviour, externalizing and total problems on the ASEBA than adolescents of non-smokers (p < 0.01), when reported by mothers, fathers and teachers. ADHD symptoms were reported more frequently (p < 0.05), and mothers also reported more internalizing symptoms (p < 0.05) and social problems (p < 0.001). The ASSQ sum score was higher (p < 0.001), and overall function as measured by the CGAS was lower (p < 0.01) for the smoking-exposed group. Associations were still present after controlling for possible confounding factors. CONCLUSION Adolescents exposed to prenatal smoking had higher scores for both externalizing and internalizing psychiatric symptoms, which could not be explained by a broad range of possible psychosocial confounders. Thus, smoking in pregnancy may be a marker for increased risk of psychiatric symptoms in the offspring.