Mothers who smoke during pregnancy (SDP) put themselves and their unborn children at risk for a variety of health issues. Existing research has indicated that smoking can increase the rate of psychological problems for children, and, in particular, increase the odds of conduct and oppositional defiance problems and attention deficit hyperactivity (ADHD). Other studies have suggested that in addition to behavioral problems, internalizing is another byproduct of being exposed to maternal smoking in utero.
Mental health conditions, including anxiety and depression, have been associated with maternal smoking in some research. However, until now, there has been little focus on the link between maternal SDP and psychotropic medication use in children. Determining how many children take medication for psychological issues could provide evidence of a stronger link between SDP and mental health issues.
To look into this further, Lovisa Soderstrom of the Department of Clinical Sciences and the Faculty of Medicine at Lund University in Sweden recently conducted an analysis on population data from Sweden involving over 570,000 children. The data revealed that of that sample, nearly 40,000 were taking psychotropic medication and over 4,000 on medication had been exposed to maternal SDP.
Soderstrom did find a strong association between the number of cigarettes and psychotropic medication. Specifically, mothers who smoked more than 10 cigarettes per day had children more likely to be on medication for psychological problems than those who smoked less or did not smoke at all during pregnancy. However, when Soderstrom looked at other factors, including genetic and environmental, by examining sibling traits, the association was significantly weakened. In fact, the genetic predisposition and low economic status of the children put them at greater risk for mental health problems than did maternal smoking.
This suggests that although maternal smoking is a major public health concern and can have some indirect impact on mental health issues in children, the direct effects of maternal SDP and psychological problems in children are still tenuous at best. Reducing psychotropic drug use in children may not be best achieved by focusing smoking prevention efforts on pregnant mothers. “Rather,” says Soderstrom, “there seems to be a need for more complex strategies, with support for socioeconomically weak families and parents with psychiatric disease.”
Söderström, L., Perez-Vicente, R., Juárez, S., Merlo, J. (2013). Questioning the Causal Link between Maternal Smoking during Pregnancy and Offspring Use of Psychotropic Medication: A Sibling Design Analysis. PLoS ONE 8(5): e63420. doi:10.1371/journal.pone.0063420
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