期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 168, 期 5, 页码 522-531出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwn175
关键词
child; child development; cognition; growth; intelligence; pregnancy; smoking
资金
- National Research Service Award
- Harvard Training Program in Psychiatric Epidemiology and Biostatistics [T32 MH17119]
- Transdisciplinary Tobacco Use Research Center [P50 CA084719]
- National Institutes of Health
- Robert Wood Johnson Foundation
There remains considerable debate regarding the effects of maternal smoking during pregnancy on children's growth and development. Evidence that exposure to maternal smoking during pregnancy is associated with numerous adverse outcomes is contradicted by research suggesting that these associations are spurious. The authors investigated the relation between maternal smoking during pregnancy and 14 developmental outcomes of children from birth through age 7 years, using data from the Collaborative Perinatal Project (1959-1974; n = 52,919). In addition to adjusting for potential confounders measured contemporaneously with maternal smoking, the authors fitted conditional fixed-effects models among siblings that controlled for unmeasured confounders. Results from the conditional analyses indicated a birth weight difference of -85.63 g associated with smoking of >= 20 cigarettes daily during pregnancy (95% confidence interval: -131.91, -39.34) and 2.73 times' higher odds of being overweight at age 7 years (95% confidence interval: 1.30, 5.71). However, the associations between maternal smoking and 12 other outcomes studied (including Apgar score, intelligence, academic achievement, conduct problems, and asthma) were entirely eliminated after adjustment for measured and unmeasured confounders. The authors conclude that the hypothesized effects of maternal smoking during pregnancy on these outcomes either are not present or are not distinguishable from a broader range of familial factors associated with maternal smoking.
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