Prenatal exposure to maternal and paternal smoking on attention deficit hyperactivity disorders symptoms and diagnosis in offspring

Abstract

The study examined the effect of maternal and paternal smoking during pregnancy on the child's inattention and hyperactivity/impulsivity symptoms, and the risk for attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Generalized estimating equations, incorporating data from multiple informants (parents and teachers), was used to evaluate levels of ADHD as a function of parental smoking. The risk for ADHD, ODD, and comorbid ADHD and ODD was evaluated using polytomous logistic regression. We found that maternal, but not paternal, smoking was significantly associated with elevated inattention, hyperactivity/impulsivity, and total ADHD symptoms in children. Children of smoking, relative to nonsmoking, mothers had a significant increased risk for comorbid ADHD and ODD and ADHD, but not ODD. Although father's smoking was not associated with an increased risk, as it strongly influenced mothers' smoking, intervention for both parents may be most effective in preventing the pathway to ADHD-related problems in the children.

FIGURE 1

Inattention, hyperactivity/impulsivity, and total ADHD scores as a function of maternal and paternal smoking during pregnancy. Differences in inattention, hyperactivity, and total ADHD scores among 4 groups of offspring by parental smoking status (nether parents smoked, only father smoked, only mother smoked, and both parents smoked) after controlling for age, gender, race, SES, birth weight, maternal drinking during pregnancy, mother’s and father’s ADHD symptoms. The reference group was offspring with neither parents smoked. Information provided by multiple informants (parents and teachers) was incorporated into the analysis.