Maternal Smoking During Pregnancy and ADHD: A Comprehensive Clinical and Neurocognitive Characterization

Evidence from epidemiological studies has consistently shown an association between maternal smoking during pregnancy (MSDP) and attention-deficit/hyperactivity disorder (ADHD). The objective of this study is to test the hypothesis that children with ADHD exposed to MSDP show a distinctive clinical...

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Bibliographic Details
Published in:Nicotine & tobacco research 2013-01, Vol.15 (1), p.149-157
Main Authors: Thakur, Geeta A., Sengupta, Sarojini M., Grizenko, Natalie, Schmitz, Norbert, Pagé, Véronique, Joober, Ridha
Format: Article
Language:English
Subjects:
Adult
Alcohol Drinking
Attention Deficit Disorder with Hyperactivity - epidemiology
Attention Deficit Disorder with Hyperactivity - psychology
Child
Female
Humans
Intelligence Tests
Linear Models
Male
Maternal Age
Neuropsychological Tests
ORIGINAL INVESTIGATIONS
Pregnancy
Prenatal Exposure Delayed Effects
Smoking - adverse effects
Social Class
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Summary:Evidence from epidemiological studies has consistently shown an association between maternal smoking during pregnancy (MSDP) and attention-deficit/hyperactivity disorder (ADHD). The objective of this study is to test the hypothesis that children with ADHD exposed to MSDP show a distinctive clinical and neurocognitive profile when compared with unexposed children. Four hundred and thirty-six children diagnosed with ADHD were stratified by exposure to MSDP and compared with regard to severity of illness, comorbidity, IQ, and executive function as assessed by a battery of neuropsychological tests. All comparisons were adjusted for socioeconomic status, ethnicity, mother's age at child's birth, and maternal alcohol consumption during pregnancy. Exposed children had more severe behavioral problems with greater externalizing symptoms and more conduct and oppositional defiant disorder items, lower verbal IQ, and a sluggish cognitive profile on the Continuous Performance Test (CPT). Linear regression analyses revealed a dose-response relationship between the average number of cigarettes smoked per day during pregnancy and verbal IQ, CPT omission errors T score and several other clinical variables. These results suggest that MSDP is associated with a more severe form of ADHD, characterized by more severe clinical manifestations and poorer neuropsychological performance. This phenotypic signature associated with MSDP may help to identify a more homogenous subgroup of children with ADHD.
ISSN:1462-2203
1469-994X
DOI:10.1093/ntr/nts102