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Maternal smoking during pregnancy and offspring intellectual disability: sibling analysis in an intergenerational Danish cohort
Journal article   Open access   Peer reviewed

Maternal smoking during pregnancy and offspring intellectual disability: sibling analysis in an intergenerational Danish cohort

Paul Madley-Dowd, Amy E Kalkbrenner, Hein Heuvelman, Jon Heron, Stanley Zammit, Dheeraj Rai and Diana Schendel
Psychological medicine, v 52(10), pp 1847-1856
01 Jul 2022
DOI: https://doi.org/10.1017/S0033291720003621
PMID: 33050963
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1017/S0033291720003621View
Published, Version of Record (VoR) Open

Abstract

Child Cohort Studies Denmark - epidemiology Female Humans Intellectual Disability - complications Intellectual Disability - etiology Pregnancy Prenatal Exposure Delayed Effects - epidemiology Prenatal Exposure Delayed Effects - etiology Risk Factors Siblings Smoking - adverse effects Smoking - epidemiology
Maternal smoking has known adverse effects on fetal development. However, research on the association between maternal smoking during pregnancy and offspring intellectual disability (ID) is limited, and whether any associations are due to a causal effect or residual confounding is unknown. Cohort study of all Danish births between 1995 and 2012 (1 066 989 persons from 658 335 families after exclusions), with prospectively recorded data for cohort members, parents and siblings. We assessed the association between maternal smoking during pregnancy (18.6% exposed, collected during prenatal visits) and offspring ID (8051 cases, measured using ICD-10 diagnosis codes F70-F79) using logistic generalised estimating equation regression models. Models were adjusted for confounders including measures of socio-economic status and parental psychiatric diagnoses and were adjusted for family averaged exposure between full siblings. Adjustment for a family averaged exposure allows calculation of the within-family effect of smoking on child outcomes which is robust against confounders that are shared between siblings. We found increased odds of ID among those exposed to maternal smoking in pregnancy after confounder adjustment (OR 1.35, 95% CI 1.28-1.42) which attenuated to a null effect following adjustment for family averaged exposure (OR 0.91, 95% CI 0.78-1.06). Our findings are inconsistent with a causal effect of maternal smoking during pregnancy on offspring ID risk. By estimating a within-family effect, our results suggest that prior associations were the result of unmeasured genetic or environmental characteristics of families in which the mother smokes during pregnancy.

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15 citations in Web of Science
15 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Psychiatry
Psychology
Psychology, Clinical
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