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Table 2 Maternal smoking during pregnancy and child cognitive/educational outcomes

From: The impact of pre and perinatal lifestyle factors on child long term health and social outcomes: a systematic review

Study Aim Methods Outcome measure Findings Notes Quality assessment
Brion et al., (2010) [30] To assess the association between maternal prenatal smoking and child psychological problems. Prospective cohort study in 3 health districts in England and Brazil.
N = 6735 in England, 509 children in Brazil
Behavioural outcomes measured by Strengths and Difficulties Questionnaire (England) or Child Behaviour Checklist (Brazil) around age 4 In the UK cohort maternal smoking was significantly associated with hyperactivity/attention problems (OR = 1.17 [95% CI 1.04-1.31]), and peer social problems (OR = 1.24 [95% CI 1.1-1.4]).
Smoking was also associated with conduct/externalizing problems (OR = 1.24 [95% CI:1.07-1.46])
Adjusted for good range of covariates included paternal smoking Strong
Collins et al., (2007) [29] To assess the association between prenatal tobacco exposure and child academic achievement. Longitudinal analysis of 6390 mother-child pairs across the UK. Adolescent offspring academic achievement measured through pass/fail on O-level (GCSE equivalent) and A-level at ages 16 and 18 respectively. Prenatal exposure had no significant effects on test failure in adolescence. Some covariates accounted for Moderate
Hutchinson et al., (2010) [31] Associations between maternal smoking in pregnancy and child behaviour. Prospective cohort study of 13,778 families across the UK (MCS) followed from birth Children’s conduct and hyperactivity/inattention problems measured by the SDQ at age 3 years. After adjustment, for boys, mothers’ persistent smoking in pregnancy was significantly associated with conduct problems (OR = 1.44 [95% CI: 1.01-2.06] for light smoker; OR = 1.80 [95% CI: 1.28-2.54] for heavy smoker) and hyperactivity-inattention problem (OR = 1.56 [95% CI: 1.12-2.15] for light smoker; OR = 1.62 [95% CI: 1.13-2.33] for heavy smoker). Good range of covariates Strong
Maughan et al., (2004) [32] To explore the association between prenatal smoking and early childhood behaviour Longitudinal study of 1116 families in England and Wales. Children’s conduct problems at age 5 and 7 years were assessed using the CBCL measures. No significant association between maternal smoking and child behaviour. Some covariates Moderate