Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study

BackgroundObservational studies have described associations of maternal smoking during pregnancy with intellectual disability (ID) in the exposed offspring. Whether these results reflect a causal effect or unmeasured confounding is still unclear.MethodsUsing a UK-based prospectively collected birth...

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Main Authors: Paul Madley-Dowd, Richard Thomas, Andy Boyd, Stanley Zammit, Jon Heron, Dheeraj Rai
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-06-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1352077/full
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author Paul Madley-Dowd
Paul Madley-Dowd
Paul Madley-Dowd
Richard Thomas
Andy Boyd
Stanley Zammit
Stanley Zammit
Stanley Zammit
Jon Heron
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
author_facet Paul Madley-Dowd
Paul Madley-Dowd
Paul Madley-Dowd
Richard Thomas
Andy Boyd
Stanley Zammit
Stanley Zammit
Stanley Zammit
Jon Heron
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
author_sort Paul Madley-Dowd
collection DOAJ
description BackgroundObservational studies have described associations of maternal smoking during pregnancy with intellectual disability (ID) in the exposed offspring. Whether these results reflect a causal effect or unmeasured confounding is still unclear.MethodsUsing a UK-based prospectively collected birth cohort (the Avon Longitudinal Study of Parents and Children) of 13,479 children born between 1991 and 1992, we assessed the relationship between maternal smoking at 18 weeks’ gestation and offspring risk of ID, ascertained through multiple sources of linked information including primary care diagnoses and education records. Using confounder-adjusted logistic regression, we performed observational analyses and a negative control analysis that compared maternal with partner smoking in pregnancy under the assumption that if a causal effect were to exist, maternal effect estimates would be of greater magnitude than estimates for partner smoking if the two exposures suffer from comparable biases.ResultsIn observational analysis, we found an adjusted odds ratio for ID of 0.75 (95% CI = 0.49–1.13) for any maternal smoking and 0.97 (95% CI = 0.71–1.33) per 10-cigarette increase in number of cigarettes smoked per day. In negative control analysis, comparable effect estimates were found for any partner smoking (OR = 0.94; 95% CI = 0.63–1.40) and number of cigarettes smoked per day (OR = 0.94; 95% CI = 0.74–1.20).ConclusionsThe results are not consistent with a causal effect of maternal smoking during pregnancy on offspring ID.
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spelling doaj-art-c5d513eea9e34e9fb78da7f8a9c89c7e2024-11-20T12:41:07ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-06-011510.3389/fpsyt.2024.13520771352077Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort studyPaul Madley-Dowd0Paul Madley-Dowd1Paul Madley-Dowd2Richard Thomas3Andy Boyd4Stanley Zammit5Stanley Zammit6Stanley Zammit7Jon Heron8Dheeraj Rai9Dheeraj Rai10Dheeraj Rai11Dheeraj Rai12Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomNational Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust and University of Bristol, Bristol, United KingdomMedical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United KingdomUK Longitudinal Linkage Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomUK Longitudinal Linkage Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomNational Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust and University of Bristol, Bristol, United KingdomMedical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United KingdomCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomNational Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust and University of Bristol, Bristol, United KingdomMedical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United KingdomAvon and Wiltshire Partnership NHS Mental Health Trust, Bath, United KingdomBackgroundObservational studies have described associations of maternal smoking during pregnancy with intellectual disability (ID) in the exposed offspring. Whether these results reflect a causal effect or unmeasured confounding is still unclear.MethodsUsing a UK-based prospectively collected birth cohort (the Avon Longitudinal Study of Parents and Children) of 13,479 children born between 1991 and 1992, we assessed the relationship between maternal smoking at 18 weeks’ gestation and offspring risk of ID, ascertained through multiple sources of linked information including primary care diagnoses and education records. Using confounder-adjusted logistic regression, we performed observational analyses and a negative control analysis that compared maternal with partner smoking in pregnancy under the assumption that if a causal effect were to exist, maternal effect estimates would be of greater magnitude than estimates for partner smoking if the two exposures suffer from comparable biases.ResultsIn observational analysis, we found an adjusted odds ratio for ID of 0.75 (95% CI = 0.49–1.13) for any maternal smoking and 0.97 (95% CI = 0.71–1.33) per 10-cigarette increase in number of cigarettes smoked per day. In negative control analysis, comparable effect estimates were found for any partner smoking (OR = 0.94; 95% CI = 0.63–1.40) and number of cigarettes smoked per day (OR = 0.94; 95% CI = 0.74–1.20).ConclusionsThe results are not consistent with a causal effect of maternal smoking during pregnancy on offspring ID.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1352077/fullALSPACintellectual disabilitynegative controlprenatal exposuresmoking
spellingShingle Paul Madley-Dowd
Paul Madley-Dowd
Paul Madley-Dowd
Richard Thomas
Andy Boyd
Stanley Zammit
Stanley Zammit
Stanley Zammit
Jon Heron
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
Dheeraj Rai
Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
Frontiers in Psychiatry
ALSPAC
intellectual disability
negative control
prenatal exposure
smoking
title Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
title_full Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
title_fullStr Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
title_full_unstemmed Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
title_short Maternal smoking during pregnancy and offspring risk of intellectual disability: a UK-based cohort study
title_sort maternal smoking during pregnancy and offspring risk of intellectual disability a uk based cohort study
topic ALSPAC
intellectual disability
negative control
prenatal exposure
smoking
url https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1352077/full
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