tobacco

Prenatal Tobacco Exposure and Neurodevelopmental Outcomes in Middle Childhood

Posted on by Jodi Snare

A collaborative study led by ECHO researcher Liz Conradt, PhD of the University of Utah, examined the effects of simultaneous exposure to multiple substances—like tobacco, alcohol, and opioids—on outcomes in middle childhood. The team found that children ages 6 to 11 who were exposed prenatally to tobacco and multiple other substances were more likely to have below average verbal reasoning skills and higher levels of behavioral problems. Their research, titled “Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood,” is published in the American Journal of Perinatology.

To gather these results, the team collected data on prenatal exposure to substances such as alcohol, tobacco, marijuana, and opioids. A total of 256 mother-child pairs participated from two ECHO cohorts with locations in Rhode Island, Minnesota, Washington, California, and New York. When the children were between six and 11 years old, their caregivers were asked to report on the absence or presence of problem behaviors, such as aggression and anxiety. The team also collected data on verbal and nonverbal reasoning and problem solving skills.

Using this information, the researchers identified two specific groups—Group 1 had average verbal reasoning skills, average spatial reasoning skills, and normal levels of problem behavior. Children in this group were exposed to fewer substances before birth. Group 2 had below average verbal reasoning skills, but average spatial reasoning skills, and higher levels of problem behavior. The researchers found that children exposed to multiple substances prenatally, especially including tobacco, were more likely to be in Group 2. The effects of tobacco exposure on problem behavior and reasoning skills were stronger than expected.

“This study shows that children with prenatal tobacco exposure may be at risk for having higher levels of problem behaviors and more challenges with verbal reasoning during middle childhood,” said Conradt. “This is an important risk for pediatricians to keep in mind when conducting yearly check-ups on these children.”

The practice of grouping children based on problem behavior and reasoning skills was a novel approach and can be used in future studies to identify subgroups of children at risk for these outcomes.

Visit The Center for Parenting and Opioids and National Institute on Drug Abuse sites for more information on substance exposures and outcomes.

Read the Research Summary.

ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

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ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

Authors: Liz Conradt, et al.

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

 

Why was this study needed?

Little is known about how a pregnant mother’s exposure to multiple substances, like tobacco, alcohol, or opioids, during pregnancy may be associated with outcomes for their children when they reach middle childhood. Most research looks at the effects of single-substance exposures or focuses on the effects of prenatal exposures on the child’s health exclusively during birth or early childhood. In this study, the research team evaluated the effects of prenatal exposure to multiple substances (alcohol, tobacco, marijuana, and opioids) on children’s reasoning skills and behavior during middle childhood.

 

What were the study results?

The team identified two groups of children based on their reasoning skills and problem behavior scores. Group 1 had average verbal reasoning skills, average spatial reasoning skills, and normal levels of problem behavior. Children in this group were exposed to fewer substances before birth. Group 2 included children with multiple substance exposures before birth. This group had below average verbal reasoning skills, but average spatial reasoning skills, and higher levels of problem behavior.  Children in Group 2 were significantly more likely to be exposed to tobacco before birth. The effects of tobacco exposure on problem behavior and reasoning skills were stronger than expected.

 

What was the study's impact?

This study suggests that children exposed to tobacco and other substances before birth may be at increased risk for problem behaviors and lower verbal reasoning skill scores during middle childhood. These findings will help pediatricians identify children who are at risk for behavior problems and poorer reasoning skill scores. If replicated, this information might help pregnant women and their doctors to recognize how prenatal tobacco, especially in the context of other substance exposure, might affect their child’s verbal reasoning and behavior in middle childhood.

 

Who was involved?

This study involved pairs of mothers and their biological children. There were 256 mother-child pairs from two ECHO research sites with locations in Rhode Island, Minnesota, Washington, California, and New York. Children were ages six to 11 at the time of the behavioral and reasoning skills assessments.

 

What happened during the study?

Researchers collected data on prenatal exposure to substances including alcohol, tobacco, marijuana, and opioids. When the children were between six and 11 years old, their caregivers reported on the presence of problem behaviors such as aggression and anxiety. The researchers also collected data on problem solving skills with words, pictures, and diagrams (verbal and nonverbal reasoning).

 

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Moving forward, the team wants to improve their measures of prenatal substance exposure and expand their sample size to include more ECHO participants.  Grouping children that have been exposed to substances prenatally can help identify subgroups of children at risk for problem behaviors and low reasoning skill scores.

 

Where can I learn more?

The Center for Parenting and Opioids and National Institute on Drug Abuse have additional helpful resources.

The full journal article, titled “Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood” is published in the American Journal of Perinatology.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 10, 2023

 

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ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

Rob McConnell: Vaping: Risks to Children and Youth

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Vaping: Risks to Children and Youth

Speaker:

Rob McConnell, MD

Keck School of Medicine

University of Southern California

 

 

Speaker Bio: Rob McConnell is a physician and environmental epidemiologist, and Professor of Preventive Medicine. He directs the NIH/Environmental Protection Agency-supported Southern California Children’s Environmental Health Center. He has studied the effects of air pollution on children’s health, including the development of asthma and lung function deficits, and early markers for cardiovascular disease. Dr. McConnell has investigated susceptibility to the effects of environmental exposures conferred by psychosocial stress and social factors, exercise, genetics and co-exposures associated with housing conditions.

Topic:  Vaping

Date: Wednesday, July 8, 1 to 2pm

Slides

ECHO-funded Study Sheds Light on Second- and Third-hand Smoke Exposure in Kids

Posted on by Jodi Snare

A recent study funded by the ECHO Program, National Institute of Child Health and Human Development (NICHD), and National Institute on Drug Abuse, shows that infants and toddlers in low-income, rural areas may be at higher risk for second- and third-hand smoke than previously reported in the National Health and Nutrition Examination Survey. Findings were dependent on the detectable presence of cotinine – the byproduct formed when the body breaks down nicotine – in the children’s systems.

Based on an analysis of saliva samples collected from 1,218 children, 15 percent were in the high exposure group when tested for cotinine, demonstrating levels that are comparable to active adult smokers. Forty-eight percent of the children classified as moderate exposure and 37 percent fell in the low exposure group.

Other key findings from the study include lower smoke exposure for children in center-based daycare facilities and higher smoke exposure for infants, compared with toddlers. This is partially attributed to crawling and infants’ tendencies to put objects into their mouths. Additionally, according to the study, “lower income, less education, frequent residential moves and fluctuations in the number of adults within the home were associated with high smoke exposure.”

“Our results, if supported by future studies, can help educate parents and caregivers, as well as improve prevention programs that seek to reduce children’s smoke exposure,” said Clancy Blair, Ph.D., M.P.H., a professor at New York University’s Steinhardt School of Culture, Education and Human Development, and the senior author of the study.

The study was published in Nicotine & Tobacco Research December 5, 2018.