Sellers, Ruth, Warne, Naomi, Rice, Frances, Langley, Kate, Maughan, Barbara, Pickles, Andrew, Thapar, Anita and Collishaw, Stephan (2020) Using a cross-cohort comparison design to test the role of maternal smoking in pregnancy in child mental health and learning: evidence from two UK cohorts born four decades apart. International Journal of Epidemiology. pp. 1-10. ISSN 0300-5771

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Abstract

Background: Maternal smoking in pregnancy is associated with low birth weight (LBW), child conduct problems, hyperactivity and lower cognitive attainment, but associations may reflect measured and unmeasured confounding. Cross-cohort designs can aid causal inference through comparison of associations across populations with different confounding structures. We compared associations between maternal smoking in pregnancy and child conduct and hyperactivity problems, cognition and LBW across two cohorts born four decades apart.

Methods: Two national UK cohorts born 1958 (N = 12415) and 2000/1 (N = 11800) were compared. Maternal smoking in pregnancy and child birth weight was assessed at or shortly after birth. Parents rated children’s conduct problems and hyperactivity, and children completed standardized tests of reading and mathematics.

Results: Maternal smoking in pregnancy was less common and more strongly associated with social disadvantage in 2001/1 compared to 1958 (interactions p<.001). Maternal smoking in pregnancy was robustly and equivalently associated with infant LBW in both cohorts (interactions boys OR = 1.01 [.89, 1.16], p=.838; girls OR = 1.01 [.91, 1.17], p=0.633). Maternal smoking was more strongly associated with conduct problems, hyperactivity and reading in 2000/1 cohort (interactions p<.001).

Conclusions: Marked cross-cohort change in associations between maternal smoking and child conduct problems, hyperactivity and reading highlights the likely role of confounding factors. In contrast, association with LBW was unaffected by change in prevalence of maternal smoking and patterns of confounding. The study highlights the utility of cross-cohort designs in helping triangulate conclusions about the role of putative causal risk factors in observational epidemiology.

Item Type:	Article
Schools and Departments:	Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User:	Sanjeedah Choudhury
Date Deposited:	03 Mar 2020 08:20
Last Modified:	03 Mar 2020 08:30
URI:	http://sro.sussex.ac.uk/id/eprint/90165

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