PASSIVE AND ACTIVE MATERNAL SMOKING DURING PREGNANCY, AS MEASURED BY SERUM COTININE, AND POSTNATAL SMOKE EXPOSURE .2. EFFECT ON NEURODEVELOPMENT AT AGE 5 YEARS

The authors sought to determine the neurobehavioral effects of prenata l exposure to maternal active smoking and environmental tobacco smoke (ETS), assessed by maternal serum cotinine level, and of postnatal exp osure to smoke based on maternal report. Five-year-old children (n = 2 ,124) who were participants in the Child Health and Development Studie s in Oakland, California, between 1964 and 1967 were evaluated with th e use of the Peabody Picture Vocabulary Test (PPVT) and the Raven Colo ured Progressive Matrices Test, and also assessed on a behavioral rati ng scale completed by the mother that included questions on activity l evel. Children of ETS-exposed women did not differ from children of ot her nonsmokers on neurobehavioral assessment. Children whose mothers s moked during pregnancy had somewhat higher adjusted Raven (p = 0.10) a nd PPVT scores (p = 0.06) than children of nonsmokers, although they d id not differ in their activity level (p = 0.32). However, children sm oke-exposed during childhood did have lower adjusted Raven (p = 0.01) and PPVT scores (p = 0.16), and were rated more active by their mother s (p = 0.04). These differences may be attributed to uncontrolled conf ounding of sociobehavioral variables. However, the authors cannot rule out the possibility that ETS exposure during childhood may be more ha zardous to neurodevelopment than prenatal exposure.