Sy. Hill et al., Maternal smoking and drinking during pregnancy and the risk for child and adolescent psychiatric disorders, J STUD ALC, 61(5), 2000, pp. 661-668
Citations number
26
Categorie Soggetti
Public Health & Health Care Science","Clinical Psycology & Psychiatry
Objective: To examine the relative importance of prenatal exposure to cigar
ettes and alcohol and familial/genetic susceptibility for alcohol dependenc
e in the etiology of childhood psychopathology. Method: A longitudinal pros
pective study of 150 children/adolescents (51.3% male), who were at either
high or low risk for developing alcohol dependence because of their familia
l loading for alcoholism, provided multiple diagnostic assessments (N = 318
) of these subjects. High-risk families were identified through the presenc
e of two adult alcoholic sisters; low-risk control families were selected f
rom the community. Annual assessments of offspring from these families incl
uded an in-depth psychiatric interview of each child;Ind his/her parent to
determine the presence or absence of childhood disorders. Mothers were inte
rviewed concerning their prenatal use of substances, and information was ga
thered concerning their personal and familial loading for psychiatric disor
ders. Results: Using conventional logistic regression analyses, internalizi
ng and externalizing disorders were found to be associated with familial lo
ading for alcoholism and prenatal exposure to cigarettes and alcohol. In ad
dition, a specialized statistical analysis, a multivariate confounder score
approach, was conducted using familial risk status and the child's exposur
e to maternal prenatal use of alcohol and cigarettes. This analysis demonst
rated that only one relationship between a single variable and a childhood
disorder was significant while controlling for the other two variables: Opp
ositional disorder remained significant in association with familial risk s
tatus. Three additional analyses were performed to evaluate the effects of
familial risk status, prenatal alcohol exposure and prenatal cigarette expo
sure on childhood psychopathology while controlling for two known risk fact
ors (SES and parental ASPD) for externalizing disorders. Results of these a
nalyses revealed that the only childhood disorder that was elevated was ADH
D, and that this was the result of the familial risk Variable only. Conclus
ions: Familial loading for alcohol dependence is an important risk factor f
or the development of childhood psychopathology and may account for the pre
viously reported associations between prenatal exposure to nicotine and alc
ohol. Studies of substance abuse/dependence etiology and childhood psychopa
thology need to include consideration of both prenatal exposures and famili
al loading for alcohol dependence and other psychiatric disorders.