Contribution of maternal smoking during pregnancy and lead exposure to early child behavior problems

Maternal smoking during pregnancy elevates risk for later child behavior pr oblems. Because prior studies considered only Western settings, where smoki ng cooccurs with social disadvantage, we examined this association in Yugos lavia, a different cultural setting. Mothers enrolled in pregnancy as the l ow-exposure group in a prospective study of lead exposure were interviewed about health, including smoking history. A total of 199 children were asses sed on the Child Behavior Checklist (CBCL) at ages 4, 4 1/2, and 5 years. A verage cumulative blood lead (BPb) was determined from serial samples taken biannually since delivery. Longitudinal analyses were derived from 191 chi ldren with available data on behavior and covariates. Smoking was unrelated to social adversity. Controlling for age, gender, birthweight, ethnicity, maternal education, and Home Observation for Measurement of the Environment (HOME) Acceptance, smoking was associated with worse scores on almost all subscales; BPb concentration was related to small increases in the Delinque ncy subscale. Daughters of smokers received significantly higher scores on Somatic Complaints compared to daughters of nonsmokers, consistent with oth er work relating biological factors and internalizing problems in young gir ls. Because the present smoking/child behavior associations persist after c ontrol for individual and social factors also related to behavior problems, possible biological mediators are considered. (C) 2001 Elsevier Science In c. All rights reserved.