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The Role of Maternal Smoking in Effect of Fetal Growth Restriction on Poor Scholastic Achievement in Elementary School
Department of Environmental and Occupational Health, School of Public Health, Drexel University, 1505 Race Street, Philadelphia, PA 19102, USA
Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
Division of Neonatal-Perinatal Medicine, Perinatal Epidemiology Research Unit, Dalhousie University & IWK Health Centre, Halifax, Nova Scotia, Canada
* Author to whom correspondence should be addressed.
Received: 12 December 2011; in revised form: 18 January 2012 / Accepted: 19 January 2012 / Published: 27 January 2012
Abstract: Fetal growth restriction and maternal smoking during pregnancy are independently implicated in lowering intellectual attainment in children. We hypothesized that only reduction of fetal growth that is attributable to extrinsic causes (e.g., maternal smoking) affects intellectual development of a child. Cross-sectional survey of 3,739 students in Nova Scotia (Canada) in 2003 was linked with the perinatal database, parental interviews on socio-demographic factors and the performance on standardized tests when primarily 11–12 years of age, thereby forming a retrospective cohort. Data was analyzed using hierarchical logistic regression with correction for clustering of children within schools. The risk of poor test result among children born small-for-gestational-age (SGA) to mothers who smoked was 29.4%, higher than in any other strata of maternal smoking and fetal growth. The adjusted odds ratio among SGA children born to mothers who smoked was the only one elevated compared to children who were not growth restricted and born to mothers who did not smoke (17.0%, OR = 1.46, 95% CI 1.02, 2.09). Other perinatal, maternal and socio-demographic factors did not alter this pattern of effect modification. Heterogeneity of etiology of fetal growth restriction should be consider in studies that address examine its impact on health over life course.
Keywords: fetal growth retardation; tobacco smoking; maternal exposure; educational achievement; retrospective cohort study; cross-sectional sample
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Burstyn, I.; Kuhle, S.; Allen, A.C.; Veugelers, P. The Role of Maternal Smoking in Effect of Fetal Growth Restriction on Poor Scholastic Achievement in Elementary School. Int. J. Environ. Res. Public Health 2012, 9, 408-420.
Burstyn I, Kuhle S, Allen AC, Veugelers P. The Role of Maternal Smoking in Effect of Fetal Growth Restriction on Poor Scholastic Achievement in Elementary School. International Journal of Environmental Research and Public Health. 2012; 9(2):408-420.
Burstyn, Igor; Kuhle, Stefan; Allen, Alexander C.; Veugelers, Paul. 2012. "The Role of Maternal Smoking in Effect of Fetal Growth Restriction on Poor Scholastic Achievement in Elementary School." Int. J. Environ. Res. Public Health 9, no. 2: 408-420.