The 130th Annual Meeting of APHA

Abstract #49698

Marygrace E. Yale, PhD¹, Keith G. Scott, PhD¹, Carrie Lazurus, BA¹, Craig A. Mason, PhD², and Antonio Gonzalez, BS¹. (1) Department of Psychology, University of Miami, Psychology Annex, PO Box 249229, Coral Gables, FL 33124, (305)284-4943, myale@miami.edu, (2) University of Maine, 5717 Corbett Hall, Room 3, Orono, ME 04469

Evidence suggests that maternal smoking during pregnancy has negative impacts on infant and child development. Using a population-based sample, we examined the individual- and population-level risks of prenatal exposure to tobacco and low birthweight on the development of childhood disabilities.

Participants included 259,977 children born in Florida between 1990 and 1992 who attended public school in 1999-2000. Three risk groups (low birthweight (LBW) alone, prenatal exposure to tobacco (PET) alone and LBW plus PET) were compared to a reference group of children born normal birthweight whose mothers did not smoke during pregnancy. Outcome variables included (1) mental retardation, (2) learning disabilities, (3) behavior problems, (4) language/speech impairments, and (5) a combination of all disability categories.

Prenatal exposure to tobacco had adverse effects on the development of childhood disabilities by itself and in combination with low birthweight. Children born low birthweight to mothers who reported smoking during pregnancy were at the highest levels of risk for a developmental disability. Prenatal exposure to tobacco alone also resulted in significant increases in risk for the outcome categories and had the strongest association with development of behavior problems (RR=2.10, 95% CI=1.98-2.23), irrespective of birthweight.

Prevalence of the risk factors was also taken into account. Prenatal exposure to tobacco alone accounted for 5.60% of all exceptionalities cases, 4.01% of mild mental retardation cases, 6.44% of learning disabilities cases, 2.59% of speech/language impairments cases, and 15.69% of behavior problems cases. The important health and educational implications of these data will be discussed.

Learning Objectives: Participants will be presented with information leading to an understanding of the individual risk and population risk associated with maternal smoking during pregnancy as a cause for specific childhood disabilities. At the conclusion of the session the participants will be able

• Recognize the difference between individual- and population-levels of risk.
• Describe the effects of prenatal exposure to tobacco on the development of childhood disabilities, both alone and in combination with low birthweight.
• Identify specific disabilities that are especially affected by maternal smoking during pregnancy.

Keywords: Disability, Pregnancy Outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.