Prenatal Exposure to Nicotine and Impaired Reading Performance

  • Kelly Cho
    Correspondence
    Kelly Cho, PhD, MPH.
    Affiliations
    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT

    Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

    Massachusetts Veterans Epidemiology Research and Information Center, Veterans Administration Boston Healthcare System, Boston, MA

    Departments of Pediatrics, Genetics, and Investigative Medicine, Yale Child Health Research Center, Yale University School of Medicine, New Haven, CT
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  • Jan C. Frijters
    Affiliations
    Departments of Child and Youth Studies and Psychology, Brock University, Ontario, Canada
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  • Heping Zhang
    Affiliations
    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT
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  • Laura L. Miller
    Affiliations
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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  • Jeffrey R. Gruen
    Correspondence
    Reprint requests: Jeffrey R. Gruen, MD, Departments of Pediatrics, Genetics, and Investigative Medicine, Yale Child Health Research Center, Yale School of Medicine, PO Box 208064, New Haven, CT 06520.
    Affiliations
    Departments of Pediatrics, Genetics, and Investigative Medicine, Yale Child Health Research Center, Yale University School of Medicine, New Haven, CT
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Published:November 05, 2012DOI:https://doi.org/10.1016/j.jpeds.2012.09.041

      Objective

      To investigate whether prenatal exposure to nicotine has an impact on several reading skill outcomes in school age children.

      Study design

      Using a longitudinal sample of 5119 school age children in the Avon Longitudinal Study of Parents and Children, this study investigated specific reading skill outcomes in the area of speed, fluency, accuracy, spelling, and comprehension in relation to prenatal nicotine exposure, after adjusting for potential mediators and confounders. Prenatal nicotine exposure was divided into 3 categories: high (>17 mg per day), low (≤17 mg per day), and no exposure.

      Results

      We found that prenatal nicotine exposure was associated with increased risk of underperformance in specific reading skill outcomes after adjusting for potential mediators and confounders ( P = .006). The effect of poor performance in decoding single words was most pronounced among children with prenatal exposure to high levels of nicotine in conjunction with a phonological deficit. Overall, the results showed that maternal smoking has moderate to large associations with delayed or decreased reading skills of children in the Longitudinal Study of Parents and Children.

      Conclusions

      High prenatal nicotine exposure has a negative association with reading performance in school age children. In addition, modeling showed that environmental factors significantly moderated the interaction between prenatal nicotine exposure and reading skill outcomes.
      ADHD ( Attention deficit-hyperactivity disorder), ALSPAC ( Avon Longitudinal Study of Parents and Children), RD ( Reading disability), WORD ( Wechsler Objective Reading Dimensions)
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