| Association of Prenatal Maternal or Postnatal Child Environmental Tobacco Smoke Exposure and Neurodevelopmental and Behavioral Problems in Children Brenda Eskenazi and Rosemary Castorina Center for Children's Environmental Health Research, School of Public Health, University of California, Berkeley, California, USA Abstract
We review the potential neurodevelopmental and behavioral effects of children's prenatal and/or postnatal exposure to environmental tobacco smoke (ETS) . Children's exposure to ETS has been assessed in epidemiologic studies as a risk factor for a variety of behavioral and neurodevelopmental problems including reduced general intellectual ability, skills in language and auditory tasks, and academic achievement, and behavioral problems such as hyperactivity and decreased attention spans. We review 17 epidemiologic studies that have attempted to separate the effects of maternal active smoking during pregnancy from passive ETS smoke exposure by the pregnant mother or the child. Based on the available data, we found that ETS exposure could cause subtle changes in children's neurodevelopment and behavior. However, studies to date are difficult to interpret because of the unknown influence of uncontrolled confounding factors, imprecision in measurements of smoking exposure, and collinearity of pre- and postnatal maternal smoking. Although some evidence suggests that maternal smoking during pregnancy may be associated with deficits in intellectual ability and behavioral problems in children, the impact of prenatal or postnatal ETS exposure remains less clear. Key words: behavior, children, cognition, ETS, exposure, neurodevelopment, postnatal, pregnancy, prenatal, tobacco smoke pollution. Environ Health Perspect 107:991-1000 (1999) . [Online 10 November 1999] http://ehpnet1.niehs.nih.gov/docs/1999/107p991-1000eskenazi/ abstract.html Address correspondence to B. Eskenazi, School of Public Health, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94720-7360 USA. Telephone: (510) 642-3496. Fax: (510) 642-5815. E-mail: eskenazi@uclink4.berkeley.edu This review was initially prepared as part of the 1999 World Health Organization International Consultation on Environmental Tobacco Smoke (ETS) and Child Health. We thank P. Fried, J. Jinot, and D. Sharp for their helpful comments. We also thank C. Igondjo for technical assistance. Received 29 April 1999 ; accepted 19 August 1999.
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