Authors:
Mikael Ekblad, Mika Gissler, Liisa Lehtonen, & Jyrki Korkeila
Summary:
Background - Prenatal smoking exposure has been shown to modulate brain development, which may induce psychiatric problems that needs psychiatric medication in the offspring.
Objective - To investigate the effect of prenatal smoking exposure on children's subsequent use of psychiatric drugs and the prevalence of special reimbursements for medication of severe psychiatric disorders among Finnish young adults using a population-based longitudinal register data.
Design/Methods - The study population consisted of all children born singleton in Finland in 1987 through 1989 (n=175869) excluding children with major congenital anomalies (3.2%). Information of maternal smoking as reported by the mothers (0/lees than 10/more than 10 cigarettes/day) and other background factors (gestational age, birth weight, 5min Apgar score, mother's age, parity) were collected from the Finnish Medical Birth Register (THL) and information on mothers' psychiatric inpatient care (1969-1989) was derived from the Finnish Hospital Discharge Register. Information on children's use of psychiatric drugs (N05-N07, years 1994-2007) and granted special reimbursements for medication of severe psychiatric disorders were received from the Finnish Social Insurance Institution.
Results - A total of 12.3% of the young adults had used psychiatric drugs, and of these 19.2% had been exposed to prenatal smoking. Young adults exposed to prenatal smoking had an increased risk for using psychiatric drugs after adjusting for confounding factors (<10 cig/day: OR 1.3, CL 1.2-1.3 and >10 cig/day: 1.4, 1.4-1.5). More specifically, the risks were significantly increased most in using drugs for depression (N06A, 1.4, 1.3-1.5; 1.7, 1.6-1.8), addiction (N07B, 2.2, 1.4-3.5; 2.6, 1.5-4.5) and stimulants (N06B, 1.8, 1.3-3.3; 2.6, 1.9-3.5). Special reimbursements for psychoses (0.6%) and epilepsy (1.2%) were rare among study population, and there were no differences between exposed and unexposed children after adjusting the confounding factors.
Conclusions - Young adults exposed to prenatal smoking had a significantly increased risk for use of psychiatric drugs than unexposed young adults. Our study suggests that preventing prenatal smoking exposure could reduce psychiatric problems in young adults.
Source:
Pediatric Academic Societies (PAS) Annual Meeting; Vancouver, British Columbia, Canada, Poster Session: Epidemiology; 10:00AM-2:00 PM; Presentation Time - 10:00AM, Room - Exhibit Hall C; Vancouver Convention Centre; Board Number – 56; Course Number - 4401 (05/04/10)