{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:05:23Z","timestamp":1787681123640,"version":"build-2784847793"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["R01ES026993"],"award-info":[{"award-number":["R01ES026993"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeckfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Evidence supports no link between maternal smoking in pregnancy and autism spectrum disorder (autism) overall. To address remaining questions about the unexplained heterogeneity between study results and the possibility of risk for specific autism sub\u2010phenotypes, we conducted a whole\u2010population cohort study in Denmark. We followed births 1991\u20132011 (1,294,906 persons, including 993,301 siblings in 728,271 families), from 1 year of age until an autism diagnosis (13,547), death, emigration, or December 31, 2012. Autism, with and without attention deficit hyperactivity disorder (ADHD) and with and without intellectual disability (ID) were based on ICD\u20108 and ICD\u201010 codes from Danish national health registers, including 3,319 autism\u2009+\u2009ADHD, 10,228 autism\u2009\u2212\u2009no ADHD, 2,205 autism\u2009+\u2009ID, and 11,342 autism\u2009\u2212\u2009no ID. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) between any maternal smoking (from birth records) and autism (or sub\u2010phenotypes) using survival models with robust standard errors, stratifying by birth year and adjusting for child sex, parity, and parental age, education, income, and psychiatric history. To additionally address confounding using family designs, we constructed a maternal cluster model (adjusting for the smoking proportion within the family), and a stratified sibling model. Associations with maternal smoking and autism were elevated in conventional adjusted analyses (HR of 1.17 [1.13\u20131.22]) but attenuated in the maternal cluster (0.98 [0.88\u20131.09]) and sibling (0.86 [0.64\u20131.15]) models. Similarly, risks of autism sub\u2010phenotypes with maternal smoking were attenuated in the family\u2010based models. Together these results support that smoking in pregnancy is not linked with autism or select autism comorbid sub\u2010phenotypes after accounting for familial confounding.\n                      <jats:italic>\n                        <jats:bold>Autism Res<\/jats:bold>\n                        2020, 13: 134\u2013144\n                      <\/jats:italic>\n                      . \u00a9 2019 International Society for Autism Research, Wiley Periodicals, Inc.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>Smoking during pregnancy has many harmful impacts, which may include harming the baby's developing brain. However, in a study of thousands of families in Denmark, it does not appear that smoking in pregnancy leads to autism or autism in combination with intellectual problems or attention deficits, once you account for the way smoking patterns and developmental disabilities run in families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/aur.2196","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T03:38:37Z","timestamp":1567049917000},"page":"134-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Familial confounding of the association between maternal smoking in pregnancy and autism spectrum disorder in offspring"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3888-0539","authenticated-orcid":false,"given":"Amy E.","family":"Kalkbrenner","sequence":"first","affiliation":[{"name":"Joseph J. Zilber School of Public Health University of Wisconsin\u2010Milwaukee  Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M.","family":"Meier","sequence":"additional","affiliation":[{"name":"Child and Adolescent Mental Health Centre\u2013Mental Health Services Capital Region  Copenhagen Region Denmark"},{"name":"Psychosis Research Unit Aarhus University Hospital  Risskov Denmark"},{"name":"The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Madley\u2010Dowd","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Ladd\u2010Acosta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"},{"name":"Wendy Klag Center for Autism and Developmental Disabilities Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret Daniele","family":"Fallin","sequence":"additional","affiliation":[{"name":"Wendy Klag Center for Autism and Developmental Disabilities Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"},{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Parner","sequence":"additional","affiliation":[{"name":"Department of Public Health, Section for Biostatistics Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Schendel","sequence":"additional","affiliation":[{"name":"Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register\u2010based Research Aarhus University  Aarhus Denmark"},{"name":"Department of Economics and Business, National Centre for Register\u2010based Research Aarhus University  Aarhus Denmark"},{"name":"Department of Public Health, Section for Epidemiology Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200801978672"},{"issue":"3","key":"e_1_2_7_3_1","first-page":"263","article-title":"The Danish National Hospital Register. A valuable source of data for modern health sciences","volume":"46","author":"Andersen T. F.","year":"1999","journal-title":"Danish Medical Bulletin"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811405098"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrrev.2017.04.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1524"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0356-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.30.4.04"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-011-9575-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/em.22097"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301252"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711002534"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200701491255"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31825fa230"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn175"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep46179"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-009-0543-5"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2509"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-018-0527-4"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200207000-00009"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2007.00916.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394715"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-04413-1"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1104556"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2014.06.001"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/87565640802564366"},{"issue":"3","key":"e_1_2_7_28_1","first-page":"320","article-title":"The Danish medical birth registry","volume":"45","author":"Knudsen L. B.","year":"1998","journal-title":"Danish Medical Bulletin"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr510"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-011-1425-4"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"e_1_2_7_32_1","first-page":"1","article-title":"Familial confounding of the association between maternal smoking during pregnancy and internalizing disorders in offspring","volume":"19","author":"Meier S. M.","year":"2017","journal-title":"Psychological Medicine"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.16080898"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810395825"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym290"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810387965"},{"issue":"4","key":"e_1_2_7_37_1","first-page":"441","article-title":"The Danish civil registration system. A cohort of eight million persons","volume":"53","author":"Pedersen C. B.","year":"2006","journal-title":"Danish Medical Bulletin"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32338"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2012.02.012"},{"issue":"4","key":"e_1_2_7_40_1","first-page":"442","article-title":"Secondhand tobacco smoke exposure associations with DNA methylation of the aryl hydrocarbon receptor repressor","volume":"19","author":"Reynolds L. M.","year":"2017","journal-title":"Nicotine and Tobacco Research"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1409204111"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-014-2327-z"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2015.09.016"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2661"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1515\/2161-962X.1015"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5767"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000649"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12124"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2003.06.001"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1996.tb09519.x"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph120910418"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.11.1985"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.109.062828"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12043"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-012-1678-6"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-0213"}],"container-title":["Autism Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.2196","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/aur.2196","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.2196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T08:01:55Z","timestamp":1694073715000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/aur.2196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,29]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/aur.2196"],"URL":"https:\/\/doi.org\/10.1002\/aur.2196","archive":["Portico"],"relation":{},"ISSN":["1939-3792","1939-3806"],"issn-type":[{"value":"1939-3792","type":"print"},{"value":"1939-3806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,29]]},"assertion":[{"value":"2018-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}