{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:12:03Z","timestamp":1790802723351,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"French Congress of Psychiatry"},{"DOI":"10.13039\/100001808","name":"National Institute of Public Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001808","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002915","name":"Foundation for medical research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children\u2019s behavioral problems is still a matter of controversy. We tested this association using data collected among a sample of pregnant women and their offspring followed up from birth to early adolescence (age 12 years), accounting for multiple parent, child, and family characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>Data come from 1424 mother\u2013child pairs participating in the \u00c9tude des D\u00e9terminants pr\u00e9 et post-natals pr\u00e9coces du d\u00e9veloppement psychomoteur et de la sant\u00e9 de l\u2019ENfant mother\u2013child cohort in France. Using repeated measures (3, 5.5, 8, and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children\u2019s emotional and behavioral difficulties. Two aspects of maternal smoking were studied: The timing (nonsmoker, smoking during the periconceptional period, or throughout pregnancy) and the level of use (cigarettes\/day) during the first trimester of pregnancy. Robust Poisson regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Contrary to bivariate analyses, in propensity score\u2013controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioral difficulties. Maternal heavy smoking (\u226510 cigarettes\/day) remained significantly associated with intermediate levels of conduct problems (RR 1.25, 95% CI 1.19 to 1.31).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The association between maternal smoking in pregnancy and offspring\u2019s emotional and behavioral difficulties appears to be largely explained by women\u2019s other characteristics. However, maternal heavy smoking appears to be related to offspring behavioral difficulties beyond the role of confounding characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>The relationship between maternal smoking during pregnancy (in two modalities: Timing and level of smoking) and behavioral difficulties in children is still a matter of debate. While the relationship between any maternal tobacco use and offspring behavioral difficulties appears to be largely explained by confounding factors, heavy maternal smoking in the first trimester of pregnancy seems to be associated with offspring behavioral difficulties beyond the socioeconomic and mental health characteristics transmitted across generations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad023","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T11:56:47Z","timestamp":1676375807000},"page":"1174-1183","source":"Crossref","is-referenced-by-count":6,"title":["Maternal Tobacco Smoking During Pregnancy and Children\u2019s Emotional and Behavioral Trajectories: The EDEN Mother\u2013Child Birth Cohort Study"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2894-4711","authenticated-orcid":false,"given":"Kim","family":"Bonello","sequence":"first","affiliation":[{"name":"Department of 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