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Prenatal smoke exposure (PSE) is a risk factor for adverse outcomes in the offspring, including those affecting psychological development. However, it is uncertain whether these associations are the direct result of PSE or other confounding factors. The aim of this study was to examine the possible relationship between PSE and behavioral development in children at 7.5 years of age, considering several prenatal, neonatal and postnatal covariates. A cohort of 266 mother-child pairs was followed from the first trimester of pregnancy until the children reached 7.5 years of age. PSE was assessed using a questionnaire from prenatal clinical records and corroborated by plasma cotinine determinations in the first and second trimesters and in the cord. Mother-child pairs were classified into one of four groups: unexposed, exposed to passive smoking, first trimester active smoking only and active smoking throughout pregnancy. Child behavior was assessed using the Child Behavior Checklist for ages 6–18 and the Childhood Autism Spectrum Test. In multiple linear regression models, smoking during pregnancy was associated with higher scores in affective problems (β?=?0.298; p?=?0.004). No significant associations were found between smoking during pregnancy and externalizing problems. Findings indicate that PSE is negatively associated with behavioral development in childhood.
相似文献Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.
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