Prenatal Smoking and Internalizing and Externalizing Problems in Children Studied From Childhood to Late Adolescence

ObjectiveTo study whether prenatal smoking only relates to externalizing problems or whether it is associated with both internalizing and externalizing problems from childhood into late adolescence.MethodChild Behavior Checklist-derived, parent-reported internalizing and externalizing problems of 396 children were longitudinally assessed at ages 5, 10 to 11, and 18 years. The influence of self-reported prenatal smoking on the course of internalizing and externalizing problems over these ages was assessed, controlling for the co-occurrence of internalizing and externalizing problems and co-occurring pre- and perinatal risk factors, demographic characteristics, maternal mental health, and child social and attention problems.ResultsChildren whose mothers had smoked during pregnancy had increased levels of both internalizing and externalizing problems over the period of ages 5 to 18 years when compared with children whose mothers did not smoke during pregnancy. These associations remained significant after controlling internalizing for externalizing and vice versa and possible confounding variables.ConclusionsMaternal smoking during pregnancy is a predictor of internalizing as well as externalizing psychopathology in offspring. The association between prenatal smoking and internalizing and externalizing problems persists throughout childhood and late adolescence. J. Am. Acad. Child Adolesc. Psychiatry, 2008; 47(7):779–787.