Association of Prepregnancy to Early Adolescence Maternal Smoking With Young Adult Mental Health

OBJECTIVE Maternal smoking across pregnancy and childhood is associated with adverse mental health outcomes in offspring. Few studies have prospectively examined this using administrative data. This study investigated whether maternal smoking from prepregnancy through the child’s early adolescence (age 13 years) was associated with mental health diagnoses in the offspring (ages 18-23 years), identified via medical service use. METHODS Data came from 2082 mother-child dyads in the Québec Longitudinal Study of Child Development (born in 1997-1998) linked to administrative health databases. Maternal smoking was reported when children were aged 5 months and 1.5, 2.5, 3.5, 5, 7, 10, and 13 years. Trajectories were identified using latent class growth analysis. Offspring mental health diagnoses (mood disorders, anxiety disorders, psychotic disorders, and Attention-Deficit/Hyperactivity Disorder ADHD) were extracted from administrative databases between ages 18 and 23 years. Poisson regression models were adjusted for key sociodemographic and perinatal confounders. RESULTS Three smoking trajectories were identified: no smoking (77.3%), moderate sustained smoking (∼11 cigarettes/day; 15.1%), and high sustained smoking (∼19 cigarettes/day; 7.4%). Offspring of mothers in the high sustained smoking group had a higher risk of mood (risk ratio RR, 1.83; 95% CI, 1.28–2.60), anxiety (RR, 1.55; 95% CI, 1.16–2.05), and psychotic (RR, 3.33; 95% CI, 1.43–7.78) diagnoses compared with the offspring of nonsmoking mothers. No associations were observed for moderate sustained smoking or ADHD diagnoses. CONCLUSION High sustained maternal smoking from prepregnancy through child’s early adolescence was associated with increased likelihood of mood, anxiety, and psychotic diagnoses in offspring during young adulthood. Maternal smoking may inform youth mental health screening.