Pre-conceptional and Prenatal Exposure to Secondhand Smoke and Autism Spectrum Disorder: a National Multi-center Study in China

Overview

Journal World J Pediatr

Specialty Pediatrics

Date 2022 Nov 10

PMID 36355326

Authors

Li-Zi Lin

Xiao-Xuan Ou

Xiao-Ling Zhan

Xin Wang

Li Cai

Xiu-Hong Li

Jin Jing

Guang-Hui Dong

Affiliations

Soon will be listed here.

Abstract

Background: Despite extensive research evaluating the association between prenatal exposure to secondhand smoke (SHS) and the development of autism spectrum disorders (ASD), no study has investigated the association by considering the pre-conceptional period. This study aimed to investigate the associations of pre-conceptional and prenatal SHS exposure and the development of ASD among toddlers.

Methods: In this cross-sectional study, parents of 6049 toddlers aged 16-30 months were recruited from 7 tertiary hospitals, 21 communities, and 7 kindergartens located in seven cities in six provinces from five geographical regions of China. We analyzed the associations of SHS exposure and the odds of ASD among toddlers in different exposure windows (pre-conceptional and/or prenatal periods). Data were analyzed from November 2021 to January 2022.

Results: Among the 6049 toddlers included in the analysis [22.7 (4.1) months; 44.8% girls], 71 were identified and diagnosed with ASD. Compared with the unexposed toddlers, toddlers with pre-conceptional SHS exposure had higher odds of ASD (OR 2.30, 95% CI 1.36-3.84), while we observed a non-significantly positive association regarding prenatal SHS exposure. When considering both pre-conceptional and prenatal periods, toddlers who were continuously exposed to SHS during these two periods had higher odds than those without SHS exposure (OR 2.32, 95% CI 1.24-4.14).

Conclusion: We reported positive SHS-ASD associations when exposed during the pre-conceptional period and continuously exposed during pre-conceptional and prenatal periods, emphasizing the critical window of pre-conception for targeted intervention on smoking.

Citing Articles

Global trends of secondhand smoke exposure among young adolescents from 27 countries, 2003-2021: findings from the World Health Organization database.

Lee S, Son Y, Hong S, Lee M, Kim H, Lee H Sci Rep. 2024; 14(1):29798.

PMID: 39616221 PMC: 11608270. DOI: 10.1038/s41598-024-80713-7.

Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment.

Karatayev O, Collier A, Targoff S, Leibowitz S Int J Mol Sci. 2024; 25(15).

PMID: 39125913 PMC: 11313660. DOI: 10.3390/ijms25158341.

Global, regional, and national burden of ischemic heart disease attributable to secondhand smoke from 1990 to 2019.

Yang X, Zhang Z, Sun J, Zhang W Tob Induc Dis. 2024; 22.

PMID: 38966818 PMC: 11223517. DOI: 10.18332/tid/189771.

References

Kim J, Son M, Son C, Radua J, Eisenhut M, Gressier F . Environmental risk factors and biomarkers for autism spectrum disorder: an umbrella review of the evidence. Lancet Psychiatry. 2019; 6(7):590-600. DOI: 10.1016/S2215-0366(19)30181-6. View

Tang S, Wang Y, Gong X, Wang G . A Meta-Analysis of Maternal Smoking during Pregnancy and Autism Spectrum Disorder Risk in Offspring. Int J Environ Res Public Health. 2015; 12(9):10418-31. PMC: 4586619. DOI: 10.3390/ijerph120910418. View

Jung Y, Lee A, McKee S, Picciotto M . Maternal smoking and autism spectrum disorder: meta-analysis with population smoking metrics as moderators. Sci Rep. 2017; 7(1):4315. PMC: 5489536. DOI: 10.1038/s41598-017-04413-1. View

Jung Y, Hsieh L, Lee A, Zhou Z, Coman D, Heath C . An epigenetic mechanism mediates developmental nicotine effects on neuronal structure and behavior. Nat Neurosci. 2016; 19(7):905-14. PMC: 4925298. DOI: 10.1038/nn.4315. View

Pistillo F, Clementi F, Zoli M, Gotti C . Nicotinic, glutamatergic and dopaminergic synaptic transmission and plasticity in the mesocorticolimbic system: focus on nicotine effects. Prog Neurobiol. 2014; 124:1-27. DOI: 10.1016/j.pneurobio.2014.10.002. View

Kim K, Lim M, Kwon H, Yoo S, Kim E, Kim J . Associations between urinary cotinine and symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder. Environ Res. 2018; 166:481-486. DOI: 10.1016/j.envres.2018.06.018. View

Larsson M, Weiss B, Janson S, Sundell J, Bornehag C . Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-8 years of age. Neurotoxicology. 2009; 30(5):822-31. PMC: 3787697. DOI: 10.1016/j.neuro.2009.01.011. View

Duan G, Yao M, Ma Y, Zhang W . Perinatal and background risk factors for childhood autism in central China. Psychiatry Res. 2014; 220(1-2):410-7. DOI: 10.1016/j.psychres.2014.05.057. View

Pham C, Symeonides C, OHely M, Sly P, Knibbs L, Thomson S . Early life environmental factors associated with autism spectrum disorder symptoms in children at age 2 years: A birth cohort study. Autism. 2022; 26(7):1864-1881. DOI: 10.1177/13623613211068223. View

10.

Gibson L, Porter M . Alcohol and Tobacco use While Breastfeeding and Risk of Autism Spectrum Disorder or Attention Deficit/Hyperactivity Disorder. J Autism Dev Disord. 2021; 52(3):1223-1234. PMC: 8067780. DOI: 10.1007/s10803-021-05027-3. View

11.

Bolte E, Moorshead D, Aagaard K . Maternal and early life exposures and their potential to influence development of the microbiome. Genome Med. 2022; 14(1):4. PMC: 8751292. DOI: 10.1186/s13073-021-01005-7. View

12.

Breuss M, Antaki D, George R, Kleiber M, James K, Ball L . Autism risk in offspring can be assessed through quantification of male sperm mosaicism. Nat Med. 2019; 26(1):143-150. PMC: 7032648. DOI: 10.1038/s41591-019-0711-0. View

13.

Greenblatt E, Spradling A . Fragile X mental retardation 1 gene enhances the translation of large autism-related proteins. Science. 2018; 361(6403):709-712. PMC: 6905618. DOI: 10.1126/science.aas9963. View

14.

Zhang X, Lv C, Tian J, Miao R, Xi W, Hertz-Picciotto I . Prenatal and perinatal risk factors for autism in China. J Autism Dev Disord. 2010; 40(11):1311-21. PMC: 2974190. DOI: 10.1007/s10803-010-0992-0. View

15.

Cheslack-Postava K, Sourander A, Hinkka-Yli-Salomaki S, McKeague I, Surcel H, Brown A . A biomarker-based study of prenatal smoking exposure and autism in a Finnish national birth cohort. Autism Res. 2021; 14(11):2444-2453. PMC: 10339819. DOI: 10.1002/aur.2608. View

16.

Berger K, Pearl M, Kharrazi M, Li Y, DeGuzman J, She J . The association of in utero tobacco smoke exposure, quantified by serum cotinine, and Autism Spectrum Disorder. Autism Res. 2021; 14(9):2017-2026. PMC: 10752221. DOI: 10.1002/aur.2561. View

17.

Jo H, Eckel S, Wang X, Chen J, Cockburn M, Martinez M . Sex-specific associations of autism spectrum disorder with residential air pollution exposure in a large Southern California pregnancy cohort. Environ Pollut. 2019; 254(Pt A):113010. PMC: 6764604. DOI: 10.1016/j.envpol.2019.113010. View

18.

Pagalan L, Bickford C, Weikum W, Lanphear B, Brauer M, Lanphear N . Association of Prenatal Exposure to Air Pollution With Autism Spectrum Disorder. JAMA Pediatr. 2018; 173(1):86-92. PMC: 6583438. DOI: 10.1001/jamapediatrics.2018.3101. View

19.

Guo C, Luo M, Wang X, Huang S, Meng Z, Shao J . Reliability and Validity of the Chinese Version of Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F). J Autism Dev Disord. 2018; 49(1):185-196. DOI: 10.1007/s10803-018-3682-y. View

20.

Pierce K, Gazestani V, Bacon E, Barnes C, Cha D, Nalabolu S . Evaluation of the Diagnostic Stability of the Early Autism Spectrum Disorder Phenotype in the General Population Starting at 12 Months. JAMA Pediatr. 2019; 173(6):578-587. PMC: 6547081. DOI: 10.1001/jamapediatrics.2019.0624. View