Behavior Genetics

, Volume 44, Issue 5, pp 456–467 | Cite as

Maternal Smoking During Pregnancy and Adverse Outcomes in Offspring: Genetic and Environmental Sources of Covariance

  • Ralf Kuja-HalkolaEmail author
  • Brian M. D’Onofrio
  • Henrik Larsson
  • Paul Lichtenstein
Original Research


Maternal smoking during pregnancy (SDP) has been associated with several psychiatric outcomes in the offspring; studies have questioned whether the associations are causal, however. We analyzed all children born in Sweden between 1983 and 2009 to investigate the effect of SDP on multiple indicators of adverse outcomes in three areas: pregnancy outcomes (birth weight, preterm birth and being born small for gestational age), long-term cognitive abilities (low academic achievement and general cognitive ability) and externalizing behaviors (criminal conviction, violent criminal conviction and drug misuse). SDP was associated with all outcomes. Within-family analyses of the pregnancy outcomes were consistent with a causal interpretation as the associations persisted when siblings discordant for SDP were compared. For the cognitive and externalizing outcomes, the results were not consistent with causal effects; when comparing differentially exposed siblings none of the associations remained significant. In quantitative genetic models genetic factors explained the majority of the associations between SDP and cognitive and externalizing outcomes. The results suggest that the associations between SDP in mothers and cognition and externalizing behaviors in their offspring is primarily due to genetic effects that influence the behaviors in both generations.


Smoking during pregnancy Children of siblings Sibling comparison Cousin comparison Extended family model 



Preliminary partial results were presented at the 42nd Annual Meeting of the Behavior Genetics Association; June 24, 2012; Edinburgh, Scotland. The study was supported by Grants from the National Institute of Child Health and Human Development (B.M.D., Grant Number HD061817); by the Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework grant no 340-2013-5867, by the and Swedish Research Council for Health, Working Life and Welfare, and by the Swedish Prison and Probation Services.

Conflict of Interest

Author Kuja-Halkola R, Author D’Onofrio BM, Author Larsson H and Author Lichtenstein P declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Data was merged and anonymized by Statistics Sweden, an independent governmental agency. The key linking the personal number to the data was destroyed immediately after merging; therefore no informed consent was required.

Supplementary material

10519_2014_9668_MOESM1_ESM.docx (985 kb)
Supplementary material 1 (DOCX 984 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ralf Kuja-Halkola
    • 1
    Email author
  • Brian M. D’Onofrio
    • 2
  • Henrik Larsson
    • 1
  • Paul Lichtenstein
    • 1
  1. 1.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  2. 2.Department of Psychological and Brain SciencesIndiana UniversityBloomingtonUSA

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