A Propensity Scoring Approach to Characterizing the Effects of Maternal Smoking During Pregnancy on Offspring’s Initial Responses to Cigarettes and Alcohol
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When examining the effects of prenatal exposure to maternal smoking during pregnancy (MSDP) on later offspring substance use, it is critical to consider familial environments confounded with MSDP. The purpose of this study was to examine the effect of MSDP on offspring’s initial reactions to cigarettes and alcohol, which are indicators of future substance-use related problems. We tested these effects using two propensity score approaches (1) by controlling for confounding using the MSDP propensity score and (2) examining effects of MSDP across the MSDP risk distribution by grouping individuals into quantiles based on their MSDP propensity score. This study used data from 829 unrelated mothers with a reported lifetime history of smoking to determine the propensity for smoking only during their first trimester (MSDP-E) or throughout their entire pregnancy (MSDP-T). Propensity score analyses focused on the offspring (N = 1616 female twins) of a large subset of these mothers. We examined the effects of levels of MSDP-E/T on offspring initial reactions to their first experiences with alcohol and cigarettes, across the distribution of liability for MSDP-E/T. MSDP-E/T emerged as significant predictors of offspring reactions to alcohol and cigarettes, but the effects were confounded by the familial liability for MSDP. Further, the unique MSDP effects that emerged were not uniform across the MSDP familial risk distribution. Our findings underscore the importance of properly accounting for correlated familial risk factors when examining the effects of MSDP on substance related outcomes.
KeywordsPrenatal exposure Nicotine Subjective drug responses Genetic Tobacco Substance use
The authors would like to acknowledge the families that have and continue to participate in the Missouri Adolescent Female Twin Study. This work supported by NIH Grants: DA17671 (Knopik), AA07728 (Heath), AA09022 (Heath), AA11998 (Heath), HD049024 (Heath), AA017688 (Heath), AA021492 (Heath) and DA0027995 (Madden). Dr. Bidwell is supported by K23DA033302. Dr. Palmer is supported by K01 AA021113.
All authors collaborated to develop the study concept and design. L.C.B, R.H.P. and L.A.B. performed the data analysis and interpretation under the guidance of P.A.M., A.C.H, and V.S.K. L.C.B. drafted the paper, and V.S.K, R.H.P, P.A.M., and A.C.H. provided critical revisions. All authors approved the final version of the paper for submission.
Compliance with Ethical Standards
Conflict of interest
L. Cinnamon Bidwell, Rohan H.C. Palmer, Leslie Brick, Pamela A.F. Madden, Andrew C. Heath and Valerie S. Knopik declare that they have no conflicts of interests.
Human and Animal Rights and Informed Consent
This research was approved by the Washington University School of Medicine IRB.
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