UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Smoking; Pregnancy; Prenatal Exposure Delayed Effects; Infant, Newborn


Biostatistics | Epidemiology | Health Services Research


Smoking during pregnancy is a persistent public health problem that has been linked to later adverse outcomes. The neonatal period-the first month of life-carries substantial developmental change in regulatory skills and is the period when tobacco metabolites are cleared physiologically. Studies to date mostly have used cross-sectional designs that limit characterizing potential impacts of prenatal tobacco exposure on the development of key self-regulatory processes and cannot disentangle short-term withdrawal effects from residual exposure-related impacts. In this study, pregnant participants (N = 304) were recruited prospectively during pregnancy, and smoking was measured at multiple time points, with both self-report and biochemical measures. Neonatal attention, irritable reactivity, and stress dysregulation were examined longitudinally at three time points during the first month of life, and physical growth indices were measured at birth. Tobacco-exposed infants showed significantly poorer attention skills after birth, and the magnitude of the difference between exposed and nonexposed groups attenuated across the neonatal period. In contrast, exposure-related differences in irritable reactivity largely were not evident across the 1st month of life, differing marginally at 4 weeks of age only. Third-trimester smoking was associated with pervasive, deleterious, dose-response impacts on physical growth measured at birth, whereas nearly all smoking indicators throughout pregnancy predicted level and growth rates of early attention. The observed neonatal pattern is consistent with the neurobiology of tobacco on the developing nervous system and fits with developmental vulnerabilities observed later in life. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Rights and Permissions

Copyright © 2010 American Psychological Association. Used by permission. “This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.” Link to article on publisher's site

DOI of Published Version



Developmental Psychology, Vol 47(1), Jan 2011, 153-169. doi: 10.1037/a0020724. Link to article on publisher's site

Journal/Book/Conference Title

Developmental psychology

PubMed ID


Related Resources

Link to Article in PubMed



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.