Prospective Associations between Maternal Smoking Status During Pregnancy and Parenting Behaviors at Six Months Postpartum

• In Event: 3-129 - Examining Novel Predictors of Maternal Sensitivity during Infancy within the context of Risk

Integrative Statement

Maternal smoking during pregnancy (MSDP) remains a major public health concern. Despite widespread campaigns, over 7% of pregnant women smoke in the US with rates of >15% in poor, less-educated, and underserved populations according to self-report and/or biochemical verification. Among smokers, there is considerable variability in cigarette use over the course of pregnancy, with a subset of women spontaneously quitting smoking and remaining abstinent through delivery. Given higher levels of maternal-fetal attachment observed among quitters relative to persistent smokers and nonsmokers, as well as links between MSDP and comorbid conduct disorder, ADHD, and antisocial behavior, it is plausible that MSDP may be associated with postpartum parenting. Indeed, quitters have demonstrated increased responsiveness to young children relative to persistent smokers. We sought to extend these findings to parenting during infancy, investigating group differences in maternal parenting among quitters, persistent smokers, and nonsmokers.
Participants included 145 mother-infant dyads. Mothers completed 2-4 interview sessions during pregnancy and at delivery. During each interview, mothers completed the Timeline Follow Back interview, a calendar-based assessment of tobacco use and provided saliva for biochemical verification of smoking status. At 6-months of age, mothers and their infants engaged in a 7-minute Free Play Task designed to assess parenting. Maternal behavior during the Free Play Task was coded by research assistants trained to reliability criterion of .80 and blind to smoking status using the Parent Caregiver Involvement Scale and the Emotional Availability Scales. Participants in the current analysis include 18 quitters (12%), 37 persistent smokers (26%), and 90 nonsmokers (62%). On average, mothers were 26 years old, were racially diverse (56% non-white), and had a high school education or less (50%).
One-way ANOVAs revealed significant group differences in several parenting behaviors. First, maternal sensitivity differed according to smoking status (F = 3.57, p = .03), such that such that persistent smokers were less sensitive than quitters (p = .03) and nonsmokers (p = .02). Maternal acceptance also differed across groups (F = 4.29, p = .02), such that persistent smokers displayed a lower acceptance towards their infants than quitters (p = .01) and nonsmokers (p = .05). Maternal positive regard also differed across groups (F = 3.39, p = .036), such that nonsmokers displayed higher levels of positive regard toward their infants relative to smokers (p= .01). Finally, maternal enjoyment differed across groups (F = 3.11, p = .05), such that quitters demonstrated higher levels of enjoyment of play relative to persistent smokers (p = .02). Across all indices of parenting, quitters and nonsmokers did not significantly differ.
Overall, persistent smokers demonstrated less sensitivity, acceptance, and enjoyment during interactions with their infants relative to quitters and control mothers, whereas parenting among women who quit smoking during pregnancy did not differ from nonsmokers. Our findings suggest differences in parenting between smokers and quitters/nonsmokers may exacerbate the negative effects of prenatal smoking on infant behavior. Implications for education and prevention efforts with pregnant and postpartum smokers and also for elucidating pathways underlying the intergenerational transmission of smoking will be discussed.

Authors

• Meaghan McCallum, Warren Alpert Medical School of Brown University
  Presenting Author

• Katelyn Borba, The Miriam Hospital
  Non-Presenting Author

• Alana Corey, The Miriam Hospital
  Non-Presenting Author

• Cynthia Nguyen, The Miriam Hospital
  Non-Presenting Author

• Chantelle Ward, Emory University
  Non-Presenting Author

• Stephanie H. Parade, Bradley Research Center/Brown University
  Non-Presenting Author

• Laura Stroud, Brown University
  Non-Presenting Author