Early Life Stress, Prenatal Environmental Tobacco Smoke Exposure, and Children’s Emotional and Behavioral Problems

• In Event: Effects of Environmental Exposures on Birth and Early developmental Outcomes

Abstract

INTRODUCTION:
Environmental tobacco smoke (ETS) is a highly prevalent but understudied neurotoxicant with known associations to externalizing problems in youth. Associations between ETS and internalizing problems are inconsistent, with some studies reporting strong associations and others reporting little or no association between ETS and internalizing symptoms. Thus, it is possible that the association between ETS and childhood internalizing problems is moderated by another developmental neurotoxicant. Early life adversities (ELS) are also a known risk factor for myriad mental health concerns. Given that ELS commonly co-occurs with ETS, ETS exposure may moderate associations between ELS and mental health problems in youth. To date, the interacting effects of ELS and ETS on children’s mental health have not been examined. Such work can provide opportunities for personalized prevention.
HYPOTHESIS: ETS moderates associations between ELS exposure and the trajectory of children’s internalizing and externalizing symptoms over time. We further hypothesized that individual components of early life stress (material hardship, maternal perceived stress, intimate partner violence, lack of current social support, neighborhood quality, and maternal demoralization) would contribute differently to children’s mental and behavioral health problems.
STUDY POPULATION: The present study leveraged a prospective longitudinal birth cohort of Black and Latinx mothers residing in three neighborhoods of a metropolitan city in the east coast region.
METHOD: Cotinine, a blood metabolite of nicotine, was used as a biomarker of exposure to tobacco smoke during the third trimester. Internalizing and externalizing problem scores from parent-reported Child Behavior Checklists examined children’s mental and behavioral problems during four study visits between children’s age five to age eleven. Exposure to ELS was measured as a composite of six domains of parent mental health, exposure to traumatic events, and proximal poverty collected by parent report at age 5. Latent growth models examined the moderating effect of ETS on associations between ELS and the trajectory of children’s mental health problems. Weighted quintile sum regression was used to examine the mixture of ELS contributing to children’s mental health problems in significant latent growth models.
RESULTS: Children with higher exposure to ETS and ELS had higher internalizing problems scores at age 5 and a slower increase in internalizing problems over time. Similar results were not observed for externalizing problems. Main effects of ELS were significant in both models, above and beyond effects of ETS. Weighted quintile sum regression revealed significant contributions of maternal demoralization and material hardship to children’s internalizing problems.
CONCLUSION: In sum, ETS moderates associations between ELS and the trajectory of children’s internalizing problems, leading to higher internalizing problem scores at age five and a slower increase in internalizing problems over time. Our results add to the growing body of literature examining the unique and overlapping effects of chemical and social exposures to children’s mental health problems and highlights areas important for personalized prevention.

Authors

• Mariah Deserisy
  Presenting Author

• Jacob W Cohen

• Jordan D. Dworkin

• Jeanette Stingone

• Bruce Ramphal, Columbia University

• Julie Herbstman, Columbia University

• David Pagliaccio, New York State Psychiatric Institute

• Amy Margolis, Columbia University