Smoking During Pregnancy Associated Risk of Bipolar Disorder

A study by researchers at Columbia University’s Mailman School of Public Health and the New York State Psychiatric Institute in collaboration with the Kaiser Permanente Division of Research reports an association between smoking during pregnancy and increased risk for developing bipolar disorder (BD) in adult children. The paper evaluated offspring from a large cohort of pregnant women who participated in the Child Health and Development Study (CHDS) from 1959-1966.  The study was based on 79 cases and 654 comparison subjects.  Maternal smoking during pregnancy was associated with a twofold increased risk of BD in their offspring.
Findings are published in the American Journal of Psychiatry.

Smoking during pregnancy is known to contribute to significant problems in utero and following birth, including low birth weight and attentional difficulties. This is the first study to suggest an association between prenatal tobacco exposure and BD, a serious psychiatric illness marked by significant shifts in mood that alternate between periods of depression and mania. Symptoms typically become noticeable in the late teens or early adulthood.

“These findings underscore the value of ongoing public health education on the potentially debilitating, and largely preventable, consequences that smoking may have on children over time,” said Alan Brown, MD, MPH, senior author and professor of epidemiology and clinical psychiatry.
“Much of the psychopathology associated with prenatal tobacco exposure clusters around the ‘externalizing’ spectrum, which includes attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance abuse disorders,” noted Dr. Brown and colleagues. “Although not diagnostically classified along the externalizing spectrum, BD shares a number of clinical characteristics with these disorders, including inattention, irritability, loss of self-control, and proclivity to drug/alcohol use.” In effect, children who were exposed to tobacco smoke in utero may exhibit some symptoms and behaviors that are found in BD.

A previous study by Dr. Brown and colleagues found that flu virus in pregnant mothers was associated with a fourfold increased risk that their child would develop BD.

Funding for the study was provided by the National Institute of Mental Health and the National Institute on Child Health and Development.