Abstract
OBJECTIVE: To investigate whether prenatal exposure to nicotine has an impact on several reading skill outcomes in school age children. STUDY DESIGN: Using a longitudinal sample of 5119 school age children in the Avon Longitudinal Study of Parents and Children, this study investigated specific reading skill outcomes in the area of speed, fluency, accuracy, spelling, and comprehension in relation to prenatal nicotine exposure, after adjusting for potential mediators and confounders. Prenatal nicotine exposure was divided into 3 categories: high (>17 mg per day), low (≤17 mg per day), and no exposure. RESULTS: We found that prenatal nicotine exposure was associated with increased risk of underperformance in specific reading skill outcomes after adjusting for potential mediators and confounders (P = .006). The effect of poor performance in decoding single words was most pronounced among children with prenatal exposure to high levels of nicotine in conjunction with a phonological deficit. Overall, the results showed that maternal smoking has moderate to large associations with delayed or decreased reading skills of children in the Longitudinal Study of Parents and Children. CONCLUSIONS: High prenatal nicotine exposure has a negative association with reading performance in school age children. In addition, modeling showed that environmental factors significantly moderated the interaction between prenatal nicotine exposure and reading skill outcomes.