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In their most interesting paper on psychiatric disorders in SGA and VLBW
adolescents, Indredavik et al. conclude that a biological cause-effect
seems plausible to explain the association between psychiatric symptoms
and disorders by the age of 14 and VLBW. Consequently, the most relevant
question here is how to prevent the development of such disorders.
possible - and preventable...
possible - and preventable - cause of these findings could be maternal
smoking during pregnancy. There is an impressive amount of data indicating
that maternal prenatal smoking can cause low birthweight - though not in
all women equally severe  - and there is also sufficient data
demonstrating that passive smoking can cause alterations in the
development of the brain , and is associated with psychiatric behaviour
and disorders .
It would be most interesting if the authors could correlate the
information on prenatal maternal smoking, if available. Obviously,
immaturity of the brain and damaging neonatal incidents are likely to play
a role as well, but premature birth and neonatal complications have also
been attributed to prenatal maternal smoking .
(1). M S Indredavik, T Vik, S Heyerdahl, S Kulseng, P Fayers, and A-M
Brubakk. Psychiatric symptoms and disorders in adolescents with low birth
weight. Arch. Dis. Child. Fetal Neonatal Ed. 2004; 89: F445-F450.
(2). Bush PG, Mayhew TM, Abramovich DR, Aggett PJ, Burke MD, Page KR. A
quantitative study on the effects of maternal smoking on placental
morphology and cadmium concentration. Placenta 2000;21(2-3):247-56.
(3). Slotkin, T. A. 1998. Fetal nicotine or cocaine exposure: which one is
worse? J Pharmacol Exp Ther 285(3):931-45.
(4). Eskenazi B, Castorina R. Association of prenatal maternal or postnatal
child environmental tobacco smoke exposure and neurodevelopmental and
behavioral problems in children. Environ Health Perspect 1999;107(12):991-
(5). Andres RL, Day MC. Perinatal complications associated with maternal
tobacco use. Semin Neonatol 2000;5(3):231-41.