The impact of early life stress on risk of tobacco smoking initiation by adolescents.

AIMS: Our study aimed to examine the association between early life stress and early initiation of alcohol and tobacco use. DESIGN: This prospective cohort study of women and children belongs to the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood. SETTING: Dniprodzerzhynsk, a city of some 250,000 inhabitants in south central Ukraine. PARTICIPANTS: All 4398 women who visited antenatal clinics between December 25, 1992 and July 23, 1994, planned to continue their pregnancy, and were permanent residents of the city were invited to participate. Of the 4398 invitees, 2148 agreed and 1020 of the mother-child pairs were available for complete follow-up until the children were 16 years old. MEASUREMENTS: When study children reached ages 3 and 7, their mothers completed questionnaires about their children's exposure to and impact from a standard list of recent stressful life events. From the data on event prevalence and severity, we assigned each child to low, medium, or high early life stress. When the children became age 16, they completed questionnaires about their history of smoking and drinking. FINDINGS: In multivariate analysis that controlled for current level of family income, current family type, current school type, year of child's birth, lifetime smoking and current drinking by mother, and education of mother and father, girls with high stress at age 3 had 2.2 times (95% confidence interval: 1.23-4.08) higher odds than girls with low stress to start smoking early. CONCLUSIONS: Our study may be the first to use a longitudinal study design to examine early life stress as a risk factor for early smoking initiation in adolescence.

Risk factors for wheezing in Ukrainian children: Ukraine European Longitudinal Study of Pregnancy and Childhood Group.

The prevalence of wheezing in children varies widely around the world. The reasons for this geographic variability remain unclear but may be related in part to exposures in the home environment during pregnancy and early childhood. We investigated the prenatal and early childhood risk factors for wheezing symptoms among 2127 children aged 6-8 years who were participants in the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Cases included the 169 children whose parents answered yes to the International Study of Asthma and Allergy in Children (ISAAC) question: 'Has your child had wheezing or whistling in the chest in the past 12 months' during the ELSPAC assessment of the children at age 7. These were compared with the 1861 children in the cohort whose parents answered 'no' to this question. Factors significantly associated with increased risk of wheezing illness at age 7 in adjusted analyses included mother's asthma [adjusted odds ratio (OR) 3.46, 95% confidence interval (CI) 1.22, 9.85]; mother's allergy problems (OR 1.43, [1.00, 2.05]); rarely playing with other children at age 3 (OR 1.84, [1.09, 3.11]); water intrusion (OR 1.62, [1.09, 2.39]) and inadequate heating of the home (OR 1.52, [1.06, 2.16]) during pregnancy. Factors protective of wheezing at age 7 included being first-born (adjusted OR 0.70, 95% CI 0.50, 0.98); living in the city of Dniprodzerzynsk as compared with Kyiv (OR 0.36, [0.24, 0.54]) and weekly contact with furry animals (OR 0.44, [0.20, 0.97]) before age 3. The constellation of risk factors for wheezing in Ukrainian children is similar to that of children in other parts of the world. Known risk factors do not account for the significant between-city variability of wheezing in Ukrainian children.