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Mothers who smoke during pregnancy may be increasing their children's risk of developing bipolar disorder, according to a new study.

Researchers looked at data from a large cohort of pregnant women who participated in the Child Health and Development Study from 1959 to 1966. The latest research was based on 79 cases and 654 controls.

The study linked maternal smoking during pregnancy to a twofold-increased risk of bipolar disorder in their offspring.

Previous studies linked several significant problems in utero and after birth to smoking during pregnancy. Children of mothers who smoked during pregnancy were more likely to have low birth weight and problems with attention.

However, this is the first study to suggest a link between prenatal tobacco exposure and BD, a serious psychiatric illness characterized by significant shifts in mood that alternate between periods of depression and mania.  

"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," Alan Brown, MD, MPH, senior author and Professor of Clinical Psychiatry and Epidemiology at the New York State Psychiatric Institute, Columbia University and Mailman School of Public Health, said in a news release.

"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. 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," researchers wrote.

The findings are published in the American Journal of Psychiatry.