Human studies on the effect of prenatal exposures on offspring substance use may be confounded by co-occurring environmental and genetic risk factors for offspring substance use and problems. Mothers who continue to smoke, drink, and use illicit substances during pregnancy have lower levels of educational attainment, less annual income, higher rates of antisocial behavior, and more substance use problems (Gilman et al., 2008, Smith et al., 1987, Wendell, 2013). Given that offspring of substance-abusing parents are at increased risk for SUD (Dawson and Grant, 1998, Grant, 1998, Hill et al., 2008, Hill et al., 2011), a family history of SUD may be a particularly important factor to consider in the relation between prenatal exposures and offspring substance use problems.
