Introduction: Previous studies have reported associations between prenatal cell phone use and child behavioral problems, but findings have been inconsistent and based on retrospective assessment of cell phone use. This study aimed to assess this association in a multi-national analysis, using data from three cohorts with prospective data on prenatal cell phone use, together with previously published data from two cohorts with retrospectively collected cell phone use data.
Methods: We used individual participant data from 83,884 mother-child pairs in the five cohorts from Denmark (1996-2002), Korea (2006-2011), the Netherlands (2003-2004), Norway (2004-2008), and Spain (2003-2008). We categorized cell phone use into none, low, medium, and high, based on frequency of calls during pregnancy reported by the mothers. Child behavioral problems (reported by mothers using the Strengths and Difficulties Questionnaire or Child Behavior Checklist) were classified in the borderline/clinical and clinical ranges using validated cut-offs in children aged 5-7. years. Cohort specific risk estimates were meta-analyzed.
Results: Overall, 38.8% of mothers, mostly from the Danish cohort, reported no cell phone use during pregnancy and these mothers were less likely to have a child with overall behavioral, hyperactivity/inattention or emotional problems. Evidence for a trend of increasing risk of child behavioral problems through the maternal cell phone use categories was observed for hyperactivity/inattention problems (OR for problems in the clinical range: 1.11, 95%CI 1.01, 1.22; 1.28, 95%CI 1.12, 1.48, among children of medium and high users, respectively). This association was fairly consistent across cohorts and between cohorts with retrospectively and prospectively collected cell phone use data.
Conclusions: Maternal cell phone use during pregnancy may be associated with an increased risk for behavioral problems, particularly hyperactivity/inattention problems, in the offspring. The interpretation of these results is unclear as uncontrolled confounding may influence both maternal cell phone use and child behavioral problems.

Additional Metadata
Keywords Attention deficit disorder with hyperactivity, Cell phones, Child behavior, Child health, Electromagnetic radiation, Pregnancy
Persistent URL dx.doi.org/10.1016/j.envint.2017.03.024, hdl.handle.net/1765/99227
Journal Environment International
Citation
Birks, L, Guxens Junyent, M, Papadopoulou, E, Alexander, J, Ballester, F, Estarlich, M, … Vrijheid, M. (2017). Maternal cell phone use during pregnancy and child behavioral problems in five birth cohorts. Environment International, 104, 122–131. doi:10.1016/j.envint.2017.03.024