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Parental psychosocial influences and adverse lifestyle choices have consistently impacted upon the outcome for newborn infants. Psychopathology morbidity can persist throughout childhood and into adulthood (Hien and Honeyman 2000; Maughan et al. 2001; Dawson 2003; Disney et al. 2008) and mortality in extreme cases (Victoria Climbié Inquiry [Lord Laming Chair] 2003). There are extensive and varied socio‐demographic variables that indicate the complexity of the subject matter (see website that accompanies this book for more information on safeguarding). Co‐morbidities exist between smoking, alcohol and substance misuse, domestic violence, maternal depression and adverse social environments that place the newborn at greater risk of maladaptive behaviours in childhood and adulthood that replicate that of the parents (Leonard et al. 2007). Therefore, the aim of social support and intervention strategies in the prenatal period and beyond is to break the cycle. See Table 1.6 for a summary of fetal and newborn outcome adverse effects related to lifestyle.

TABLE 1.6 Maternal/paternal lifestyle and psychosocial influences.

Sources: Adapted from Hien and Honeyman 2000; Maughan et al. 2001; Dawson 2003; Disney et al. 2008.

Lifestyle	Fetal effect	Potential neonatal and childhood outcome
Smoking	Spontaneous abortion Altered placental morphology Chronic hypoxia Intrauterine growth restriction (IUGR)	Abnormal newborn neurobehaviour Increased risk of infant irritability Hypertonia Childhood behavioural problems Lowered immunity SIDS, RSV infection Lower respiratory tract infections Altered pulmonary function Childhood asthma Increased risk of tobacco dependency in adulthood
Alcohol use	Fetal alcohol syndrome (FAS) IUGR	FAS Fetal alcohol disorder spectrum Behavioural problems
Substance misuse	Risk of transplacental transmission of hepatitis B and C Congenital anomalies Symmetrical IUGR Prematurity Meconium liquor	Neonatal Abstinence syndrome
High‐conflict relationships: domestic abuse	Intrauterine death Increased risk of acute obstetric complications that impact on newborn outcome	Child abuse Cognitive psychological impairment Childhood depression
Parent in care system		Increased risk of infant in care system Increased risk of child neglect