Prenatal smoking might not cause attention-deficit/hyperactivity disorder: evidence from a novel design.
Prenatal smoking might not cause attention-deficit/hyperactivity disorder: evidence from a novel design.
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DOI：
10.1016/j.biopsych.2009.05.032
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发表时间：
2009-10-15
影响因子：
10.6
通讯作者：
Harold, Gordon
中科院分区：
文献类型：
--
作者：
Thapar, Anita;Rice, Frances;Hay, Dale;Boivin, Jacky;Langley, Kate;van den Bree, Marianne;Rutter, Michael;Harold, Gordon
母亲在怀孕期间吸烟被广泛认为对后代注意力缺陷/多动障碍（ADHD）有危险作用。这一观点得到了对关联的一致观察的支持。然而，不可能确定观察设计对混杂因素的充分控制。我们使用一种新颖的“自然实验”设计，将产前环境与替代遗传效应分开。该设计基于从英国和美国的20家生育诊所招募的辅助生殖技术受孕的后代，这些后代：1）遗传无关，2）与怀孕的女性有关。如果母亲在怀孕期间吸烟具有真正的风险影响，则无论母亲和后代是否相关或无关，都将观察到与ADHD的关联。数据来自815个4岁至11岁儿童的家庭，父母问卷调查和产前记录。出生体重被用作比较结果。主要考虑的结果是儿童ADHD症状。在无血缘关系和有血缘关系的母亲-子女对中发现了怀孕期间吸烟与出生体重较低之间的关联，这与真正的风险效应一致。然而，对于ADHD症状，相关对的关联程度（β = 0.102，p <0.02）显著高于不相关对（β=-0.052，p > 0.10），这表明遗传效应。我们的研究结果强调了用遗传敏感设计来检验因果假设的必要性。遗传混淆不一定通过统计控制消除。先前观察到的母亲在怀孕期间吸烟和ADHD之间的关联可能代表了遗传效应。
It is widely considered that exposure to maternal cigarette smoking in pregnancy has risk effects on offspring attention-deficit/hyperactivity disorder (ADHD). This view is supported by consistent observations of association. It is, however, impossible to be certain of adequate control for confounding factors with observational designs. We use a novel “natural experiment” design that separates prenatal environmental from alternative inherited effects. The design is based on offspring conceived with Assisted Reproductive Technologies recruited from 20 fertility clinics in the United Kingdom and United States who were: 1) genetically unrelated, and 2) related to the woman who underwent the pregnancy. If maternal smoking in pregnancy has true risk effects, association will be observed with ADHD regardless of whether mother and offspring are related or unrelated. Data were obtained from 815 families of children ages 4 years–11 years with parent questionnaires and antenatal records. Birth weight was used as a comparison outcome. The key outcome considered was child ADHD symptoms. Association between smoking in pregnancy and lower birth weight was found in unrelated and related mother-offspring pairs, consistent with a true risk effect. However, for ADHD symptoms, the magnitude of association was significantly higher in the related pairs (β = .102, p < .02) than in the unrelated pairs (β= −.052, p > .10), suggesting inherited effects. Our findings highlight the need to test causal hypotheses with genetically sensitive designs. Inherited confounds are not necessarily removed by statistical controls. The previously observed association between maternal smoking in pregnancy and ADHD might represent an inherited effect.
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DOI：
10.1111/1469-7610.00196
发表时间：
2003-11-01
期刊：
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES
影响因子：
--
作者：
D'Onofrio, BM;Turkheimer, EN;Emery, RE
通讯作者：
Emery, RE
影响因子：
3.8
作者：
Carmines, Edward L.;Rajendran, Narayanan
通讯作者：
Rajendran, Narayanan
影响因子：
6.9
作者：
Knopik, Valerie S.;Heath, Andrew C.;Martin, Nicholas G.
通讯作者：
Martin, Nicholas G.
DOI：
10.1207/s15374424jccp2003_3
发表时间：
1991-09-01
期刊：
JOURNAL OF CLINICAL CHILD PSYCHOLOGY
影响因子：
--
作者：
DUPAUL, GJ
通讯作者：
DUPAUL, GJ
影响因子：
4.7
作者：
Agrawal, Arpana;Knopik, Valerie S.;Madden, Pamela A. F.
通讯作者：
Madden, Pamela A. F.