The role of neonatal vitamin D in the association of prenatal depression with toddlers ADHD symptoms: A birth cohort study
The role of neonatal vitamin D in the association of prenatal depression with toddlers ADHD symptoms: A birth cohort study
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新生儿维生素 D 在产前抑郁症与幼儿 ADHD 症状关联中的作用：出生队列研究
DOI：
10.1016/j.jad.2020.12.033
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发表时间：
2021-02-15
影响因子：
6.6
通讯作者：
Zhu, Peng
中科院分区：
文献类型：
--
作者：
Ma, Shuang-shuang;Zhu, Dao-min;Zhu, Peng
背景资料：维生素D已被证明具有“神经保护”作用，但尚不清楚早期充足的维生素D是否能保护不良的神经发育。我们的目的是研究新生儿维生素D在母亲抑郁症（MD）症状与幼儿ADHD.Methods的关联中的作用：参与者包括来自中国-安徽出生队列研究的1 125对母婴。采用流行病学研究中心抑郁量表（CES-D）在孕30-34周对MD进行评估。在产后48-54个月，Conners多动症指数（CHI）报告了幼儿ADHD。结果：母亲抑郁评分越高，其子女患ADHD的危险性越高（20.1%vs11.1%，P = 0.003;校正RR=1.75，95%CI：1.10-2.81）。在患有新生儿维生素D缺乏症（VDD）的幼儿中，母亲MD显著增加ADHD风险（校正RR=3.74，95%CI：1.49-9.41），但在患有新生儿维生素D充足症（VDA）的幼儿中未发现这种关联。与无MD的幼儿相比，MD和新生儿VDD的幼儿患ADHD的风险更高（校正RR=3.10，95%CI：1.44-6.63）。结论：本前瞻性研究表明，母亲产前抑郁症状对子代ADHD症状的不利影响在新生儿VDD患儿中有所加强，母亲产前抑郁症状对子代ADHD症状的不利影响在新生儿VDD患儿中有所加强。
Background: Vitamin D has been demonstrated a "neuroprotective" effect, but it is unclear whether early-life adequate vitamin D protect adverse neurodevelopment. We aimed to examine the role of neonatal vitamin D in the association of maternal depression (MD) symptoms with toddlers ADHD.Methods: Participants included 1 125 mother-infant pairs from the China-Anhui Birth Cohort study. MD was assessed by the Center for Epidemiological Studies Depression Scale (CES-D) at 30-34 gestational weeks. Toddlers ADHD was reported by the Conners' Hyperactivity Index (CHI) at 48-54 months postpartum. Multiple logistic regression models were performed to evaluate the association of maternal depressive score and toddlers ADHD while cord blood 25(OH)D levels were stratified.Results: Toddlers of mothers with higher depression score were at higher risk of ADHD (20.1% vs 11.1%, P = 0.003; adjusted RR=1.75, 95% CI: 1.10-2.81). Among toddlers with neonatal vitamin D deficiency (VDD), ADHD risk was significantly increased with maternal MD (adjusted RR=3.74, 95% CI: 1.49-9.41), but the association was not found in toddlers with neonatal vitamin D adequacy (VDA). Compared to toddlers without MD, toddlers with both MD and neonatal VDD had higher risk of ADHD (adjusted RR=3.10, 95% CI: 1.44-6.63). But the risk did not significantly increase in toddlers with MD and neonatal VDA (adjusted RR=1.53, 95% CI: 0.86-2.72).Limitations: Maternal depressive symptoms in early pregnancy and anxious symptoms were needed to include.Conclusion: This prospective study indicated that the detrimental effect of maternal prenatal depressive symptoms on offspring's ADHD symptoms strengthened in toddlers with neonatal VDD.