Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring:: evidence from three prospective pregnancy cohorts
Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring:: evidence from three prospective pregnancy cohorts
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DOI：
10.1038/sj.ijo.0803741
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发表时间：
2008-03-01
影响因子：
4.9
通讯作者：
Jarvelin, M-R
中科院分区：
文献类型：
--
作者：
Rodriguez, A.;Miettunen, J.;Jarvelin, M-R
目的：我们研究妊娠体重（孕前体重指数 (BMI) 和/或体重增加）是否与学龄后代注意力缺陷多动障碍 (ADHD) 的核心症状相关。设计：对北欧 ADHD 网络内瑞典、丹麦和芬兰的前瞻性妊娠队列进行随访。方法：前瞻性收集孕产妇妊娠和分娩数据。教师对后代的注意力不集中和多动症状进行评分。高分被定义为至少一种核心症状被评为“严重”，两种核心症状被评为“存在”（大约 10% 的儿童得分在此范围内）。使用Logistic回归和潜在类别分析来检查母亲怀孕体重与儿童ADHD核心症状的关系。结果：教师对12 556名学龄儿童进行了评分。医学研究所指南之外的妊娠体重增加与 ADHD 症状无关（以下建议：优势比 (OR)：0.96；95% 置信区间 (CI)：0.81, 1.14；以上建议：OR：0.98；95% CI：0.82, 1.16）。为了检查孕前 BMI 和体重增加的各种模式，我们使用潜在类别分析，发现包括孕前超重或肥胖在内的类别与后代的高 ADHD 症状评分之间存在显着关联，根据胎龄、出生体重、体重增加、怀孕进行调整后，OR 范围在 1.37 (95% CI: 1.07, 1.75) 和 1.89 (95% CI: 1.13, 3.15) 之间吸烟、孕产妇年龄、孕产妇教育、儿童性别、家庭结构和队列原籍国。与体重正常的女性相比，超重且在妊娠期间体重增加较多的女性所生的孩子出现 ADHD 症状的风险是正常体重女性的 2 倍（OR：2.10，95% CI：1.19，3.72）。 结论：我们首次表明，孕前 BMI 与儿童 ADHD 症状相关。如果这些关联是因果关系，那么我们的结果就具有公共卫生意义，并将后代的多动症症状添加到与产前超重和肥胖相关的有害结果列表中。
Objectives: We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring.Design: Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within the Nordic Network on ADHD.Methods: Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as 'severe' and two as 'present' (approximately 10% of children scored in this range). Logistic regression and latent class analyses were used to examine maternal pregnancy weight in relation to children's ADHD core symptoms.Results: Teacher rated 12 556 school-aged children. Gestational weight gain outside of the Institute of Medicine guidelines was not related to ADHD symptoms (below recommendations: odds ratio (OR): 0.96; 95% confidence interval (CI): 0.81, 1.14; above recommendations: OR: 0.98; 95% CI: 0.82, 1.16). To examine various patterns of pre-pregnancy BMI and weight gain, we used latent class analysis and found significant associations between classes that included pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure and cohort country of origin. Children of women who were both overweight and gained a large amount of weight during gestation had a 2-fold risk of ADHD symptoms (OR: 2.10, 95% CI: 1.19, 3.72) compared to normal-weight women.Conclusions: We show for the first time that pre-pregnancy BMI is associated with ADHD symptoms in children. Our results are of public health significance if the associations are causal and will then add ADHD symptoms in offspring to the list of deleterious outcomes related to overweight and obesity in the prenatal period.