Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study
Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study
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DOI：
10.1017/s2045796018000185
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发表时间：
2019-10-01
影响因子：
8.1
通讯作者：
Richiardi, L.
中科院分区：
文献类型：
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作者：
Vizzini, L.;Popovic, M.;Richiardi, L.
目标。母亲精神障碍与儿童注意力缺陷/多动障碍(ADHD)的风险有关。在母子队列的背景下，我们检查了母亲的焦虑、抑郁和睡眠障碍是否与学龄前ADHD症状有关。这项研究包括来自意大利宁菲(Nascita e Infanzia：Gli effetti Dell‘Ambiente’)队列的3634名单身人士。孕妇医生在怀孕前和怀孕期间诊断的焦虑、抑郁和睡眠障碍的评估是通过在怀孕期间和分娩后6个月完成的问卷进行的。根据《精神疾病诊断和统计手册》，母亲们在4岁时对孩子的ADHD症状进行了评级。对多动冲动(ADHD-H)、注意力不集中(ADHD-I)和ADHD总分进行分析，调整了儿童性别、头胎状况、母亲年龄、文化程度、孕期饮酒和吸烟等因素。4岁时ADHD总分与母亲的终生焦虑(17.1%，与从未有差异；95%可信区间7.3-27.9%)、睡眠障碍(35.7%；95%可信区间10.7-66.5%)和抑郁(17.5%；95%可信区间3.2-33.8%)有关。ADHD-H和ADHD-I特征也观察到了类似的正相关性，母亲睡眠障碍与儿童ADHD-I得分、母亲抑郁和这两个ADHD得分之间的关联略有减弱。当疾病在妊娠期活跃时，所有的估计值都增加了，而只有在孕前活跃的疾病时，所有的估计值都降低了。母亲的焦虑、抑郁和睡眠障碍与学龄前儿童ADHD-H、ADHD-I和ADHD症状总数的相对增加有关。
Aims. Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother-child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms.Methods. The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente') cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive-impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy.Results. The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3-27.9%), sleep disorders (35.7%; 95% CI 10.7-66.5%) and depression (17.5%; 95% CI 3.2-33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period.Conclusions. Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.