Impaired executive function mediates the association between maternal pre-pregnancy body mass index and child ADHD symptoms.
Impaired executive function mediates the association between maternal pre-pregnancy body mass index and child ADHD symptoms.
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DOI：
10.1371/journal.pone.0037758
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Sandman CA
中科院分区：
文献类型：
--
作者：
Buss C;Entringer S;Davis EP;Hobel CJ;Swanson JM;Wadhwa PD;Sandman CA
越来越多的证据表明，子宫内生活中暴露于不良条件可能会增加儿童患注意缺陷/多动障碍（ADHD）的风险。母亲孕前高体重指数（BMI）已被证明可预测儿童的ADHD症状，然而这种关系背后的神经认知过程尚不清楚。本研究的目的是检验这种关联是由儿童执行功能的改变所介导的这一假设。
对一个基于人群的174名儿童队列（平均年龄 = 7.3±0.9（标准差）岁，55%为女孩）使用儿童行为检查表评估ADHD症状，并使用Go/No - go任务评估神经认知功能。该队列从妊娠早期和出生开始，经过婴儿期和儿童期进行了前瞻性随访，对母婴产前和产后因素进行了系列测量。在控制关键的潜在混杂变量后，母亲孕前BMI是儿童ADHD症状（F(1,158) = 4.80，p = 0.03）以及儿童在Go/No - go任务中的表现（F(1,157) = 8.37，p = 0.004）的重要预测因素。对中介模型的检验显示，母亲孕前较高BMI与儿童ADHD症状之间的关联是由执行功能受损（低效/注意力不集中的处理；索贝尔检验：t = 2.39（±0.002，标准误），p = 0.02）所介导的。
据我们所知，这是第一项报告母亲孕前BMI相关的儿童神经认知功能改变可能介导其对ADHD风险影响的研究。这一发现具有临床意义，并且可能推断出肥胖母亲的孩子与非肥胖母亲的孩子相比，ADHD患病率大约增加2.8倍。这些结果为人们日益认识到像ADHD这样的神经发育障碍可能在生命早期就奠定基础提供了进一步的证据。
Increasing evidence suggests exposure to adverse conditions in intrauterine life may increase the risk of developing attention-deficit/hyperactivity disorder (ADHD) in childhood. High maternal pre-pregnancy body mass index (BMI) has been shown to predict child ADHD symptoms, however the neurocognitive processes underlying this relationship are not known. The aim of the present study was to test the hypothesis that this association is mediated by alterations in child executive function. A population-based cohort of 174 children (mean age = 7.3±0.9 (SD) yrs, 55% girls) was evaluated for ADHD symptoms using the Child Behavior Checklist, and for neurocognitive function using the Go/No-go task. This cohort had been followed prospectively from early gestation and birth through infancy and childhood with serial measures of maternal and child prenatal and postnatal factors. Maternal pre-pregnancy BMI was a significant predictor of child ADHD symptoms (F(1,158) = 4.80, p = 0.03) and of child performance on the Go/No-go task (F(1,157) = 8.37, p = 0.004) after controlling for key potential confounding variables. A test of the mediation model revealed that the association between higher maternal pre-pregnancy BMI and child ADHD symptoms was mediated by impaired executive function (inefficient/less attentive processing; Sobel Test: t = 2.39 (±0.002, SEM), p = 0.02). To the best of our knowledge this is the first study to report that maternal pre-pregnancy BMI-related alterations in child neurocognitive function may mediate its effects on ADHD risk. The finding is clinically significant and may extrapolate to an approximately 2.8-fold increase in the prevalence of ADHD among children of obese compared to those of non-obese mothers. These results add further evidence to the growing awareness that neurodevelopmental disorders such as ADHD may have their foundations very early in life.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1111/j.1469-7610.1993.tb01785.x
发表时间：
1993-10-01
期刊：
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES
影响因子：
--
作者：
BIEDERMAN, J;FARAONE, SV;TSUANG, MT
通讯作者：
TSUANG, MT
影响因子：
5.9
作者：
CHEN, WJ;FARAONE, SV;TSUANG, MT
通讯作者：
TSUANG, MT
影响因子：
3
作者：
Bilbo SD;Schwarz JM
通讯作者：
Schwarz JM
DOI：
10.1097/med.0b013e3283405921
发表时间：
2010-12
期刊：
Current opinion in endocrinology, diabetes, and obesity
影响因子：
--
作者：
Entringer S;Buss C;Wadhwa PD
通讯作者：
Wadhwa PD