PILOT--ADHD IN CHILDREN OF MOTHERS WHO SMOKED

除了对ADHD有重大遗传影响的证据外，越来越多的证据表明父母酗酒和母亲在怀孕期间饮酒和吸烟对后代ADHD的风险有影响。以前的研究表明，产前接触酒精和尼古丁与儿童多动症的风险增加有关。初步分析还表明：（i）父母酗酒与ADHD之间存在显着关联，以及母亲在怀孕期间吸烟与父母酗酒之间存在显着关联;（ii）父母酗酒与后代ADHD之间存在遗传相关性的证据。考虑到这些结果，除了遗传传播外，与父母酗酒相关的怀孕期间母亲吸烟率增加可能是导致父母酗酒与ADHD之间关联的重要因素。综上所述，有证据表明，ADHD的遗传和环境风险因素都在酗酒者的孩子中起作用，这增加了这些风险因素相互作用的可能性。使用一种创新的母亲内比较方法，这项试点研究将评估母亲在怀孕期间吸烟对200名“高遗传风险”儿童（100对父亲酗酒的兄弟姐妹）和200名“低遗传风险”儿童（100对没有父亲酗酒史的兄弟姐妹）ADHD的相对影响。新的母亲内方法侧重于在一次怀孕期间吸烟但不是在所有怀孕期间吸烟的母亲，允许比较兄弟姐妹对之间的结果，其中一个在产前暴露于尼古丁，另一个没有，同时控制相关的环境变量（例如，社会经济地位、父母教育等）。因此，从母体侧（母亲在怀孕期间吸烟）选择ADHD的环境风险和从父亲侧（具有DWI/酒精问题史的那些）选择ADHD的遗传风险的样品。抽样将侧重于1992-1996年期间生育子女（7-11岁儿童）的母亲。从密苏里州的出生记录中，共有4,835名母亲因怀孕期间吸烟而不和谐。其中，608人的伴侣（在孩子的出生记录中被列为父亲）被判DWI。总共将对400名母亲进行资格审查（即，出生记录的准确性）。有资格参加的人（预计200人）将通过电话采访儿童多动症，详细的怀孕期间吸烟，吸烟和尼古丁依赖史，酒精问题和酒精依赖史，以及有限的父母精神病理学（即，ADHD筛查，CD筛查）。

In addition to the evidence for substantial genetic effects on ADHD, there is increasing evidence for the roles of parental alcoholism and maternal drinking and smoking during pregnancy in the risk of offspring ADHD. Previous studies have associated prenatal exposure to both alcohol and nicotine with increased risk of ADHD in children. Preliminary analyses also suggested (i) significant associations between parental alcoholism and ADHD, as well as between maternal smoking during pregnancy and parental alcoholism, and (ii) evidence for a genetic correlation between parental alcoholism and offspring ADHD. Given these results, in addition to genetic transmission, increased rates of maternal smoking during pregnancy associated with parental alcoholism may be an important factor contributing to the association between parental alcoholism and ADHD. Taken together, evidence suggests that both genetic and environmental risk factors for ADHD are at work in the children of alcoholics, raising the possibility that these risk factors may interact with on e another. Using an innovative within-mother comparison approach, this pilot study will assess relative effects of maternal smoking during pregnancy on ADHD in 200 'high genetic risk' children (100 sibling pairs with alcoholic fathers) and 200 'low genetic risk' children (100 sibling pairs with no history of paternal alcoholism). The novel within-mother approach focuses on mothers who have smoked during one pregnancy but not during all pregnancies, allowing the comparison of outcomes between sibling pairs, one of which has been exposed to nicotine prenatally and the other who has not, while controlling for pertinent environmental variables (e.g., SES, parental education, etc.). Thus, the samples are chosen for environmental risk for ADHD from the maternal side (maternal smoking during pregnancy) and genetic risk for ADHD from the paternal side (those with history of DWI/alcohol problems). The sample will focus on mothers who gave birth to children between 1992-1996 (children aged 7-11). A total of 4,835 mothers who are discordant for smoking during their pregnancies have been identified from Missouri birth records. Of these, 608 have a partner (listed as the father on the child's birth record) who has been given a DWI. A total of 400 mothers will be screened for eligibility (i.e., accuracy of birth records). Those eligible to participate (200 projected) will be interviewed via telephone regarding children's ADHD, detailed smoking during pregnancy, history of smoking and nicotine dependence, history of alcohol problems and alcohol dependence, and limited parental psychopathology (i.e., screen for ADHD, screen for CD).