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Maher BS, Bitsko RH, Claussen AH, O'Masta B, Cerles A, Holbrook JR, Mahmooth Z, Chen-Bowers N, Rojo ALA, Kaminski JW, Rush M. Systematic Review and Meta-analysis of the Relationship Between Exposure to Parental Substance Use and Attention-Deficit/Hyperactivity Disorder in Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:291-315. [PMID: 37976008 PMCID: PMC11098969 DOI: 10.1007/s11121-023-01605-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent patterns of inattention, hyperactivity, and impulsiveness. Among US children and adolescents aged 3-17 years, 9.4% have a diagnosis of ADHD. Previous research suggests possible links between parental substance use and ADHD among children. We conducted a systematic review and meta-analysis of 86 longitudinal or retrospective studies of prenatal or postnatal alcohol, tobacco, or other parental substance use and substance use disorders and childhood ADHD and its related behavioral dimensions of inattention and hyperactivity-impulsivity. Meta-analyses were grouped by drug class and pre- and postnatal periods with combined sample sizes ranging from 789 to 135,732. Prenatal exposure to alcohol or tobacco and parent substance use disorders were consistently and significantly associated with ADHD among children. Other parental drug use exposures resulted in inconsistent or non-significant findings. Prevention and treatment of parental substance use may have potential for impacts on childhood ADHD.
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Affiliation(s)
- Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Naomi Chen-Bowers
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA
| | | | - Jennifer W Kaminski
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA.
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Xie T, Mao Y. The causal impact of maternal smoking around birth on offspring ADHD: A two-sample Mendelian randomization study. J Affect Disord 2024; 351:24-30. [PMID: 38266926 DOI: 10.1016/j.jad.2024.01.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The previous literature highlights a relationship between maternal smoking around birth (MSAB) and offspring attention-deficit/hyperactivity disorder (ADHD). These studies have focused on the causal effects of MSAB on offspring ADHD. METHOD A Mendelian randomization analysis was conducted using summary statistics. Data on MSAB were obtained from a recent study including 391,992 participants. ADHD data were obtained from six sources for 246,888 participants. The present study used five methods to examine the causal impact from outcomes on exposures. The inverse variance weighted (IVW) was the main method of analysis, while the other four methods were supplementary methods. RESULT The IVW revealed that MSAB was a risk factor for offspring ADHD (OR: 2.54; 95 % confidence interval [CI]: 1.61-4.00, p = 6.04 × 10-5). Concerning ADHD in both sexes, MSAB was associated with females (OR = 3.96, 95 % CI: 1.99-7.90, p = 8.98 × 10-5) and males (OR = 3.74, 95 % CI: 1.74-5.72, p = 1.48 × 10-4). In different diagnosis periods for ADHD, MSAB increased the risk of childhood (OR = 3.63, 95 % CI: 2.25-5.87, p = 1.31 × 10-7), late-diagnosed (OR = 2.99, 95 % CI: 1.74-5.14, p = 7.33 × 10-5), and persistent (OR = 4.77, 95 % CI: 1.88-12.14, p = 1.03 × 10-3) ADHD. The final analysis did not reveal heterogeneity. CONCLUSIONS A causal impact of MSAB on offspring ADHD was observed. These findings highlight the need for careful consideration of prenatal exposure (MSAB) during the assessment of offspring ADHD. Additionally, it can provide targeted guidance for prenatal interventions. Future studies should analyze the effects of different doses of maternal smoking on ADHD.
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Affiliation(s)
- Tao Xie
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
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Fotopoulos NH, Chaumette B, Devenyi GA, Karama S, Chakravarty M, Labbe A, Grizenko N, Schmitz N, Fageera W, Joober R. Maternal smoking during pregnancy and cortical structure in children with attention-deficit/hyperactivity disorder. Psychiatry Res 2024; 334:115791. [PMID: 38367455 DOI: 10.1016/j.psychres.2024.115791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/28/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
Maternal smoking during pregnancy (MSDP) is considered a risk factor for ADHD. While the mechanisms underlying this association are not well understood, MSDP may impact the developing brain in ways that lead to ADHD. Here, we investigated the effect of prenatal smoking exposure on cortical brain structures in children with ADHD using two methods of assessing prenatal exposure: maternal recall and epigenetic typing. Exposure groups were defined according to: (1) maternal recall (+MSDP: n = 24; -MSDP: n = 85) and (2) epigenetic markers (EM) (+EM: n = 14 -EM: n = 21). CIVET-1.1.12 and RMINC were used to acquire cortical brain measurements and perform statistical analyses, respectively. The vertex with highest significance was tested for association with Continuous Performance Test (CPT) dimensions. While no differences of brain structures were identified between +MSDP and -MSDP, +EM children (n = 10) had significantly smaller surface area in the right orbitofrontal cortex (ROFc), middle temporal cortex (RTc) and parahippocampal gyrus (RPHg) (15% FDR) compared to -EM children (n = 20). Cortical surface area in the RPHg significantly correlated with CPT commission errors T-scores. This study suggests that molecular markers may better define exposure to environmental risks, as compared to human recall.
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Affiliation(s)
- Nellie H Fotopoulos
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Boris Chaumette
- Department of Psychiatry, McGill University, Montréal, Québec, Canada; Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GHU-Paris Psychiatrie et Neurosciences, Paris, France
| | - Gabriel A Devenyi
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Sherif Karama
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Montréal Neurological Institute, Montréal, Québec, Canada
| | - Mallar Chakravarty
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Biological and Biomedical Engineering, McGill University, Montréal, Québec, Canada
| | - Aurelie Labbe
- Department of Decision Sciences, HEC Montreal, Montréal, Québec, Canada
| | - Natalie Grizenko
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Norbert Schmitz
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Weam Fageera
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, Montréal, Québec, Canada; Department of Human Genetics, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada.
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Zhou M, Qiu W, Ohashi N, Sun L, Wronski ML, Kouyama-Suzuki E, Shirai Y, Yanagawa T, Mori T, Tabuchi K. Deep-Learning-Based Analysis Reveals a Social Behavior Deficit in Mice Exposed Prenatally to Nicotine. Cells 2024; 13:275. [PMID: 38334667 PMCID: PMC10855062 DOI: 10.3390/cells13030275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
Cigarette smoking during pregnancy is known to be associated with the incidence of attention-deficit/hyperactive disorder (ADHD). Recent developments in deep learning algorithms enable us to assess the behavioral phenotypes of animal models without cognitive bias during manual analysis. In this study, we established prenatal nicotine exposure (PNE) mice and evaluated their behavioral phenotypes using DeepLabCut and SimBA. We optimized the training parameters of DeepLabCut for pose estimation and succeeded in labeling a single-mouse or two-mouse model with high fidelity during free-moving behavior. We applied the trained network to analyze the behavior of the mice and found that PNE mice exhibited impulsivity and a lessened working memory, which are characteristics of ADHD. PNE mice also showed elevated anxiety and deficits in social interaction, reminiscent of autism spectrum disorder (ASD). We further examined PNE mice by evaluating adult neurogenesis in the hippocampus, which is a pathological hallmark of ASD, and demonstrated that newborn neurons were decreased, specifically in the ventral part of the hippocampus, which is reported to be related to emotional and social behaviors. These results support the hypothesis that PNE is a risk factor for comorbidity with ADHD and ASD in mice.
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Affiliation(s)
- Mengyun Zhou
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Wen Qiu
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Nobuhiko Ohashi
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Lihao Sun
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Marie-Louis Wronski
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, 01307 Dresden, Germany
| | - Emi Kouyama-Suzuki
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Yoshinori Shirai
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
| | - Toru Yanagawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
| | - Takuma Mori
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
- Department of Neuroinnovation, Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, Matsumoto 390-8621, Japan
| | - Katsuhiko Tabuchi
- Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan; (M.Z.); (W.Q.); (N.O.); (L.S.); (M.-L.W.); (E.K.-S.); (Y.S.)
- Department of Neuroinnovation, Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, Matsumoto 390-8621, Japan
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Motamedi S, Amleshi RS, Javar BA, Shams P, Kohlmeier KA, Shabani M. Cannabis during pregnancy: A way to transfer an impairment to later life. Birth Defects Res 2023; 115:1327-1344. [PMID: 37318343 DOI: 10.1002/bdr2.2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/11/2023] [Accepted: 05/20/2023] [Indexed: 06/16/2023]
Abstract
Epidemiological studies examining the influence of cannabis across the lifespan show that exposure to cannabis during gestation or during the perinatal period is associated with later-life mental health issues that manifest during childhood, adolescence, and adulthood. The risk of later-life negative outcomes following early exposure is particularly high in persons who have specific genetic variants, implying that cannabis usage interacts with genetics to heighten mental health risks. Prenatal and perinatal exposure to psychoactive components has been shown in animal research to be associated with long-term effects on neural systems relevant to psychiatric and substance use disorders. The long-term molecular, epigenetic, electrophysiological, and behavioral consequences of prenatal and perinatal exposure to cannabis are discussed in this article. Animal and human studies, as well as in vivo neuroimaging methods, are used to provide insights into the changes induced in the brain by cannabis. Here, based on the literature from both animal models and humans, it can be concluded that prenatal cannabis exposure alters the developmental route of several neuronal regions with correlated functional consequences evidenced as changes in social behavior and executive functions throughout life.
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Affiliation(s)
- Sina Motamedi
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Saboori Amleshi
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnoush Akbari Javar
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Parisa Shams
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
- Department of Anatomical Sciences, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kristi A Kohlmeier
- Department of Drug Design and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Woolf B, Sallis HM, Munafò MR, Gill D. Deriving GWAS summary estimates for paternal smoking in UK biobank: a GWAS by subtraction. BMC Res Notes 2023; 16:159. [PMID: 37518004 PMCID: PMC10387204 DOI: 10.1186/s13104-023-06438-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE To use genome-wide association study (GWAS) by subtraction, a method for deriving novel GWASs from existing summary statistics, to derive genome-wide summary statistics for paternal smoking. RESULT A GWAS by subtraction was implemented using a weighted linear model that defined the child-genotype paternal-phenotype association as the child-genotype child-phenotype association minus the child-genotype maternal-phenotype association. We first use the laws of inherence to derive the weighted linear model. We then implemented the linear model to create a GWAS of paternal smoking by subtracting the summary statistics from a GWAS of maternal smoking from the summary statistics of a GWAS of the index individual's smoking. We used a Monte-Carlo simulation to validate the model and showed that this approach performed similarly in terms of bias to performing a traditional GWAS of paternal smoking. Finally, we validated the summary statistics in a Mendelian randomisation analysis by demonstrating an association of genetically predicted paternal smoking with paternal lung cancer and emphysema.
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Affiliation(s)
- Benjamin Woolf
- School of Psychological Science, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- MRC Biostatistics Unit at the University of Cambridge, Cambridge, UK.
| | - Hannah M Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Chief Scientific Advisor Office, Research and Early Development, Novo Nordisk, Copenhagen, Denmark
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Ni M, Li L, Li W, Zhang Q, Zhao J, Shen Q, Yao D, Wang T, Li B, Ding X, Qi S, Huang X, Liu Z. Examining the relationship between birth weight and attention-deficit hyperactivity disorder diagnosis. Front Psychiatry 2023; 14:1074783. [PMID: 37293403 PMCID: PMC10244743 DOI: 10.3389/fpsyt.2023.1074783] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Background Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that is prevalent in children worldwide. We evaluated the potential relationship between birth weight and ADHD using newly released data from the National Survey of Children's Health 2019-2020. Methods This population-based survey study used parent recollection data that were collected and submitted by 50 states and the District of Columbia to the National Survey of Children's Health database from the National Survey of Children's Health database. Those aged < 3 years and without birth weight or ADHD records were excluded. Children were stratified according to ADHD diagnosis and birth weight: very low birth weight (VLBW, < 1,500 g), low birth weight (LBW, 1,500-2,500 g), and normal birth weight (NBW, ≥ 2,500 g). Multivariable logistic regression was applied to examine the causal association between birth weight and ADHD while controlling for child and household characteristics. Results The final sample consisted of 60,358 children, of whom 6,314 (9.0%) were reported to have an ADHD diagnosis. The prevalence of ADHD was 8.7% in NBW children, 11.5% in LBW, and 14.4% in VLBW. Compared with NBW children, LBW children [adjusted odds ratio (aOR), 1.32 (95% CI, 1.03-1.68)], and VLBW children [aOR, 1.51 (95% CI, 1.06-2.15)] had a significantly higher risk of ADHD after adjusting all variables. These associations persisted in the male subgroups. Conclusion and relevance This study found that LBW and VLBW children were at a higher risk of ADHD.
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Affiliation(s)
- Meng Ni
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Lijuan Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Wei Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Qianqian Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Jiuru Zhao
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Qianwen Shen
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Dongting Yao
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Tao Wang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Baihe Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Xiya Ding
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Sudong Qi
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Xiaoyi Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
| | - Zhiwei Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- International Peace Maternity and Child Health Hospital of China Welfare, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
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Jansone K, Eichler A, Fasching PA, Kornhuber J, Kaiser A, Millenet S, Banaschewski T, Nees F. Association of Maternal Smoking during Pregnancy with Neurophysiological and ADHD-Related Outcomes in School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4716. [PMID: 36981624 PMCID: PMC10048892 DOI: 10.3390/ijerph20064716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Data of a longitudinal cohort study were analyzed to investigate the association between prenatal tobacco exposure and electroencephalographical (EEG) power spectrum in healthy, school-aged children as well as its relationship with attention deficit hyperactivity disorder (ADHD)-related symptoms. Group comparisons (exposed, non-exposed) were performed to test whether prenatal tobacco exposure was associated with brain activity and ADHD symptoms, with adjustments made for covariates including child's sex, child's age, maternal age, maternal smoking habit before pregnancy, alcohol consumption during pregnancy, gestation age, and maternal psychopathology. Tobacco-exposed children showed higher brain activity in the delta and theta frequency bands. This effect was independent of the considered covariates. However, the effects on hyperactivity were found to significantly depend on maternal age and alcohol consumption during pregnancy, but not on the amount of exposure. In summary, smoking during pregnancy significantly affected the resting-state brain activity in children, independent of socio-demographic factors, indicating potential long-lasting effects on brain development. Its impact on ADHD-related behavior was shown to be influenced by socio-demographic confounding factors, such as maternal alcohol consumption and the age of the mother.
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Affiliation(s)
- Karina Jansone
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Peter A. Fasching
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany
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Lee S, Lee W. The association between attention deficit hyperactivity disorder (ADHD) and smoking experience or exposure to environmental tobacco smoke among children and adolescents. Tob Induc Dis 2023; 21:15. [PMID: 36762265 PMCID: PMC9885444 DOI: 10.18332/tid/157209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/01/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Direct and indirect smoking exposure is highly related to mental health in children. This study aimed to identify the association between exposure to smoking or secondhand smoke (SHS) and attention deficit hyperactivity disorder (ADHD). METHODS We used data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2019, including variables such as diagnosed ADHD, smoking status, SHS, and urine cotinine levels among children and adolescents. We estimated the risk of ADHD according to smoking or SHS exposure in various exposure groups using adjusted logistic or linear regression models. RESULTS Among 16434 participants, 133 children were diagnosed with ADHD (0.8%). Of these, 58 (43.6%) were aged <12 years and 75 (56.3%) were aged ≥12 years. Smoking was significantly associated with ADHD (crude odds ratio, OR=1.48; 95% CI: 1.14-3.26 and adjusted odds ratio, AOR=1.22; 95% CI: 1.02- 1.64). SHS exposure and ADHD were attenuated after adjustment (OR=2.42; 95% CI: 1.08-4.02; AOR=1.42; 95% CI: 0.86-2.64) in the logistic regression model. Smoking history was statistically associated with a younger age of ADHD diagnosis in the linear regression model. CONCLUSIONS Smoking and the amount of smoking among children and adolescents was associated with ADHD.
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Affiliation(s)
- Sunho Lee
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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10
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Liu D, Ren Y, Wu T, Shen H, Yan P, Meng Y, Zhang Q, Zhang J, Bai P, Zhao J. Parental smoking exposure before and during pregnancy and offspring attention-deficit/hyperactivity disorder risk: A Chinese child and adolescent cohort study. Front Public Health 2022; 10:1017046. [PMID: 36299741 PMCID: PMC9589153 DOI: 10.3389/fpubh.2022.1017046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023] Open
Abstract
Background Previous studies revealed that maternal smoking exposure during pregnancy was an essential risk factor for offspring developing attention-deficit/hyperactivity disorder (ADHD). The impact of paternal smoking exposure 1 year before pregnancy on offspring ADHD risk is still unclear. Methods The present study included 2,477 school-age children and their parents from the Shanghai Child and Adolescent Health Cohort who had complete data for offspring ADHD diagnosis and parents' smoking exposure before and during pregnancy information. A multivariate logistic regression model and Firth's logistic regression model were used to determine the associations of paternal smoking and parental smoke exposure patterns before and during pregnancy with offspring ADHD risk. Results Children whose fathers smoked before pregnancy had a higher risk of developing ADHD [odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.35-4.98] compared to those whose fathers had never been exposed to smoking. Similarly, parents who were exposed to smoking or second-hand smoke before pregnancy had 1.96 times (OR = 1.96, 95% CI: 1.19-3.22) more likely to have offspring with ADHD. Moreover, children whose parents were exposed to smoking both before and during pregnancy were 2.01 times (OR = 2.01, 95% CI: 1.29-3.12) more likely to develop ADHD. Conclusion Paternal smoking before pregnancy and parental smoking exposure 1 year ahead of and throughout pregnancy were all risk factors for offspring developing ADHD.
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Affiliation(s)
- Dong Liu
- The Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaping Ren
- Department of School Health, Food Nutrition and Safety, Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Tianfeng Wu
- Department of School Health, Food Nutrition and Safety, Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Huiping Shen
- Department of School Health, Food Nutrition and Safety, Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Peijing Yan
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yu Meng
- The Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianlong Zhang
- The Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- The Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pinqing Bai
- Department of School Health, Food Nutrition and Safety, Pudong New Area Center for Disease Control and Prevention, Shanghai, China,Pinqing Bai
| | - Jian Zhao
- The Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Jian Zhao
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11
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Haan E, Westmoreland KE, Schellhas L, Sallis HM, Taylor G, Zuccolo L, Munafò MR. Prenatal smoking, alcohol and caffeine exposure and offspring externalizing disorders: a systematic review and meta-analysis. Addiction 2022; 117:2602-2613. [PMID: 35385887 DOI: 10.1111/add.15858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Several studies have indicated an association between maternal prenatal substance use and offspring externalizing disorders; however, it is uncertain whether this relationship is causal. We conducted a systematic review to determine: (1) if the literature supports a causal role of maternal prenatal substance use on offspring externalizing disorders diagnosis and (2) whether these associations differ across externalizing disorders. METHODS We searched Web of Science, Embase, PsycINFO and Medline databases. Risk of bias assessment was conducted using the Newcastle-Ottawa Scale (NOS), and where possible meta-analysis was conducted for studies classed as low risk of bias. We included studies of any design that examined prenatal smoking, alcohol or caffeine use. Studies in non-English language, fetal alcohol syndrome and comorbid autism spectrum disorders were excluded. Participants in the included studies were mothers and their offspring. Measurements included prenatal smoking, alcohol or caffeine use as an exposure, and diagnosis of attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) in offspring as an outcome. RESULTS We included 63 studies, 46 of which investigated smoking and ADHD. All studies were narratively synthesized, and seven studies on smoking and ADHD were meta-analysed. The largest meta-analysis based on genetically sensitive design included 1 011 546 participants and did not find evidence for an association [odds ratio (OR)1-9 cigarettes = 0.90, 95% confidence interval (CI) = 0.83-1.11; OR > 10 cigarettes = 1.04, 95% CI = 0.79-1.36). Studies on alcohol exposure in all the outcomes reported inconsistent findings and no strong conclusions on causality can be made. Studies on caffeine exposure were mainly limited to ADHD and these studies do not support a causal effect. CONCLUSIONS There appears to be no clear evidence to support a causal relationship between maternal prenatal smoking and offspring attention-deficit hyperactivity disorder. Findings with alcohol and caffeine exposures and conduct disorder and oppositional-defiant disorder need more research, using more genetically sensitive designs.
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Affiliation(s)
- Elis Haan
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | | | - Laura Schellhas
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Hannah M Sallis
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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12
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Havdahl A, Wootton RE, Leppert B, Riglin L, Ask H, Tesli M, Bugge Askeland R, Hannigan LJ, Corfield E, Øyen AS, Andreassen OA, Tilling K, Davey Smith G, Thapar A, Reichborn-Kjennerud T, Stergiakouli E. Associations Between Pregnancy-Related Predisposing Factors for Offspring Neurodevelopmental Conditions and Parental Genetic Liability to Attention-Deficit/Hyperactivity Disorder, Autism, and Schizophrenia: The Norwegian Mother, Father and Child Cohort Study (MoBa). JAMA Psychiatry 2022; 79:799-810. [PMID: 35793100 PMCID: PMC9260642 DOI: 10.1001/jamapsychiatry.2022.1728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/10/2022] [Indexed: 02/02/2023]
Abstract
Importance Several maternal exposures during pregnancy are considered predisposing factors for offspring neurodevelopmental conditions. However, many of these exposures may be noncausal and biased by maternal genetic liability. Objective To assess whether pregnancy-related predisposing factors for offspring neurodevelopmental conditions are associated with maternal genetic liability for attention-deficit/hyperactivity disorder (ADHD), autism, and schizophrenia and to compare associations for maternal genetic liability with those for paternal genetic liability, which could indicate that paternal exposures are not suitable negative controls for maternal exposures. Design, Setting, and Participants The Norwegian Mother, Father and Child Cohort Study (MoBa) is a population-based pregnancy cohort that recruited parents from June 1999 to December 2008. Polygenic scores (PGS) for ADHD, autism, and schizophrenia were derived in mothers and fathers. The associations between maternal PGS and 37 pregnancy-related measures were estimated, and these results were compared with those from paternal PGS predicting paternal measures during the mother's pregnancy. Analysis took place between March 2021 and March 2022. Exposures PGS for ADHD, autism, and schizophrenia, calculated (using discovery effect size estimates and threshold of P < .05) from the largest available genome-wide association studies. Main Outcomes and Measures Self-reported pregnancy-related measures capturing lifestyle behaviors, metabolism, infectious and autoimmune diseases, other physical health conditions, and medication use. Results Data were available for up to 14 539 mothers (mean [SD] age, 30.00 [4.45] years) and 14 897 fathers (mean [SD] age, 32.46 [5.13] years) of European ancestry. Modest but robust associations were observed between specific pregnancy-related measures and maternal PGS, including ADHD PGS with asthma (odds ratio [OR], 1.15 [95% CI, 1.06-1.25]), smoking (OR, 1.26 [95% CI, 1.19-1.33]), prepregnancy body mass index (β, 0.25 [95% CI, 0.18-0.31]), pregnancy weight gain (β, 0.20 [95% CI, 0.10-0.30]), taking folate (OR, 0.92 [95% CI, 0.88-0.96]), and not taking supplements (OR, 1.09 [95% CI, 1.04-1.14]). Schizophrenia PGS was associated with coffee consumption (OR, 1.09 [95% CI, 1.05-1.12]), smoking (OR, 1.12 [95% CI, 1.06-1.19]), prepregnancy body mass index (β, -0.18 [95% CI, -0.25 to -0.11]), and pregnancy weight gain (β, 0.17 [95% CI, 0.07-0.27]). All 3 PGSs associated with symptoms of depression/anxiety (ADHD: OR, 1.15 [95% CI, 1.09-1.22]; autism: OR, 1.13 [95% CI, 1.06-1.19]; schizophrenia: OR, 1.13 [95% CI, 1.07-1.20]). Associations were largely consistent for maternal and paternal PGS, except ADHD PGS and smoking (fathers: OR, 1.13 [95% CI, 1.09-1.17]). Conclusions and Relevance In this study, genetic liability to neurodevelopmental conditions that is passed from mothers to children was associated with several pregnancy-related factors and may therefore confound associations between these pregnancy-related factors and offspring neurodevelopment that have previously been thought to be causal. It is crucial that future study designs account for genetic confounding to obtain valid causal inferences so that accurate advice can be given to pregnant individuals.
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Affiliation(s)
- Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Robyn E. Wootton
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Beate Leppert
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Cardiff, United Kingdom
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Martin Tesli
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ragna Bugge Askeland
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Laurie J. Hannigan
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Corfield
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne-Siri Øyen
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Ole A. Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kate Tilling
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Cardiff, United Kingdom
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Evie Stergiakouli
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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13
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Haan E, Sallis HM, Zuccolo L, Labrecque J, Ystrom E, Reichborn-Kjennerud T, Andreassen O, Havdahl A, Munafò MR. Prenatal smoking, alcohol and caffeine exposure and maternal-reported attention deficit hyperactivity disorder symptoms in childhood: triangulation of evidence using negative control and polygenic risk score analyses. Addiction 2022; 117:1458-1471. [PMID: 34791750 PMCID: PMC7613851 DOI: 10.1111/add.15746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/29/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Studies have indicated that maternal prenatal substance use may be associated with offspring attention deficit hyperactivity disorder (ADHD) via intrauterine effects. We measured associations between prenatal smoking, alcohol and caffeine consumption with childhood ADHD symptoms accounting for shared familial factors. DESIGN First, we used a negative control design comparing maternal and paternal substance use. Three models were used for negative control analyses: unadjusted (without confounders), adjusted (including confounders) and mutually adjusted (including confounders and partner's substance use). The results were meta-analysed across the cohorts. Secondly, we used polygenic risk scores (PRS) as proxies for exposures. Maternal PRS for smoking, alcohol and coffee consumption were regressed against ADHD symptoms. We triangulated the results across the two approaches to infer causality. SETTING We used data from three longitudinal pregnancy cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom, Generation R study (GenR) in the Netherlands and Norwegian Mother, Father and Child Cohort study (MoBa) in Norway. PARTICIPANTS Phenotype data available for children were: NALSPAC = 5455-7751; NGENR = 1537-3119; NMOBA = 28 053-42 206. Genotype data available for mothers was: NALSPAC = 7074; NMOBA = 14 583. MEASUREMENTS A measure of offspring ADHD symptoms at age 7-8 years was derived by dichotomizing scores from questionnaires and parental self-reported prenatal substance use was measured at the second pregnancy trimester. FINDINGS The pooled estimate for maternal prenatal substance use showed an association with total ADHD symptoms [odds ratio (OR)SMOKING = 1.11, 95% confidence interval (CI) = 1.00-1.23; ORALCOHOL = 1.27, 95% CI = 1.08-1.49; ORCAFFEINE = 1.05, 95% CI = 1.00-1.11], while not for fathers (ORSMOKING = 1.03, 95% CI = 0.95-1.13; ORALCOHOL = 0.83, 95% CI = 0.47-1.48; ORCAFFEINE = 1.02, 95% CI = 0.97-1.07). However, maternal associations did not persist in sensitivity analyses (substance use before pregnancy, adjustment for maternal ADHD symptoms in MoBa). The PRS analyses were inconclusive for an association in ALSPAC or MoBa. CONCLUSIONS There appears to be no causal intrauterine effect of maternal prenatal substance use on offspring attention deficit hyperactivity disorder symptoms.
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Affiliation(s)
- Elis Haan
- School of Psychological Science, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Hannah M. Sallis
- School of Psychological Science, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK,Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK,Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jeremy Labrecque
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,School of Pharmacy, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alexandra Havdahl
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway,Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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14
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Jogia J, Sharif AH, Nawaz FA, Khan AR, Alawami RH, Aljanahi MA, Sultan MA. Comorbidities Associated With Attention-Deficit/Hyperactivity Disorder in Children and Adolescents at a Tertiary Care Setting. Glob Pediatr Health 2022; 9:2333794X221076607. [PMID: 35224143 PMCID: PMC8864264 DOI: 10.1177/2333794x221076607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/06/2022] [Indexed: 11/15/2022] Open
Abstract
Studies have revealed high rates of neurodevelopmental and psychiatric comorbid conditions among individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, research on this topic in the Arab world has been limited. This study evaluates the medical, neurodevelopmental, and psychiatric comorbidities in children and adolescents diagnosed with ADHD in Dubai, United Arab Emirates (UAE). A total of 428 pediatric patients diagnosed with ADHD were included. Children and adolescents with ADHD had high rates of comorbid disorders. Twenty comorbid conditions were identified. More than 3 quarters of the study sample had at least 1 comorbid disorder. The most common comorbidity among children was autism spectrum disorder, and among adolescents was anxiety disorders. Comprehensive assessments are highly warranted to identify and manage associated comorbid conditions. Further research is needed in exploring the biopsychosocial factors contributing to the elevated rate of comorbidity in children and adolescents with ADHD.
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Affiliation(s)
| | | | - Faisal A. Nawaz
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Abdul Rahman Khan
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Raed H. Alawami
- King Fahad Specialist Hospital, Dammam, Eastern Province, Saudi Arabia
| | | | - Meshal A. Sultan
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- Al Jalila Children’s Speciality Hospital, Dubai, UAE
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15
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Schellhas L, Haan E, Easey KE, Wootton RE, Sallis HM, Sharp GC, Munafò MR, Zuccolo L. Maternal and child genetic liability for smoking and caffeine consumption and child mental health: an intergenerational genetic risk score analysis in the ALSPAC cohort. Addiction 2021; 116:3153-3166. [PMID: 33891774 PMCID: PMC9376939 DOI: 10.1111/add.15521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/30/2020] [Accepted: 04/07/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Previous studies suggest an association between maternal tobacco and caffeine consumption during and outside of pregnancy and offspring mental health. We aimed to separate effects of the maternal environment (intrauterine or postnatal) from pleiotropic genetic effects. DESIGN Secondary analysis of a longitudinal study. We (i) validated smoking and caffeine genetic risk scores (GRS) derived from published genome-wide association study (GWAS) for use during pregnancy, (ii) compared estimated effects of maternal and offspring GRS on childhood mental health outcomes and (iii) tested associations between maternal and offspring GRS on their respective outcomes. SETTING We used data from a longitudinal birth cohort study from England, the Avon Longitudinal Study of Parents and Children (ALSPAC). PARTICIPANTS Our sample included 7921 mothers and 7964 offspring. MEASUREMENTS Mental health and non-mental health phenotypes were derived from questionnaires and clinical assessments: 79 maternal phenotypes assessed during and outside of pregnancy and 71 offspring phenotypes assessed in childhood (<10 years) and adolescence (11-18 years). FINDINGS The maternal smoking and caffeine GRS were associated with maternal smoking and caffeine consumption during pregnancy (2nd trimester: Psmoking = 3.0 × 10-7 , Pcaffeine = 3.28 × 10-5 ). Both the maternal and offspring smoking GRS showed evidence of association with reduced childhood anxiety symptoms (βmaternal = -0.033; βoffspring = -0.031) and increased conduct disorder symptoms (βmaternal = 0.024; βoffspring = 0.030), after correcting for multiple testing. Finally, the maternal and offspring smoking GRS were associated with phenotypes related to sensation seeking behaviours in mothers and adolescence (e.g. increased symptoms of externalising disorders, extraversion and monotony avoidance). The caffeine GRS showed weaker evidence for associations with mental health outcomes. CONCLUSIONS We did not find strong evidence that maternal smoking and caffeine genetic risk scores have a causal effect on offspring mental health outcomes. Our results confirm that the smoking genetic risk scores also captures liability for sensation seeking personality traits.
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Affiliation(s)
- Laura Schellhas
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
| | - Elis Haan
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
| | - Kayleigh E. Easey
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Robyn E. Wootton
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Hannah M. Sallis
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- Centre for Academic Mental Health, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Gemma C. Sharp
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- Bristol Dental SchoolUniversity of BristolBristolUK
| | - Marcus R. Munafò
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of BristolBristolUK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit at the University of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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16
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Easey KE, Sharp GC. The impact of paternal alcohol, tobacco, caffeine use and physical activity on offspring mental health: a systematic review and meta-analysis. Reprod Health 2021; 18:214. [PMID: 34702308 PMCID: PMC8549222 DOI: 10.1186/s12978-021-01266-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is some evidence that paternal health behaviours during and around pregnancy could be associated with offspring health outcomes. However, the impact that paternal health behaviours during pregnancy can have on offspring mental health is understudied and remains unclear. METHODS We conducted a systematic review and meta-analysis of articles in PubMed describing studies of potentially modifiable paternal health behaviours (tobacco smoking, alcohol consumption, caffeine consumption and physical activity) in the prenatal period in relation to offspring mental health. GRADE was used to measure risk of bias. RESULTS Eight studies were included and categorized by paternal health behaviour and offspring mental health outcome investigated. The narrative synthesis provided evidence of association between paternal health behaviours around pregnancy and offspring mental health problems, with the strongest evidence shown for tobacco use. Grouped by analysis type, two separate meta-analyses showed evidence of paternal smoking during pregnancy being associated with greater odds of ADHD in offspring (OR 1.42, 95% CI 1.02-1.99; HR 1.28, 95% CI 1.19-1.39). CONCLUSIONS The small number of studies that have investigated paternal prenatal effects on offspring mental health, and the limited sample sizes of those studies, makes it challenging to draw firm conclusions. Although existing studies suggest that paternal tobacco smoking and alcohol consumption in the prenatal period are associated with poorer offspring mental health, (particularly hyperactivity/ADHD), further investigation of potential paternal effects is required, using methods that allow stronger inference to determine whether associations are causal.
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Affiliation(s)
- Kayleigh E Easey
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Gemma C Sharp
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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17
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Brikell I, Burton C, Mota NR, Martin J. Insights into attention-deficit/hyperactivity disorder from recent genetic studies. Psychol Med 2021; 51:2274-2286. [PMID: 33814023 DOI: 10.1017/s0033291721000982] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and highly heritable neurodevelopmental disorder (NDD). In this narrative review, we summarize recent advances in quantitative and molecular genetic research from the past 5-10 years. Combined with large-scale international collaboration, these advances have resulted in fast-paced progress in understanding the etiology of ADHD and how genetic risk factors map on to clinical heterogeneity. Studies are converging on a number of key insights. First, ADHD is a highly polygenic NDD with a complex genetic architecture encompassing risk variants across the spectrum of allelic frequencies, which are implicated in neurobiological processes. Second, genetic studies strongly suggest that ADHD diagnosis shares a large proportion of genetic risks with continuously distributed traits of ADHD in the population, with shared genetic risks also seen across development and sex. Third, ADHD genetic risks are shared with those implicated in many other neurodevelopmental, psychiatric and somatic phenotypes. As sample sizes and the diversity of genetic studies continue to increase through international collaborative efforts, we anticipate further success with gene discovery, characterization of how the ADHD phenotype relates to other human traits and growing potential to use genomic risk factors for understanding clinical trajectories and for precision medicine approaches.
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Affiliation(s)
- Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Christie Burton
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Canada
| | - Nina Roth Mota
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joanna Martin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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18
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Su Y, D'Arcy C, Meng X. Research Review: Developmental origins of depression - a systematic review and meta-analysis. J Child Psychol Psychiatry 2021; 62:1050-1066. [PMID: 33259072 PMCID: PMC8451906 DOI: 10.1111/jcpp.13358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many observational studies have found a direct association between adverse in utero, perinatal and postnatal exposures and offspring's depression. These findings are consistent with the 'developmental origins of disease hypothesis'. But no review has comprehensively summarized the roles of these exposures. This review aims to systematically scrutinize the strength of associations between individual prenatal, perinatal, and postnatal exposures and subsequent depression in offspring. METHODS We conducted a systematic review and meta-analysis to synthesize the literature from the EMBASE, HealthStar, PsychoInfo, and Medline databases since their inception to September 1, 2019. English language articles on population-based prospective cohort studies examining the associations between in utero, perinatal, and postnatal exposures and offspring's depression were searched. Random-effects models were used to calculate pooled estimates, and heterogeneity and sensitivity tests were conducted to explore potential confounders in the relationships of depression and early-life factors. Qualitative analysis was also conducted. RESULTS Sixty-four prospective cohort studies with 28 exposures studied in the relationships to offspring's depression met inclusion criteria. The meta-analysis found 12 prenatal, perinatal, and postnatal characteristics were associated with an increased risk of depression in offspring: low birth weight, premature birth, small gestational age, maternal education, socioeconomic status, having younger parents (<20 years), having older parents (≥35 years), maternal smoking, paternal smoking, maternal stress, maternal anxiety, and prenatal depression. Heterogeneity and sensitivity tests supported the findings. By and large, study characteristics had no effects on conclusions. Qualitative analyses generally supported the findings of meta-analysis and reported on additional risk factors. CONCLUSIONS This review provides a robust and comprehensive overview of the lasting psychopathological effects of in utero, perinatal, and postnatal exposures. The findings highlight the need for clinical and public health interventions focusing on the identified risk factors. Large prospective cohort studies are warranted to investigate the combined effects of multiple co-existing early-life exposures.
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Affiliation(s)
- Yingying Su
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
| | - Carl D'Arcy
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
- Department of PsychiatryCollege of MedicineUniversity of SaskatchewanSaskatoonSKCanada
| | - Xiangfei Meng
- Department of PsychiatryMcGill UniversityMontrealQCCanada
- Douglas Research CentreMontrealQCCanada
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19
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Cheslack-Postava K, Sourander A, Suominen A, Jokiranta-Olkoniemi E, McKeague IW, Brown AS. Increased Risk of ADHD at Short and Long Interpregnancy Intervals in a National Birth Cohort. Paediatr Perinat Epidemiol 2021; 35:392-400. [PMID: 32162359 PMCID: PMC10339818 DOI: 10.1111/ppe.12657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/27/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Short or long interpregnancy interval (IPI) may adversely impact conditions for foetal development. Whether attention deficit hyperactivity disorder (ADHD) is related to IPI has been largely unexplored. OBJECTIVES To examine the association between IPI and ADHD in a large, population-based Finnish study. METHODS All children born in Finland between 1991 and 2005 and diagnosed with ADHD (ICD-9 314x or ICD-10 F90.x) from 1995 to 2011 were identified using data from linked national registers. Each subject with ADHD was matched to 4 controls based on sex, date of birth, and place of birth. A total of 9564 subjects with ADHD and 34,479 matched controls were included in analyses. IPI was calculated as the time interval between sibling birth dates minus the gestational age of the second sibling. The association between IPI and ADHD was determined using conditional logistic regression and adjusted for potential confounders. RESULTS Relative to births with an IPI of 24 to 59 months, those with the shortest IPI (<6 months) had an increased risk of ADHD (odds ratio [OR] 1.30, 95% confidence interval (CI) 1.12, 1.51) and the ORs for the longer IPI births (60-119 months and ≥120 months) were 1.12 (95% CI 1.02, 1.24) and 1.25 (95% CI 1.08, 1.45), respectively. The association of longer IPI with ADHD was attenuated by adjustment for maternal age at the preceding birth, and comorbid autism spectrum disorders did not explain the associations with ADHD. CONCLUSIONS The risk of ADHD is higher among children born following short or long IPIs although further studies are needed to explain this association.
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Affiliation(s)
- Keely Cheslack-Postava
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
| | - Andre Sourander
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Ian W. McKeague
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Alan S. Brown
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
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20
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Lin LZ, Xu SL, Wu QZ, Zhou Y, Ma HM, Chen DH, Chen GB, Yu HY, Yang BY, Zeng XW, Hu LW, Dong GH. Association of Prenatal, Early Postnatal, or Current Exposure to Secondhand Smoke With Attention-Deficit/Hyperactivity Disorder Symptoms in Children. JAMA Netw Open 2021; 4:e2110931. [PMID: 34014325 PMCID: PMC8138689 DOI: 10.1001/jamanetworkopen.2021.10931] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Few studies have investigated the association between the exposure window (prenatal, early postnatal, and current period) of secondhand smoke (SHS) and attention-deficit/hyperactivity disorder (ADHD) symptoms and subtypes in children. OBJECTIVE To evaluate the associations of prenatal, early postnatal, or current SHS exposure with ADHD symptoms and subtypes among school-aged children. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, 48 612 children aged 6 to 18 years from elementary and middle schools in Liaoning province, China, between April 2012 and January 2013 were eligible for participation. Data on SHS exposure and ADHD symptoms and subtypes for each child were collected via questionnaires administered to parents or guardians by school teachers. Data were analyzed from September 14 to December 2, 2020. MAIN OUTCOMES AND MEASURES The ADHD symptoms and subtypes (inattention, hyperactivity-impulsivity, and combined) were measured based on a validated tool developed from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Generalized linear mixed models were evaluated to estimate the association of SHS exposure with ADHD symptoms and subtypes. RESULTS A total of 45 562 participants completed the questionnaires and were included in this study (22 905 girls [50.3%]; mean [SD] age, 11.0 [2.6] years; 2170 [4.8%] with ADHD symptoms). Compared with their unexposed counterparts, children who were ever exposed (odds ratio [OR], 1.50; 95% CI, 1.36-1.66) or always exposed to SHS (OR, 2.88; 95% CI, 2.55-3.25) from pregnancy to childhood had higher odds of having ADHD symptoms and subtypes (ORs ranged from 1.46 [95% CI, 1.31-1.62] to 2.94 [95% CI, 2.09-4.13]). Compared with their unexposed counterparts, children with SHS exposure had higher odds of having ADHD symptoms when exposed in the prenatal period (OR, 2.28; 95% CI, 2.07-2.51), early postnatal period (OR, 1.47; 95% CI, 1.29-1.68), or current period (OR, 1.20; 95% CI, 1.09-1.31). Compared with their unexposed counterparts, children whose fathers smoked 10 or more cigarettes/d on both weekdays and weekends had higher odds of having ADHD symptoms and subtypes (ORs ranged from 1.48 [95% CI, 1.28-1.70] to 2.25 [95% CI, 1.29-3.93]). CONCLUSIONS AND RELEVANCE Being exposed to SHS from pregnancy to childhood was associated with higher odds of having ADHD symptoms and subtypes among school-aged children, and the associations were somewhat stronger for SHS exposure during prenatal and early postnatal periods. Our findings highlight the important public health implications of reducing SHS exposure, which may decrease the health and economic burdens of individuals with ADHD.
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Affiliation(s)
- Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu-Li Xu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qi-Zhen Wu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Hui-Min Ma
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, China
| | - Duo-Hong Chen
- Department of Air Quality Forecasting and Early Warning, Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, China
| | - Gong-Bo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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21
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Vilar-Ribó L, Sánchez-Mora C, Rovira P, Richarte V, Corrales M, Fadeuilhe C, Arribas L, Casas M, Ramos-Quiroga JA, Ribasés M, Soler Artigas M. Genetic overlap and causality between substance use disorder and attention-deficit and hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2021; 186:140-150. [PMID: 33244849 DOI: 10.1002/ajmg.b.32827] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
Substance use disorder (SUD) often co-occur at high prevalence with other psychiatric conditions. Among them, attention-deficit and hyperactivity disorder (ADHD) is present in almost one out of every four subjects with SUD and is associated with higher severity, more frequent polysubstance dependence and increased risk for other mental health problems in SUD patients. Despite studies suggesting a genetic basis in the co-occurrence of these two conditions, the genetic factors involved in the joint development of both disorders and the mechanisms mediating these causal relationships are still unknown. In this study, we tested whether the genetic liability to five SUD-related phenotypes share a common background in the general population and clinically diagnosed ADHD individuals from an in-house sample of 989 subjects and further explored the genetic overlap and the causal relationship between ADHD and SUD using pre-existing GWAS datasets. Our results confirm a common genetic background between ADHD and SUD and support the current literature on the causal effect of the liability to ADHD on the risk for SUD. We added novel findings on the effect of the liability of lifetime cannabis use on ADHD and found evidence of shared genetic background underlying SUD in general population and in ADHD, at least for lifetime cannabis use, alcohol dependence and smoking initiation. These findings are in agreement with the high comorbidity observed between ADHD and SUD and highlight the need to control for substance use in ADHD and to screen for ADHD comorbidity in all SUD patients to provide optimal clinical interventions.
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Affiliation(s)
- Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Paula Rovira
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montserrat Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lorena Arribas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Miquel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
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22
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Sellers R, Warne N, Rice F, Langley K, Maughan B, Pickles A, Thapar A, Collishaw S. Using a cross-cohort comparison design to test the role of maternal smoking in pregnancy in child mental health and learning: evidence from two UK cohorts born four decades apart. Int J Epidemiol 2021; 49:390-399. [PMID: 32040173 PMCID: PMC7266557 DOI: 10.1093/ije/dyaa001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/13/2019] [Accepted: 01/24/2019] [Indexed: 12/21/2022] Open
Abstract
Background Maternal smoking in pregnancy is associated with low birth weight (LBW), child conduct problems, hyperactivity and lower cognitive attainment, but associations may reflect measured and unmeasured confounding. Cross-cohort designs can aid causal inference through comparison of associations across populations with different confounding structures. We compared associations between maternal smoking in pregnancy and child conduct and hyperactivity problems, cognition and LBW across two cohorts born four decades apart. Methods Two national UK cohorts born in 1958 (n = 12 415) and 2000/01 (n = 11 800) were compared. Maternal smoking in pregnancy and child birth weight was assessed at or shortly after birth. Parents rated children’s conduct problems and hyperactivity, and children completed standardized tests of reading and mathematics. Results Maternal smoking in pregnancy was less common and more strongly associated with social disadvantage in 2000/01 compared with 1958 (interactions P < 0.001). Maternal smoking in pregnancy was robustly and equivalently associated with infant LBW in both cohorts [interactions: boys odds ratio (OR) = 1.01 (0.89, 1.16), P = 0.838; girls OR = 1.01 (0.91, 1.17), P = 0.633]. Maternal smoking was more strongly associated with conduct problems, hyperactivity and reading in the 2000/01 cohort (interactions P < 0.001). Conclusions Marked cross-cohort change in associations between maternal smoking and child conduct problems, hyperactivity and reading highlights the likely role of confounding factors. In contrast, association with LBW was unaffected by change in prevalence of maternal smoking and patterns of confounding. The study highlights the utility of cross-cohort designs in helping triangulate conclusions about the role of putative causal risk factors in observational epidemiology.
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Affiliation(s)
- Ruth Sellers
- Rudd Centre for Adoption Research and Practice, School of Psychology, University of Sussex, Brighton, UK.,Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales
| | - Naomi Warne
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales
| | - Frances Rice
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales
| | - Kate Langley
- Cardiff University, School of Psychology, Cardiff, Wales
| | - Barbara Maughan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales
| | - Stephan Collishaw
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales
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23
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Thapar A, Rice F. Family-Based Designs that Disentangle Inherited Factors from Pre- and Postnatal Environmental Exposures: In Vitro Fertilization, Discordant Sibling Pairs, Maternal versus Paternal Comparisons, and Adoption Designs. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a038877. [PMID: 32152247 PMCID: PMC7919395 DOI: 10.1101/cshperspect.a038877] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Identifying environmental risk and protective exposures that have causal effects on health is an important scientific goal. Many environmental exposures are nonrandomly allocated and influenced by dispositional factors including inherited ones. We review family-based designs that can separate the influence of environmental exposures from inherited influences shared between parent and offspring. We focus on prenatal exposures. We highlight that the family-based designs that can separate the prenatal environment from inherited confounds are different to those that are able to pull apart later-life environmental exposures from inherited confounds. We provide a brief review of the literature on maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder (ADHD) and conduct problems; these inconsistencies in the literature make a review useful and this illustrates that results of family-based genetically informed studies are inconsistent with a causal interpretation for this exposure and these two offspring outcomes.
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Affiliation(s)
- Anita Thapar
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff CF24 4HQ, United Kingdom
| | - Frances Rice
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff CF24 4HQ, United Kingdom
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24
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Yu Y, Li H, Sun X, Liu X, Yang F, Hou L, Liu L, Yan R, Yu Y, Jing M, Xue H, Cao W, Wang Q, Zhong H, Xue F. Identification and Estimation of Causal Effects Using a Negative-Control Exposure in Time-Series Studies With Applications to Environmental Epidemiology. Am J Epidemiol 2021; 190:468-476. [PMID: 32830845 DOI: 10.1093/aje/kwaa172] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/17/2022] Open
Abstract
The initial aim of environmental epidemiology is to estimate the causal effects of environmental exposures on health outcomes. However, due to lack of enough covariates in most environmental data sets, current methods without enough adjustments for confounders inevitably lead to residual confounding. We propose a negative-control exposure based on a time-series studies (NCE-TS) model to effectively eliminate unobserved confounders using an after-outcome exposure as a negative-control exposure. We show that the causal effect is identifiable and can be estimated by the NCE-TS for continuous and categorical outcomes. Simulation studies indicate unbiased estimation by the NCE-TS model. The potential of NCE-TS is illustrated by 2 challenging applications: We found that living in areas with higher levels of surrounding greenness over 6 months was associated with less risk of stroke-specific mortality, based on the Shandong Ecological Health Cohort during January 1, 2010, to December 31, 2018. In addition, we found that the widely established negative association between temperature and cancer risks was actually caused by numbers of unobserved confounders, according to the Global Open Database from 2003-2012. The proposed NCE-TS model is implemented in an R package (R Foundation for Statistical Computing, Vienna, Austria) called NCETS, freely available on GitHub.
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25
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Family and developmental history of ADHD patients: a structured clinical routine interview identifies a significant profile. Eur Arch Psychiatry Clin Neurosci 2020; 270:1047-1061. [PMID: 31399866 DOI: 10.1007/s00406-019-01047-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/23/2019] [Indexed: 12/28/2022]
Abstract
Similar to other neurodevelopmental disorders, the diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on clinical and psychosocial assessment. This assessment is performed in clinical practice using the clinical routine interview technique. Domains of the clinical routine interview are, among others, present symptoms, history of present illness and family and developmental history. Family and developmental history are important parts in the diagnostic process of ADHD. In contrast to the domains of present symptoms and history of present illness, there are currently no structured interviews or rating scales available to thoroughly assess family and developmental history in ADHD. The aim of the study was to assess the profile of operationalized data from a structured clinical routine interview addressing family and developmental history from ADHD patients and control participants. A structured interview to assess family and developmental history was derived from the guidelines used at different university hospitals for Child and Adolescent Psychiatry as well as from the descriptions in leading textbooks. Based on these guidelines and descriptions, the interview was an optimization of possible questions. Clinical data were obtained from parents of male patients who had the diagnosis of ADHD between the ages of 12-17 years (n = 44), and of healthy controls (n = 41). Non-metric data were operationalized into three categories, 0-normal behavior, 1-minor pathological behavior, 2-major pathological behavior. ADHD patients express a profile that significantly differs from control participants. Comparison of significant items with the empirical ADHD literature indicates strong agreement. Our findings support the importance and feasibility of the clinical routine interview in family and developmental history in the context of diagnosing ADHD.
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26
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Maternal health behaviors during pregnancy in rural Northwestern China. BMC Pregnancy Childbirth 2020; 20:745. [PMID: 33256673 PMCID: PMC7708178 DOI: 10.1186/s12884-020-03444-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022] Open
Abstract
Background Maternal health during pregnancy is a key input in fetal health and child development. This study aims to systematically describe the health behaviors of pregnant women in rural China and identify which subgroups of women are more likely to engage in unhealthy behaviors during pregnancy. Methods We surveyed 1088 pregnant women in rural northwestern China on exposure to unhealthy substances, nutritional behaviors, the timing and frequency of antenatal care, and demographic characteristics. Results Pregnant women were active in seeking antenatal care and had low rates of alcohol consumption (5.1%), exposure to toxins (4.8%), and exposure to radiation (2.9%). However, tobacco exposure was widespread (40.3%), as was low dietary diversity (61.8%), unhealthy weight gain (59.7%), unhealthy pre-pregnancy BMI (29.7%), and no folic acid intake (17.1%). Maternal education is closely linked to better health behaviors, whereas experience with a previous pregnancy is not. Conclusions Tobacco exposure and unhealthy nutritional behaviors are common among pregnant women in rural northwestern China. The findings indicate that in the absence of professional health information, relying on experience of previous pregnancies alone may not help rural women avoid unhealthy maternal behaviors. Maternal health education campaigns targeting nutrition and tobacco exposure during pregnancy may improve maternal, fetal, and child health in rural China.
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27
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He Y, Chen J, Zhu LH, Hua LL, Ke FF. Maternal Smoking During Pregnancy and ADHD: Results From a Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Atten Disord 2020; 24:1637-1647. [PMID: 29039728 DOI: 10.1177/1087054717696766] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: Findings on maternal smoking during pregnancy and ADHD risk in children are inconsistent. A meta-analysis was performed to summarize effects of exposure to maternal smoking during pregnancy on ADHD risk in children. Method: We conducted a systematic literature search to select articles up to June 2016. Only prospective cohort studies were included. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated. Results: Pooled RR estimates based on 12 cohort studies including 17,304 pregnant women suggested that maternal smoking during pregnancy was associated with an increased risk of ADHD (pooled RR = 1.58, 95% CI = [1.33, 1.88]). Conclusion: Results from this study indicate that maternal smoking during pregnancy is related to an increased risk of ADHD in children. There is an urgent need to increase maternal awareness of smoking risk and quitting smoking to mitigate the ADHD risk in children.
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Affiliation(s)
- Yan He
- Ningbo Women and Children's Hospital, China
| | - Jian Chen
- Ningbo Women and Children's Hospital, China
| | - Li-Hua Zhu
- Ningbo Women and Children's Hospital, China
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28
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Biederman J, Fitzgerald M, Spencer TJ, Bhide PG, McCarthy DM, Woodworth KY, Saunders A, Faraone SV. Is Paternal Smoking at Conception a Risk for ADHD? A Controlled Study in Youth With and Without ADHD. J Atten Disord 2020; 24:1493-1496. [PMID: 28152645 DOI: 10.1177/1087054717690809] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Based on emerging preclinical findings suggesting that paternal smoking at conception may be a risk for ADHD in the offspring, we investigated whether a similar effect can be observed in humans. Method: We analyzed data from an opportunistic dataset of girl probands with (N = 140) and without (N = 122) ADHD with available information on paternal smoking at conception. Data were analyzed using Pearson's chi-square tests and multiple logistic regression. Results: ADHD probands had a significantly higher rate of paternal smoking at conception than controls (35% vs. 23%, χ2 = 3.82, p = .05) with a significant odds ratio of 1.5. However, the association lost significance after controlling for paternal ADHD, most likely due to limited statistical power. Conclusion: While preliminary, findings suggest that paternal smoking at conception may be a risk factor for ADHD in the offspring.
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Affiliation(s)
- Joseph Biederman
- Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Boston, MA, USA
| | | | - Thomas J Spencer
- Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Boston, MA, USA
| | | | | | | | | | - Stephen V Faraone
- State University of New York Upstate Medical University, Syracuse, USA.,University of Bergen, Norway, USA
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Sellers R, Harold GT, Thapar A, Neiderhiser JM, Ganiban JM, Reiss D, Shaw DS, Natsuaki MN, Leve LD. Examining the Role of Genetic Risk and Longitudinal Transmission Processes Underlying Maternal Parenting and Psychopathology and Children's ADHD Symptoms and Aggression: Utilizing the Advantages of a Prospective Adoption Design. Behav Genet 2020; 50:247-262. [PMID: 32623545 DOI: 10.1007/s10519-020-10006-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/26/2020] [Indexed: 01/27/2023]
Abstract
Although genetic factors may contribute to initial liability for ADHD onset, there is growing evidence of the potential importance of the rearing environment on the developmental course of ADHD symptomatology. However, associations between family-level variables (maternal hostility, maternal depressive symptoms) and child behaviors (developmental course of ADHD and aggression) may be explained by genes that are shared by biologically related parents and children. Furthermore, ADHD symptoms and aggression commonly co-occur: it is important to consider both simultaneously to have a better understanding of processes underlying the developmental course of ADHD and aggression. To addresses these issues, we employed a longitudinal genetically sensitive parent-offspring adoption design. Analyses were conducted using Cohort I (n = 340) of the Early Growth and Development Study with cross-validation analyses conducted with Cohort II (n = 178). Adoptive mother hostility, but not depression, was associated with later child ADHD symptoms and aggression. Mothers and their adopted children were genetically unrelated, removing passive rGE as a possible explanation. Early child impulsivity/activation was associated with later ADHD symptoms and aggression. Child impulsivity/activation was also associated with maternal hostility, with some evidence for evocative gene-environment correlation processes on adoptive mother depressive symptoms. This study provides novel insights into family-based environmental influences on child ADHD and aggression symptoms, independent of shared parental genetic factors, implications of which are further explicated in the discussion.
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Affiliation(s)
- Ruth Sellers
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Brighton, UK.,Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Gordon T Harold
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK. .,Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge, CB2 8PQ, UK.
| | - Anita Thapar
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Jody M Ganiban
- Department of Psychology, George Washington University, Washington, DC, USA
| | - David Reiss
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Misaki N Natsuaki
- Department of Psychology, University of California, Riverside, CA, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
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M. Nilsen F, Frank J, S. Tulve N. A Systematic Review and Meta-Analysis Investigating the Relationship between Exposures to Chemical and Non-Chemical Stressors during Prenatal Development and Childhood Externalizing Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072361. [PMID: 32244397 PMCID: PMC7177257 DOI: 10.3390/ijerph17072361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
Childhood behavioral outcomes have been linked to low quality intrauterine environments caused by prenatal exposures to both chemical and non-chemical stressors. The effect(s) from the many stressors a child can be prenatally exposed to may be influenced by complex interactive relationships that are just beginning to be understood. Chemical stressors influence behavioral outcomes by affecting the monoamine oxidase A (MAOA) enzyme, which is involved in serotonin metabolism and the neuroendocrine response to stress. Non-chemical stressors, particularly those associated with violence, have been shown to influence and exacerbate the externalizing behavioral outcomes associated with low MAOA activity and slowed serotonin metabolism. The adverse developmental effects associated with high stress and maternal drug use during pregnancy are well documented. However, research examining the combined effects of other non-chemical and chemical stressors on development and childhood outcomes as a result of gestational exposures is scarce but is an expanding field. In this systematic review, we examined the extant literature to explore the interrelationships between exposures to chemical and non-chemical stressors (specifically stressful/traumatic experiences), MAOA characteristics, and childhood externalizing behaviors. We observed that exposures to chemical stressors (recreational drugs and environmental chemicals) are significantly related to externalizing behavioral outcomes in children. We also observed that existing literature examining the interactions between MAOA characteristics, exposures to chemical stressors, and traumatic experiences and their effects on behavioral outcomes is sparse. We propose that maternal stress and cortisol fluctuations during pregnancy may be an avenue to link these concepts. We recommend that future studies investigating childhood behaviors include chemical and non-chemical stressors as well as children’s inherent genetic characteristics to gain a holistic understanding of the relationship between prenatal exposures and childhood behavioral outcomes.
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Affiliation(s)
- Frances M. Nilsen
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
- Correspondence:
| | - Jessica Frank
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
| | - Nicolle S. Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
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Şair YB, Sevinçok D, Kutlu A, Çakaloz B, Sevinçok L. The affective temperament traits and pregnancy-related depression in mothers may constitute risk factors for their children with attention deficit and hyperactivity disorder. J OBSTET GYNAECOL 2019; 40:1079-1084. [PMID: 31814479 DOI: 10.1080/01443615.2019.1679741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We investigated whether the affective temperaments of mothers and maternal depression before and during the index pregnancy are related to the development of Attention-Deficit Hyperactivity Disorder (ADHD) in their children. One hundred and twenty children were screened for the diagnosis of ADHD. After exclusion and inclusion criteria were applied for children and their mothers, we compared the mothers of children with (n = 63) and without ADHD (n = 60) in terms of affective temperament traits, depression before and during the index pregnancy, and some environmental risk factors. The rate of boys were significantly higher among children with ADHD compared to healthy controls. The mothers of children with ADHD had significantly lower education levels, more cigarette consumption during pregnancy, and more depression rates before the pregnancy than those of healthy children. Male gender (p = .002), Hamilton Depression Rating Scale (HDRS) (p = .002), cyclothymic (p = .022), irritable (p = .035) and anxious temperament scores (p = .016) significantly predicted the association between the mothers and their children with ADHD. Our findings might suggest that male child gender, the severity of depression at index pregnancy, higher cyclothymic, irritable, and anxious temperament scores in mothers may constitute as important risk factors for the development of ADHD in their children.Impact statementWhat is already known on this subject? Although the effects of maternal depression on ADHD were extensively investigated, the relationship between affective temperament traits of mothers and ADHD in their children has not been sufficiently examined. To investigate the roles of maternal affective temperament traits and pregnancy-related depression on offspring ADHD would help us to understand the etiopathogenic bases of ADHD.What do the results of this study add? Cyclothymic, irritable and anxious temperaments of mothers were significantly associated with the offspring ADHD after adjusting for the gender, maternal smoking, prepartum and antenatal depression.What are the implications of these findings for clinical practice and/or further research? These findings might demonstrate that some maternal affective temperaments and depression during pregnancy are suggestive of an inherited predisposition to ADHD in offsprings. Longitudinal studies are required to demonstrate the relationship between maternal affective temperament features and the development of affective illness in children with ADHD.
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Affiliation(s)
- Yaşan Bilge Şair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Doğa Sevinçok
- Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Ayşe Kutlu
- Department of Child and Adolescent Psychiatry, Dr.Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Burcu Çakaloz
- Department of Child and Adolescent Psychiatry, Pamukkale University, Denizli, Turkey
| | - Levent Sevinçok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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Minatoya M, Araki A, Itoh S, Yamazaki K, Kobayashi S, Miyashita C, Sasaki S, Kishi R. Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children's Health. Environ Health Prev Med 2019; 24:74. [PMID: 31812162 PMCID: PMC6898952 DOI: 10.1186/s12199-019-0834-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. Methods This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children’s Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22–0.51 ng/ml (low-passive smoker), 0.52–11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). Results Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. Conclusion Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.
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Affiliation(s)
- Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.,Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Seiko Sasaki
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.
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Madley-Dowd P, Rai D, Zammit S, Heron J. Simulations and directed acyclic graphs explained why assortative mating biases the prenatal negative control design. J Clin Epidemiol 2019; 118:9-17. [PMID: 31689456 PMCID: PMC7001034 DOI: 10.1016/j.jclinepi.2019.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/09/2019] [Accepted: 10/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The negative control design can be used to provide evidence for whether a prenatal exposure-outcome association occurs by in utero mechanisms. Assortative mating has been suggested to influence results from negative control designs, although how and why has not yet been adequately explained. We aimed to explain why mutual adjustment of maternal and paternal exposure in regression models can account for assortative mating. STUDY DESIGN AND SETTING We used directed acyclic graphs to show how bias can occur when modeling maternal and paternal effects separately. We empirically tested our claims using a simulation study. We investigated how increasing assortative mating influences the bias of effect estimates obtained from models that do and do not use a mutual adjustment strategy. RESULTS In models without mutual adjustment, increasing assortative mating led to increased bias in effect estimates. The maternal and paternal effect estimates were biased by each other, making the difference between them smaller than the true difference. Mutually adjusted models did not suffer from such bias. CONCLUSIONS Mutual adjustment for maternal and paternal exposure prevents bias from assortative mating influencing the conclusions of a negative control design. We further discuss issues that mutual adjustment may not be able to resolve.
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Affiliation(s)
- Paul Madley-Dowd
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University of Bristol, Bristol, UK.
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University of Bristol, Bristol, UK; Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University of Bristol, Bristol, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
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Bolea-Alamañac B, Davies SJC, Evans J, Joinson C, Pearson R, Skapinakis P, Emond A. Does maternal somatic anxiety in pregnancy predispose children to hyperactivity? Eur Child Adolesc Psychiatry 2019; 28:1475-1486. [PMID: 30868247 DOI: 10.1007/s00787-019-01289-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 02/05/2019] [Indexed: 12/22/2022]
Abstract
The objective of this study is to explore the association between maternal somatic anxiety in pregnancy and hyperactivity symptoms and ADHD diagnosis in children. Data from the Avon Longitudinal Study of Parents and Children cohort were used to examine the association between somatic anxiety symptoms in pregnancy measured with five items of the Crown-Crisp Experiential Index, ADHD diagnosis in children at 7.5 and 15 years (obtained with the Development and Well-Being Assessment-DAWBA) and hyperactivity at 4 and 16 years (measured with the Strengths and Difficulties Questionnaire hyperactivity subscale-SDQ). Maternal somatic anxiety was associated with ADHD diagnosis at age 7.5 [crude OR = 1.87 (95% CI = 1.21-2.91)], adjusted model [OR = 1.57 (95% CI = 0.99-2.48)]. There was no evidence of association with ADHD at 15: crude OR = 2.27 (95% CI = 0.90-5.71), adjusted OR = 1.65 (95% CI = 0.63-4.35). An association was found at 4 and 16 with the SDQ hyperactivity subscale: crude OR at 4: 1.70 (95% CI =1.37-2.11), adjusted OR = 1.34 (95% CI = 1.07-1.69); crude OR at 16: 1.95 (95% CI = 1.47-2.58), adjusted OR = 1.62 (95% CI = 1.21-2.17).Thus, there was evidence for an association between maternal somatic anxiety in pregnancy and increased hyperactivity symptoms (SDQ) at 4 and 16. There was no association with ADHD diagnosis.
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Affiliation(s)
- Blanca Bolea-Alamañac
- General Systems Division, Centre for Addiction and Mental Health, 80 Workman Way, 6th Floor, Toronto, ON, M6J 1H4, Canada
| | - Simon J C Davies
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, 80 Workman Way, 6th Floor, Toronto, ON, M6J 1H4, Canada.
| | - Jonathan Evans
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | - Carol Joinson
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | - Rebecca Pearson
- Centre for Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | - Petros Skapinakis
- Division of Psychiatry, University College London, London, W1T 7NF, UK
- Department of Psychiatry, University of Ioannina School of Medicine, 45110, Ioannina, Greece
| | - Alan Emond
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Office Room BG6a, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
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Kalkbrenner AE, Meier SM, Madley-Dowd P, Ladd-Acosta C, Fallin MD, Parner E, Schendel D. Familial confounding of the association between maternal smoking in pregnancy and autism spectrum disorder in offspring. Autism Res 2019; 13:134-144. [PMID: 31464107 DOI: 10.1002/aur.2196] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Evidence supports no link between maternal smoking in pregnancy and autism spectrum disorder (autism) overall. To address remaining questions about the unexplained heterogeneity between study results and the possibility of risk for specific autism sub-phenotypes, we conducted a whole-population cohort study in Denmark. We followed births 1991-2011 (1,294,906 persons, including 993,301 siblings in 728,271 families), from 1 year of age until an autism diagnosis (13,547), death, emigration, or December 31, 2012. Autism, with and without attention deficit hyperactivity disorder (ADHD) and with and without intellectual disability (ID) were based on ICD-8 and ICD-10 codes from Danish national health registers, including 3,319 autism + ADHD, 10,228 autism - no ADHD, 2,205 autism + ID, and 11,342 autism - no ID. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) between any maternal smoking (from birth records) and autism (or sub-phenotypes) using survival models with robust standard errors, stratifying by birth year and adjusting for child sex, parity, and parental age, education, income, and psychiatric history. To additionally address confounding using family designs, we constructed a maternal cluster model (adjusting for the smoking proportion within the family), and a stratified sibling model. Associations with maternal smoking and autism were elevated in conventional adjusted analyses (HR of 1.17 [1.13-1.22]) but attenuated in the maternal cluster (0.98 [0.88-1.09]) and sibling (0.86 [0.64-1.15]) models. Similarly, risks of autism sub-phenotypes with maternal smoking were attenuated in the family-based models. Together these results support that smoking in pregnancy is not linked with autism or select autism comorbid sub-phenotypes after accounting for familial confounding. Autism Res 2020, 13: 134-144. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Smoking during pregnancy has many harmful impacts, which may include harming the baby's developing brain. However, in a study of thousands of families in Denmark, it does not appear that smoking in pregnancy leads to autism or autism in combination with intellectual problems or attention deficits, once you account for the way smoking patterns and developmental disabilities run in families.
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Affiliation(s)
- Amy E Kalkbrenner
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Sandra M Meier
- Child and Adolescent Mental Health Centre-Mental Health Services Capital Region, Copenhagen Region, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Paul Madley-Dowd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Margaret Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Erik Parner
- Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus, Denmark
| | - Diana Schendel
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
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Leppert B, Havdahl A, Riglin L, Jones HJ, Zheng J, Davey Smith G, Tilling K, Thapar A, Reichborn-Kjennerud T, Stergiakouli E. Association of Maternal Neurodevelopmental Risk Alleles With Early-Life Exposures. JAMA Psychiatry 2019; 76:834-842. [PMID: 31042271 PMCID: PMC6495368 DOI: 10.1001/jamapsychiatry.2019.0774] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/14/2019] [Indexed: 12/27/2022]
Abstract
Importance Early-life exposures, such as prenatal maternal lifestyle, illnesses, nutritional deficiencies, toxin levels, and adverse birth events, have long been considered potential risk factors for neurodevelopmental disorders in offspring. However, maternal genetic factors could be confounding the association between early-life exposures and neurodevelopmental outcomes in offspring, which makes inferring a causal relationship problematic. Objective To test whether maternal polygenic risk scores (PRSs) for neurodevelopmental disorders were associated with early-life exposures previously linked to the disorders. Design, Setting, and Participants In this UK population-based cohort study, 7921 mothers with genotype data from the Avon Longitudinal Study of Parents and Children (ALSPAC) underwent testing for association of maternal PRS for attention-deficit/hyperactivity disorder (ADHD PRS), autism spectrum disorder (ASD PRS), and schizophrenia (SCZ PRS) with 32 early-life exposures. ALSPAC data collection began September 6, 1990, and is ongoing. Data were analyzed for the current study from April 1 to September 1, 2018. Exposures Maternal ADHD PRS, ASD PRS, and SCZ PRS were calculated using discovery effect size estimates from the largest available genome-wide association study and a significance threshold of P < .05. Main Outcomes and Measures Outcomes measured included questionnaire data on maternal lifestyle and behavior (eg, smoking, alcohol consumption, body mass index, and maternal age), maternal use of nutritional supplements and medications in pregnancy (eg, acetaminophen, iron, zinc, folic acid, and vitamins), maternal illnesses (eg, diabetes, hypertension, rheumatism, psoriasis, and depression), and perinatal factors (eg, birth weight, preterm birth, and cesarean delivery). Results Maternal PRSs were available from 7921 mothers (mean [SD] age, 28.5 [4.8] years). The ADHD PRS was associated with multiple prenatal factors, including infections (odds ratio [OR], 1.11; 95% CI, 1.04-1.18), use of acetaminophen during late pregnancy (OR, 1.11; 95% CI, 1.04-1.18), lower blood levels of mercury (β coefficient, -0.06; 95% CI, -0.11 to -0.02), and higher blood levels of cadmium (β coefficient, 0.07; 95% CI, 0.05-0.09). Little evidence of associations between ASD PRS or SCZ PRS and prenatal factors or of association between any of the PRSs and adverse birth events was found. Sensitivity analyses revealed consistent results. Conclusions and Relevance These findings suggest that maternal risk alleles for neurodevelopmental disorders, primarily ADHD, are associated with some pregnancy-related exposures. These findings highlight the need to carefully account for potential genetic confounding and triangulate evidence from different approaches when assessing the effects of prenatal exposures on neurodevelopmental disorders in offspring.
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Affiliation(s)
- Beate Leppert
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alexandra Havdahl
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Lucy Riglin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Hannah J. Jones
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol NHS (National Health Service) Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Jie Zheng
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Evie Stergiakouli
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom
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Huang X, Zhang Q, Gu X, Hou Y, Wang M, Chen X, Wu J. LPHN3 gene variations and susceptibility to ADHD in Chinese Han population: a two-stage case-control association study and gene-environment interactions. Eur Child Adolesc Psychiatry 2019; 28:861-873. [PMID: 30406846 DOI: 10.1007/s00787-018-1251-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/31/2018] [Indexed: 12/18/2022]
Abstract
Polymorphisms in latrophilin 3 (LPHN3) were recently reported to be associated with attention-deficit/hyperactivity disorder (ADHD), and subsequently other researchers tried to replicate the findings in different populations. This study was aimed to confirm the role of the LPHN3 in ADHD and explore the potential interactions with environmental risk factors in Chinese Han population. We examined the association of LPHN3 with ADHD in a population of 473 ADHD children and 585 controls. As a supplement of ADHD diagnosis, Conners Parent Symptom Questionnaire (PSQ) was used to evaluate ADHD symptoms. Blood lead levels (BLLs) were measured by atomic absorption spectrophotometry and other potential environmental risk factors were determined via a questionnaire filled out by the parents. Finally, after validation in an independent sample (284 cases and 390 controls), we observed significant associations between LPHN3 variants rs1868790 and ADHD risk in combined stage within codominant model [TA/AA: OR (95% CI) = 1.636 (1.325-2.021)], dominant model [OR (95% CI) = 1.573 (1.288-1.922)], and additive model [OR (95% CI) = 1.535 (1.266-1.862)]. Furthermore, rs1868790 significantly interacted with BLLs and maternal stress to modify ADHD susceptibility (P < 0.05), and rs1868790 was found to be related with ADHD symptoms (P < 0.05). Expression quantitative trait loci analysis further indicated that rs1868790 took part in the regulation of LPHN3 gene expression. As the first study to comprehensively explore the role of LPHN3 in ADHD in Chinese children, our research suggests that LPHN3 gene has a significant effect on the ADHD in a Chinese population.
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Affiliation(s)
- Xin Huang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qi Zhang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xue Gu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yuwei Hou
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Min Wang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xinzhen Chen
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jing Wu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China. .,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Thapar A, Rutter M. Do natural experiments have an important future in the study of mental disorders? Psychol Med 2019; 49:1079-1088. [PMID: 30606278 PMCID: PMC6498787 DOI: 10.1017/s0033291718003896] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Abstract
There is an enormous interest in identifying the causes of psychiatric disorders but there are considerable challenges in identifying which risks are genuinely causal. Traditionally risk factors have been inferred from observational designs. However, association with psychiatric outcome does not equate to causation. There are a number of threats that clinicians and researchers face in making causal inferences from traditional observational designs because adversities or exposures are not randomly allocated to individuals. Natural experiments provide an alternative strategy to randomized controlled trials as they take advantage of situations whereby links between exposure and other variables are separated by naturally occurring events or situations. In this review, we describe a growing range of different types of natural experiment and highlight that there is a greater confidence about findings where there is a convergence of findings across different designs. For example, exposure to hostile parenting is consistently found to be associated with conduct problems using different natural experiment designs providing support for this being a causal risk factor. Different genetically informative designs have repeatedly found that exposure to negative life events and being bullied are linked to later depression. However, for exposure to prenatal cigarette smoking, while findings from natural experiment designs are consistent with a causal effect on offspring lower birth weight, they do not support the hypothesis that intra-uterine cigarette smoking has a causal effect on attention-deficit/hyperactivity disorder and conduct problems and emerging findings highlight caution about inferring causal effects on bipolar disorder and schizophrenia.
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Affiliation(s)
- Anita Thapar
- Child & Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - Michael Rutter
- MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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Sanderson E, Macdonald-Wallis C, Davey Smith G. Negative control exposure studies in the presence of measurement error: implications for attempted effect estimate calibration. Int J Epidemiol 2019; 47:587-596. [PMID: 29088358 PMCID: PMC5913619 DOI: 10.1093/ije/dyx213] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2017] [Indexed: 11/12/2022] Open
Abstract
Background Negative control exposure studies are increasingly being used in epidemiological studies to strengthen causal inference regarding an exposure-outcome association when unobserved confounding is thought to be present. Negative control exposure studies contrast the magnitude of association of the negative control, which has no causal effect on the outcome but is associated with the unmeasured confounders in the same way as the exposure, with the magnitude of the association of the exposure with the outcome. A markedly larger effect of the exposure on the outcome than the negative control on the outcome strengthens inference that the exposure has a causal effect on the outcome. Methods We investigate the effect of measurement error in the exposure and negative control variables on the results obtained from a negative control exposure study. We do this in models with continuous and binary exposure and negative control variables using analysis of the bias of the estimated coefficients and Monte Carlo simulations. Results Our results show that measurement error in either the exposure or negative control variables can bias the estimated results from the negative control exposure study. Conclusions Measurement error is common in the variables used in epidemiological studies; these results show that negative control exposure studies cannot be used to precisely determine the size of the effect of the exposure variable, or adequately adjust for unobserved confounding; however, they can be used as part of a body of evidence to aid inference as to whether a causal effect of the exposure on the outcome is present.
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Affiliation(s)
- Eleanor Sanderson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Sourander A, Sucksdorff M, Chudal R, Surcel HM, Hinkka-Yli-Salomäki S, Gyllenberg D, Cheslack-Postava K, Brown AS. Prenatal Cotinine Levels and ADHD Among Offspring. Pediatrics 2019; 143:e20183144. [PMID: 30804074 PMCID: PMC6398365 DOI: 10.1542/peds.2018-3144] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES An association between maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder (ADHD) has been shown across several studies based on self-reports. No previous studies have investigated the association of nicotine exposure measured by cotinine levels during pregnancy and offspring ADHD. METHODS In this population-based study, 1079 patients born between 1998 and 1999 and diagnosed with ADHD according to the International Classification of Diseases and 1079 matched controls were identified from Finnish nationwide registers. Maternal cotinine levels were measured by using quantitative immunoassays from maternal serum specimens collected during the first and second trimesters of pregnancy and archived in the national biobank. RESULTS There was a significant association between increasing log-transformed maternal cotinine levels and offspring ADHD. The odds ratio was 1.09 (95% confidence interval [CI] 1.06-1.12) when adjusting for maternal socioeconomic status, maternal age, maternal psychopathology, paternal age, paternal psychopathology, and child's birth weight for gestational age. In the categorical analyses with cotinine levels in 3 groups, heavy nicotine exposure (cotinine level >50 ng/mL) was associated with offspring ADHD, with an odds ratio of 2.21 (95% CI 1.63-2.99) in the adjusted analyses. Analyses by deciles of cotinine levels revealed that the adjusted odds for offspring ADHD in the highest decile was 3.34 (95% CI 2.02-5.52). CONCLUSIONS The study reveals an association with and a dose-response relationship between nicotine exposure during pregnancy and offspring ADHD. Future studies incorporating maternal smoking and environmental, genetic, and epigenetic factors are warranted.
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Affiliation(s)
- Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland;
- Departments of Child Psychiatry and
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Minna Sucksdorff
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Pediatric and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Heljä-Marja Surcel
- Faculty of Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland
| | | | - David Gyllenberg
- Department of Child Psychiatry, University of Turku, Turku, Finland
- National Institutes of Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; and
| | - Keely Cheslack-Postava
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Alan S Brown
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Malanchini M, Smith-Woolley E, Ayorech Z, Rimfeld K, Krapohl E, Vuoksimaa E, Korhonen T, Bartels M, van Beijsterveldt TC, Rose RJ, Lundström S, Anckarsäter H, Kaprio J, Lichtenstein P, Boomsma DI, Plomin R. Aggressive behaviour in childhood and adolescence: the role of smoking during pregnancy, evidence from four twin cohorts in the EU-ACTION consortium. Psychol Med 2019; 49:646-654. [PMID: 29886849 PMCID: PMC6378412 DOI: 10.1017/s0033291718001344] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/14/2018] [Accepted: 04/24/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Maternal smoking during pregnancy (MSDP) has been linked to offspring's externalizing problems. It has been argued that socio-demographic factors (e.g. maternal age and education), co-occurring environmental risk factors, or pleiotropic genetic effects may account for the association between MSDP and later outcomes. This study provides a comprehensive investigation of the association between MSDP and a single harmonized component of externalizing: aggressive behaviour, measured throughout childhood and adolescence. METHODS Data came from four prospective twin cohorts - Twins Early Development Study, Netherlands Twin Register, Childhood and Adolescent Twin Study of Sweden, and FinnTwin12 study - who collaborate in the EU-ACTION consortium. Data from 30 708 unrelated individuals were analysed. Based on item level data, a harmonized measure of aggression was created at ages 9-10; 12; 14-15 and 16-18. RESULTS MSDP predicted aggression in childhood and adolescence. A meta-analysis across the four samples found the independent effect of MSDP to be 0.4% (r = 0.066), this remained consistent when analyses were performed separately by sex. All other perinatal factors combined explained 1.1% of the variance in aggression across all ages and samples (r = 0.112). Paternal smoking and aggressive parenting strategies did not account for the MSDP-aggression association, consistent with the hypothesis of a small direct link between MSDP and aggression. CONCLUSIONS Perinatal factors, including MSDP, account for a small portion of the variance in aggression in childhood and adolescence. Later experiences may play a greater role in shaping adolescents' aggressive behaviour.
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Affiliation(s)
- Margherita Malanchini
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
- Department of Psychology, University of Texas at Austin, United States
| | - Emily Smith-Woolley
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
| | - Ziada Ayorech
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
| | - Kaili Rimfeld
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
| | - Eva Krapohl
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
| | - Eero Vuoksimaa
- Institute for Molecular Medicine FIMM, University of Helsinki, Finland
| | - Tellervo Korhonen
- Institute for Molecular Medicine FIMM, University of Helsinki, Finland
| | - Meike Bartels
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Richard J. Rose
- Department of Psychological and Brain Sciences, Indiana University, United States
| | - Sebastian Lundström
- Centre for Ethics, Law and Mental Health and the Gillberg Neuropsychiatry Centre, Gothenburg University, Sweden
| | - Henrik Anckarsäter
- Centre for Ethics, Law and Mental Health and the Gillberg Neuropsychiatry Centre, Gothenburg University, Sweden
| | - Jaakko Kaprio
- Institute for Molecular Medicine FIMM, University of Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Dorret I. Boomsma
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | - Robert Plomin
- Social Genetic and Developmental Psychiatry Centre, King's College London, United Kingdom
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Oldereid NB, Wennerholm UB, Pinborg A, Loft A, Laivuori H, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:320-389. [PMID: 29471389 DOI: 10.1093/humupd/dmy005] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children. OBJECTIVE AND RATIONALE The aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes. SEARCH METHODS PubMed, Embase and Cochrane databases up to January 2017 were searched. Paternal factors examined included paternal age and life-style factors such as body mass index (BMI), adiposity and cigarette smoking. The outcome variables assessed were short-term outcomes such as preterm birth, low birth weight, small for gestational age (SGA), stillbirth, birth defects and chromosomal anomalies. Long-term outcome variables included mortality, cancers, psychiatric diseases/disorders and metabolic diseases. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed. OUTCOMES The search included 14 371 articles out of which 238 met the inclusion criteria, and 81 were included in quantitative synthesis (meta-analyses). Paternal age and paternal life-style factors have an association with adverse outcome in offspring. This is particularly evident for psychiatric disorders such as autism, autism spectrum disorders and schizophrenia, but an association is also found with stillbirth, any birth defects, orofacial clefts and trisomy 21. Paternal height, but not BMI, is associated with birth weight in offspring while paternal BMI is associated with BMI, weight and/or body fat in childhood. Paternal smoking is found to be associated with an increase in SGA, birth defects such as congenital heart defects, and orofacial clefts, cancers, brain tumours and acute lymphoblastic leukaemia. These associations are significant although moderate in size, with most pooled estimates between 1.05 and 1.5, and none exceeding 2.0. WIDER IMPLICATIONS Although the increased risks of adverse outcome in offspring associated with paternal factors and identified in this report represent serious health effects, the magnitude of these effects seems modest.
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Affiliation(s)
- Nan B Oldereid
- Livio IVF-klinikken Oslo, Sørkedalsveien 10A, 0369 Oslo, Norway
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, SE 416 85 Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Loft
- Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Teiskontie 35, FI-33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, FI-33520 Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, FI-00290 Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Tukhomankatu 8, FI-00290 Helsinki, Finland
| | - Max Petzold
- Swedish National Data Service and Health Metrics Unit, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Norwegian University of Science and Technology, Trondheim NO-7010, Norway.,Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Caramaschi D, Taylor AE, Richmond RC, Havdahl KA, Golding J, Relton CL, Munafò MR, Davey Smith G, Rai D. Maternal smoking during pregnancy and autism: using causal inference methods in a birth cohort study. Transl Psychiatry 2018; 8:262. [PMID: 30498225 PMCID: PMC6265272 DOI: 10.1038/s41398-018-0313-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 11/22/2022] Open
Abstract
An association between maternal smoking in pregnancy and autism may be biologically plausible, but the evidence to date is inconsistent. We aimed to investigate the causal relationship between maternal smoking during pregnancy and offspring autism using conventional analysis and causal inference methods. In the Avon Longitudinal Study of Parents and Children we investigated the association of maternal smoking during pregnancy (exposure) with offspring autism spectrum disorder (ASD) or possible ASD diagnosis (n = 11,946) and high scores on four autism-related traits (outcomes) (n = 7402-9152). Maternal smoking was self-reported and also measured using an epigenetic score (n = 866-964). Partner's smoking was used as a negative control for intrauterine exposure (n = 6616-10,995). Mendelian randomisation (n = 1002-2037) was carried out using a genetic variant at the CHRNA3 locus in maternal DNA as a proxy for heaviness of smoking. In observational analysis, we observed an association between smoking during pregnancy and impairments in social communication [OR = 1.56, 95% CI = 1.29, 1.87] and repetitive behaviours, but multivariable adjustment suggested evidence for confounding. There was weaker evidence of such association for the other traits or a diagnosis of autism. The magnitude of association for partner's smoking with impairments in social communication was similar [OR = 1.56, 95% CI = 1.30, 1.87] suggesting potential for shared confounding. There was weak evidence for an association of the epigenetic score or genetic variation at CHRNA3 with ASD or any of the autism-related traits. In conclusion, using several analytic methods, we did not find enough evidence to support a causal association between maternal smoking during pregnancy and offspring autism or related traits.
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Affiliation(s)
- Doretta Caramaschi
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Amy E Taylor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca C Richmond
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jean Golding
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Caroline L Relton
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Experimental Psychology, University of Bristol, Bristol, UK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Dheeraj Rai
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
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Abstract
Thyroid hormone plays a pivotal role in the developing brain and may affect the development of attention deficit hyperactivity disorder (ADHD). This study aimed to examine the role of maternal thyroid function during pregnancy on offspring ADHD. A total of 2912 mother-child pairs were included from the Avon Longitudinal Study of Parents and Children. Thyroid parameters were assessed during the first trimester of pregnancy. Offspring ADHD was assessed using the Development and Well-Being Assessment at the ages of 7.5 and 15 years. The odds of presenting with ADHD were estimated using generalized estimating equations. Levels of thyroid-stimulating hormone (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.48-1.75), free thyroxine (OR, 1.07; 95% CI, 0.87-1.32), and thyroid peroxidase antibodies (OR, 1.00; 95% CI, 0.80-1.25) were not associated with ADHD in children aged 7.5 and 15 years. This study showed no association between maternal thyroid function and offspring ADHD.
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Schwenke E, Fasching PA, Faschingbauer F, Pretscher J, Kehl S, Peretz R, Keller A, Häberle L, Eichler A, Irlbauer-Müller V, Dammer U, Beckmann MW, Schneider M. Predicting attention deficit hyperactivity disorder using pregnancy and birth characteristics. Arch Gynecol Obstet 2018; 298:889-895. [PMID: 30196359 DOI: 10.1007/s00404-018-4888-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/02/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE The aim of this study was to evaluate maternal, prenatal, perinatal, and postpartum parameters as risk factors for the later development of an attention deficit hyperactivity disorder (ADHD) in the child. METHODS Women who had given birth at Erlangen University Hospital between 1996 and 1999 were sent a questionnaire in 2009. The results of the questionnaire were correlated with the prospectively collected data for the births in 1996-1999. RESULTS A total of 573 mother and child pairs were analyzed. Forty-four of the mothers reported that their child had ADHD (7.7%). No significant associations were found for the following parameters: mother's age; mother's educational level; number of the pregnancy; maternal weight before and at the end of pregnancy; mother's height; alcohol consumption during pregnancy; mode of delivery; gestational week; birthweight; umbilical artery blood values; Apgar score at 5 and 10 min; or breastfeeding. The parameters of smoking in pregnancy and an Apgar score lower than 7 after 1 min were significantly associated with a risk for later development of ADHD. CONCLUSIONS This analysis of maternal, prenatal, perinatal, and postnatal parameters found that smoking in pregnancy and a low Apgar score 1 min after birth are associated with a significantly greater risk for the development of ADHD. Beyond the question of the causal mechanism involved, this is a relevant finding, since smoking during pregnancy is a preventable risk factor.
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Affiliation(s)
- Eva Schwenke
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany.
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Florian Faschingbauer
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Jutta Pretscher
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Sven Kehl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Roberta Peretz
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Andrea Keller
- IMBE, Institute of Medical Informatics, Biometry and Epidemiology, Erlangen, Germany
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
- Biostatistics Unit, Department of Gynecology and Obstetrics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Viktoria Irlbauer-Müller
- Department of Child and Adolescent Mental Health, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ulf Dammer
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
| | - Michael Schneider
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91504, Erlangen, Germany
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Roberts AL, Liew Z, Lyall K, Ascherio A, Weisskopf MG. Association of Maternal Exposure to Childhood Abuse With Elevated Risk for Attention Deficit Hyperactivity Disorder in Offspring. Am J Epidemiol 2018; 187:1896-1906. [PMID: 29762636 DOI: 10.1093/aje/kwy098] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 04/25/2018] [Indexed: 12/13/2022] Open
Abstract
Children whose mothers experienced childhood abuse are more likely to suffer various neurodevelopmental deficits. Whether an association exists specifically for attention deficit hyperactivity disorder (ADHD) is unknown. We examined the association of maternal experience of childhood abuse with ADHD in offspring, assessed by maternal report of diagnosis and validated with the ADHD Rating Scale-IV in a subsample, in the Nurses' Health Study II (n = 49,497 mothers; n = 7,607 case offspring; n = 102,151 control offspring). We examined whether 10 adverse perinatal circumstances (e.g., prematurity, smoking) or socioeconomic factors accounted for a possible association. Exposure to abuse was associated with greater prevalence of ADHD in offspring (8.7% of offspring of women exposed to severe abuse vs. 5.5% of offspring of women not abused, P = 0.0001) and with greater risk for ADHD when the model was adjusted for demographic factors (male offspring, risk ratio (RR) = 1.6, 95% confidence interval (CI): 1.3, 1.9; female offspring, RR = 2.3, 95% CI: 1.7, 3.0). After adjustment for perinatal factors, the association of maternal childhood abuse with ADHD in offspring was slightly attenuated (male offspring, RR = 1.5, 95% CI: 1.2, 1.8; female offspring, RR = 2.1, 95% CI: 1.6, 2.8). We identified an association between maternal experience of childhood abuse and risk for ADHD in offspring, which was not explained by several important perinatal risk factors or socioeconomic status.
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Affiliation(s)
- Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Alberto Ascherio
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Peralta-Carcelen M, Schwartz J, Carcelen AC. Behavioral and Socioemotional Development in Preterm Children. Clin Perinatol 2018; 45:529-546. [PMID: 30144853 DOI: 10.1016/j.clp.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Prematurity is a significant risk factor for impaired neurodevelopmental outcomes. These include motor, cognitive, language, behavioral, and socioemotional competence. Long-term overall function depends on healthy socioemotional functioning. The vulnerability of the preterm brain during critical periods of development contributes to behavioral and socioemotional problems in preterm children. Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) clinical features are more frequent in preterm children compared with their full-term counterparts; however, true rates of ASD and ADHD vary across studies. Early detection of behavioral and socioemotional problems in preterm children would enable timely early intervention to improve long-term functional outcomes.
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Affiliation(s)
- Myriam Peralta-Carcelen
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Alabama at Birmingham, Dearth Tower Suite 5602, McWane. 1600 7th Avenue South, Birmingham, AL 35233-1711, USA.
| | - Justin Schwartz
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Alabama at Birmingham, Dearth Tower Suite 5602, McWane. 1600 7th Avenue South, Birmingham, AL 35233-1711, USA
| | - Andrea C Carcelen
- International Health Department, John Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room 5517, Baltimore, MD, USA
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Sharp GC, Lawlor DA, Richardson SS. It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease. Soc Sci Med 2018; 213:20-27. [PMID: 30055422 PMCID: PMC6137073 DOI: 10.1016/j.socscimed.2018.07.035] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 12/22/2022]
Abstract
Research on the developmental origins of health and disease (DOHaD) has traditionally focused on how maternal exposures around the time of pregnancy might influence offspring health and risk of disease. We acknowledge that for some exposures this is likely to be correct, but argue that the focus on maternal pregnancy effects also reflects implicit and deeply-held assumptions that 1) causal early life exposures are primarily transmitted via maternal traits or exposures, 2) maternal exposures around the time of pregnancy and early infancy are particularly important, and 3) other factors, such as paternal factors and postnatal exposures in later life, have relatively little impact in comparison. These implicit assumptions about the "causal primacy" of maternal pregnancy effects set the agenda for DOHaD research and, through a looping effect, are reinforced rather than tested. We propose practical strategies to redress this imbalance through maintaining a critical perspective about these assumptions.
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Affiliation(s)
- Gemma C Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol Dental School, University of Bristol, United Kingdom.
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Population Health Science, Bristol Medical School, University of Bristol, United Kingdom
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Identifying the contribution of prenatal risk factors to offspring development and psychopathology: What designs to use and a critique of literature on maternal smoking and stress in pregnancy. Dev Psychopathol 2018; 30:1107-1128. [DOI: 10.1017/s0954579418000421] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AbstractIdentifying prenatal environmental factors that have genuinely causal effects on psychopathology is an important research priority, but it is crucial to select an appropriate research design. In this review we explain why and what sorts of designs are preferable and focus on genetically informed/sensitive designs. In the field of developmental psychopathology, causal inferences about prenatal risks have not always been based on evidence generated from appropriate designs. We focus on reported links between maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder or conduct problems. Undertaking a systematic review of findings from genetically informed designs and “triangulating” evidence from studies with different patterns of bias, we conclude that at present findings suggest it is unlikely that there is a substantial causal effect of maternal smoking in pregnancy on either attention-deficit/hyperactivity disorder or conduct problems. In contrast, for offspring birth weight (which serves as a positive control) findings strongly support a negative causal effect of maternal smoking in pregnancy. For maternal pregnancy stress, too few studies use genetically sensitive designs to draw firm conclusions, but continuity with postnatal stress seems important. We highlight the importance of moving beyond observational designs, for systematic evaluation of the breadth of available evidence and choosing innovative designs. We conclude that a broader set of prenatal risk factors should be examined, including those relevant in low- and middle-income contexts. Future directions include a greater use of molecular genetically informed designs such as Mendelian randomization to test causal hypotheses about prenatal exposure and offspring outcome.
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Korgan AC, O'Leary E, King JL, Weaver ICG, Perrot TS. Effects of paternal high-fat diet and rearing environment on maternal investment and development of defensive responses in the offspring. Psychoneuroendocrinology 2018. [PMID: 29518693 DOI: 10.1016/j.psyneuen.2018.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Paternal preconception risk factors (e.g. stress, diet, drug use) correlate with metabolic dysfunction in offspring, which is often comorbid with depressive and anxiety-like phenotypes. Detection of these risk factors or deleterious phenotypes informs a female about prevailing ecological demands, in addition to potential adverse environment-induced phenotypes that may be disseminated to her offspring. We examined whether a F0 male rat's prior exposure to an obesogenic high-fat diet (HFD) influences a female's attraction towards a male, subsequent mother-infant interactions and the development of defensive (emotional) responses in the F1 offspring. Females displayed less interest in the HFD exposed F0 males relative to control diet-exposed F0 males. Dams that reared F1 offspring in larger, semi-naturalistic housing provided more licking and grooming and active arched-back-nursing behavior. However, some of these effects interacted with paternal experience. F0 HFD and maternal rearing environment revealed sex-dependent, between group differences in F1 offspring wean weight, juvenile social interactions and anxiety-like behavior in adolescence. Our results show for the first time in mammals that male exposure to HFD may contribute to stable behavioral variation among females in courtship, maternal care, even when the females are not directly exposed to a HFD, and anxiety-like behavior in F1 offspring. Furthermore, when offspring were exposed to a predatory threat, hypothalamic Crf gene regulation was influenced by early housing. These results, together with our previous findings, suggest that paternal experience and maternal rearing conditions can influence maternal behavior and development of defensive responses of offspring.
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Affiliation(s)
- Austin C Korgan
- Department of Psychology and Neuroscience, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
| | - Elizabeth O'Leary
- Department of Psychology and Neuroscience, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
| | - Jillian L King
- Department of Psychology and Neuroscience, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
| | - Ian C G Weaver
- Department of Psychology and Neuroscience, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada; Brain Repair Centre, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
| | - Tara S Perrot
- Department of Psychology and Neuroscience, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada; Brain Repair Centre, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada.
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