Original Article
International Journal of Obesity (2008) 32, 550–557; doi:10.1038/sj.ijo.0803741; published online 16 October 2007
Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts
A Rodriguez1,2, J Miettunen3, T B Henriksen4, J Olsen5,6, C Obel7,8, A Taanila9, H Ebeling10, K M Linnet7, I Moilanen10 and M-R Järvelin9,11
- 1Department of Psychology, Uppsala University, Uppsala, Sweden
- 2Department of Women's and Children's Health, Karolinska Institute, Sweden
- 3Department of Psychiatry, University and University Hospital of Oulu, Finland
- 4Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark
- 5The Danish Epidemiology Science Centre, Aarhus University, Denmark
- 6Department of Epidemiology, UCLA, Los Angeles, CA, USA
- 7Department of Pediatrics and Obstetrics, Aarhus University Hospital, Skejby Sygehus, Denmark
- 8The Danish Epidemiology Science Centre, Aarhus University, Denmark
- 9Department of Public Health Science and General Practice, University of Oulu, Finland
- 10Clinic of Child Psychiatry, University and University Hospital of Oulu, Finland
- 11Department of Epidemiology and Public Health, Imperial College London, London, UK
Correspondence: Dr A Rodriguez, Department of Psychology, Uppsala University, Box 1225, Uppsala 751 42, Sweden. E-mail: Alina.Rodriguez@psyk.uu.se
Received 19 February 2007; Revised 12 July 2007; Accepted 31 July 2007; Published online 16 October 2007.
Abstract
Objectives:
We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring.
Design:
Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within the Nordic Network on ADHD.
Methods:
Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as 'severe' and two as 'present' (approximately 10% of children scored in this range). Logistic regression and latent class analyses were used to examine maternal pregnancy weight in relation to children's ADHD core symptoms.
Results:
Teacher rated 12 556 school-aged children. Gestational weight gain outside of the Institute of Medicine guidelines was not related to ADHD symptoms (below recommendations: odds ratio (OR): 0.96; 95% confidence interval (CI): 0.81, 1.14; above recommendations: OR: 0.98; 95% CI: 0.82, 1.16). To examine various patterns of pre-pregnancy BMI and weight gain, we used latent class analysis and found significant associations between classes that included pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure and cohort country of origin. Children of women who were both overweight and gained a large amount of weight during gestation had a 2-fold risk of ADHD symptoms (OR: 2.10, 95% CI: 1.19, 3.72) compared to normal-weight women.
Conclusions:
We show for the first time that pre-pregnancy BMI is associated with ADHD symptoms in children. Our results are of public health significance if the associations are causal and will then add ADHD symptoms in offspring to the list of deleterious outcomes related to overweight and obesity in the prenatal period.
Keywords:
attention deficit hyperactivity disorder, child, body mass index, pregnancy, fetal origins, cohort studies
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