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.
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Acknowledgements
This research was supported by Nordic Council of Ministers research program on Longitudinal Epidemiology (NordForsk nr. 020056). Cohorts were supported by The Swedish Research Council (345-2004-156); The Academy of Finland (103451), Sigrid Juselius Foundation, Finland; Thule Institute, University of Oulu, Finland and the Danish Medical Research Council. Parts of this paper were presented at the Congress of Epidemiology 2006, Seattle, USA. Study concept, statistical analyses and drafting the manuscript were done by A Rodriguez. J Miettunen supervised and contributed to statistical analyses and data interpretation. M-R Järvelin, TB Henriksen and J Olsen were involved in the study concept, design and data interpretation. Design and execution of the cohorts was done by A Rodriguez (Sweden), J Olsen (Denmark) and M-R Järvelin (Finland). TB Henriksen (Denmark) and I Moilanen (Finland) played important roles in original cohort design. C Obel (Denmark) and A Taanila (Finland) were responsible for cohort data integrity. All authors critically revised the manuscript. The funding sources had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
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Rodriguez, A., Miettunen, J., Henriksen, T. et al. Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts. Int J Obes 32, 550–557 (2008). https://doi.org/10.1038/sj.ijo.0803741
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DOI: https://doi.org/10.1038/sj.ijo.0803741
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