title: Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden. Alina.Rodriguez@psyk.uu.se
authors.forename: A
authors.initials: A
authors.lastname: Rodriguez
authors.forename: J
authors.initials: J
authors.lastname: Miettunen
authors.forename: T B
authors.initials: TB
authors.lastname: Henriksen
authors.forename: J
authors.initials: J
authors.lastname: Olsen
authors.forename: C
authors.initials: C
authors.lastname: Obel
authors.forename: A
authors.initials: A
authors.lastname: Taanila
authors.forename: H
authors.initials: H
authors.lastname: Ebeling
authors.forename: K M
authors.initials: KM
authors.lastname: Linnet
authors.forename: I
authors.initials: I
authors.lastname: Moilanen
authors.forename: M-R
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D050154:Adiposity; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D009035:Mothers; D009765:Obesity; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology