Developmental predictors of inattention-hyperactivity from pregnancy to early childhood.
OBJECTIVE
The objective of the study was to characterize the developmental sequence of pre- and postnatal risk factors for inattention-hyperactivity symptoms in preschoolers.


METHODS
Longitudinal data came from a French population based birth cohort study (EDEN; N = 1311 mother-child pairs followed from the pregnancy onwards). Inattention-hyperactivity symptoms were assessed with the Strengths and Difficulties Questionnaire when participating children were 3 years of age. Potential risk factors were classified in four domains (fetal exposures and child somatic characteristics, child temperament, child neurodevelopmental status, psychosocial environment) and four periods (before pregnancy, prenatal/birth, infancy, toddlerhood). Their role as potential moderator or mediator was tested with path analysis to determine the developmental sequence.


RESULTS
A low family socioeconomic status before pregnancy was the main environmental risk factor for inattention-hyperactivity symptoms at 3 years, and its effect occurred via two pathways. The first was a risk pathway, where lower SES was associated with higher maternal depression and anxiety during pregnancy; then to higher maternal and child distress and dysregulation in infancy; and in turn to higher levels of inattention-hyperactivity at 3 years. The second was a protective pathway, where higher SES was associated with longer duration of breastfeeding during infancy; then to better child neurodevelopmental status in toddlerhood; and in turn to lower levels of inattention-hyperactivity at 3 years.


CONCLUSIONS
This study identified psychosocial factors at several developmental periods that represent potential targets for preventing the emergence of inattention-hyperactivity symptoms in early childhood.
INSERM U669, University Paris-Descartes and Paris-Sud, Paris, France.
Stéphanie
S
Foulon
Division of Psychology and Language Sciences, University College London, London, United Kingdom; King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, United Kingdom.
Jean-Baptiste
JB
Pingault
Epidemiology and Clinical Research Unit, Beaujon Hospital, Clichy, France; INSERM UMR S953, Paris, France.
Béatrice
B
Larroque
INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Social Epidemiology Research Team, Paris, France; Sorbonne University, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Social Epidemiology Research Team, Paris, France.
Maria
M
Melchior
INSERM U669, University Paris-Descartes and Paris-Sud, Paris, France.
Bruno
B
Falissard
INSERM U669, University Paris-Descartes and Paris-Sud, Paris, France; International Laboratory on Child and Adolescent Health Development, University of Montreal, Montreal, Canada; Tomsk state University, Tomsk, Russian Federation.
Sylvana M
SM
Côté
D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006948:Hyperkinesis / Q000453:epidemiology* / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D011795:Surveys and Questionnaires