title: Attention-Deficit/Hyperactivity Disorder in Offspring of Mothers With Inflammatory and Immune System Diseases.
abstract: Prenatal inflammatory mechanisms may play a role in the pathogenesis of psychiatric disorders and could be relevant for attention-deficit/hyperactivity disorder (ADHD). We investigated maternal chronic somatic diseases with immune components as possible risk factors for ADHD in offspring.
  
  
  
  We performed a population-based nested case-control study by linking data from longitudinal Norwegian registers. We included all individuals born during the period 1967-2008 and alive at record linkage (2012). Individuals receiving ADHD medication during the years 2004-2012 were defined as patients with ADHD (N = 47,944), and all remaining individuals (N = 2,274,713) were defined as control subjects. The associations between maternal diseases and ADHD in offspring were analyzed using logistic regression models.
  
  
  
  The following chronic diseases with immune components were related to ADHD in offspring: multiple sclerosis (adjusted odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.2-2.5), rheumatoid arthritis (adjusted OR = 1.7; 95% CI = 1.5-1.9), type 1 diabetes (adjusted OR = 1.6; 95% CI = 1.3-2.0), asthma (adjusted OR = 1.5; 95% CI = 1.4-1.6), and hypothyroidism (adjusted OR = 1.2; 95% CI = 1.1-1.4). In contrast, chronic hypertension and type 2 diabetes showed no significant associations. Estimates were almost unchanged with additional adjustment for parental ADHD, infant birth weight, and gestational age. Although point estimates for male and female offspring were different for some diseases (e.g., maternal asthma [adjusted OR = 1.7; 95% CI = 1.5-1.8 for female offspring and adjusted OR = 1.5; 95% CI = 1.4-1.6 for male offspring]), none of the associations differed significantly by offspring sex.
  
  
  
  Several maternal somatic diseases with immune components were found to increase the risk of ADHD in offspring. The associations could involve several causal pathways, including common genetic predisposition and environmental factors, and increased insight into the mechanisms behind these relationships could enhance our understanding of the etiology of ADHD.
authors.affiliation: Department of Biomedicine, Bergen; Department of Global Public Health and Primary Care, Bergen; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen;Bergen. Electronic address: Johanne.Instanes@biomed.uib.no.
authors.forename: Johanne T
authors.initials: JT
authors.lastname: Instanes
authors.affiliation: Department of Biomedicine, Bergen; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen;Bergen; Haukeland University Hospital;Bergen.
authors.forename: Anne
authors.initials: A
authors.lastname: Halmøy
authors.affiliation: Department of Global Public Health and Primary Care, Bergen; Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Engeland
authors.affiliation: Department of Biomedicine, Bergen; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen;Bergen; Haukeland University Hospital;Bergen.
authors.forename: Jan
authors.initials: J
authors.lastname: Haavik
authors.affiliation: Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
authors.affiliation: Department of Global Public Health and Primary Care, Bergen; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen;Bergen; Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen.
authors.forename: Kari
authors.initials: K
authors.lastname: Klungsøyr
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000150:complications* / Q000453:epidemiology; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000276:immunology; D011446:Prospective Studies; D012737:Sex Factors; D055815:Young Adult
keywords: ADHD; Attention-deficit/hyperactivity disorder; Immune disease; Inflammatory disease; Maternal effects; Risk factors