title: Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study.
abstract: The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child's risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2-11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child's risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3-4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09-3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05-4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91-3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany. pohlabeln@leibniz-bips.de.
authors.forename: Hermann
authors.identifier: http://orcid.org/0000-0002-9575-1119
authors.initials: H
authors.lastname: Pohlabeln
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rach
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Eiben
authors.affiliation: Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Copenhagen, Denmark.
authors.forename: Wencke
authors.initials: W
authors.lastname: Gwozdz
authors.affiliation: Research and Education Institute of Child Health, Strovolos, Cyprus.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Hadjigeorgiou
authors.affiliation: Department of Paediatrics, Medical Faculty, University of Pécs, Pecs, Hungary.
authors.forename: Dénes
authors.initials: D
authors.lastname: Molnár
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Saragossa, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Unit of Epidemiology & Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Russo
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: Toomas
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany.
authors.forename: Iris
authors.initials: I
authors.lastname: Pigeot
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Attention-deficit/hyperactivity disorders; European children cohort; Gestational hypertension; Maternal age; Neonatal respiratory disorders; Smoking