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Ho YF, Chen YL, Stewart R, Hsu TC, Chen VCH. Maternal asthma and asthma exacerbation during pregnancy and attention-deficit/hyperactivity disorder in offspring: a population-based cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02426-6. [PMID: 38600406 DOI: 10.1007/s00787-024-02426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
The link between inflammatory disorders, such as asthma, and attention deficit hyperactivity disorder (ADHD) is attracting increasing attention but few studies have examined cross-generational associations. We sought to examine associations of maternal asthma and asthma exacerbation during pregnancy, as well as paternal asthma, with the risk of ADHD in children. This population-based cohort study used data from the Taiwan National Health Insurance Research Database from 2004 to 2017. Cox regression models compared the risk of ADHD in children of parents with and without asthma, adjusting for parental sociodemographic, physical, and mental health conditions, as well as the child's birth weight, and number of births. A sibling control approach was employed to compensate for unmeasured confounders of asthma exacerbation during pregnancy. In the fully adjusted models, maternal and paternal asthma were both significantly associated with an increased risk of ADHD in offspring, with hazard ratios (HRs) of 1.36 (1.31-1.40) and 1.10 (1.05-1.14), respectively. Acute asthma exacerbation during pregnancy was not associated with the risk of further offspring ADHD (adjusted HR 1.00, 95% CI: 0.75-1.34). Both maternal and paternal asthma are associated with an increased risk of ADHD in offspring. The risk was higher from maternal asthma. However, no such association was found with maternal asthma exacerbation during pregnancy of sibling comparison.
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Affiliation(s)
- Yi-Feng Ho
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Taso-Tun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.
- Department of Psychology, Asia University, Taichung, Taiwan.
| | - Robert Stewart
- King's College London (Institute of Psychiatry, Psychology and Neuroscience), London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Tsai-Ching Hsu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Immunology Center, Chung Shan Medical University, Taichung, Taiwan.
- Department of Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
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Kerr-German A, White SF, Santosa H, Buss AT, Doucet GE. Assessing the relationship between maternal risk for attention deficit hyperactivity disorder and functional connectivity in their biological toddlers. Eur Psychiatry 2022; 65:e66. [PMID: 36226356 PMCID: PMC9641653 DOI: 10.1192/j.eurpsy.2022.2325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with increased risk for poor educational attainment and compromised social integration. Currently, clinical diagnosis rarely occurs before school-age, despite behavioral signs of ADHD in very early childhood. There is no known brain biomarker for ADHD risk in children ages 2-3 years-old. METHODS The current study aimed to investigate the functional connectivity (FC) associated with ADHD risk in 70 children aged 2.5 and 3.5 years via functional near-infrared spectroscopy (fNIRS) in bilateral frontal and parietal cortices; regions involved in attentional and goal-directed cognition. Children were instructed to passively watch videos for approximately 5 min. Risk for ADHD in each child was assessed via maternal symptoms of ADHD, and brain data was evaluated for FC. RESULTS Higher risk for maternal ADHD was associated with lower FC in a left-sided parieto-frontal network. Further, the interaction between sex and risk for ADHD was significant, where FC reduction in a widespread bilateral parieto-frontal network was associated with higher risk in male, but not female, participants. CONCLUSIONS These findings suggest functional organization differences in the parietal-frontal network in toddlers at risk for ADHD; potentially advancing the understanding of the neural mechanisms underlying the development of ADHD.
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Affiliation(s)
- Anastasia Kerr-German
- Boys Town National Research Hospital, Center for Childhood Deafness, Language and Learning, Omaha, Nebraska68131, USA,Author for correspondence: Anastasia Kerr-German, E-mail:
| | - Stuart F. White
- Boys Town National Research Hospital, Institute for Human Neuroscience, Boys Town, Nebraska68010, USA,Department of Pharmacology and Neuroscience, Creighton School of Medicine, Omaha, Nebraska68124, USA
| | - Hendrik Santosa
- Department of Radiology, University of Pittsburg, Pittsburg, Pennsylvania15260, USA
| | - Aaron T. Buss
- Department of Psychology, University of Tennessee, Knoxville, Tennessee37996, USA
| | - Gaelle E. Doucet
- Boys Town National Research Hospital, Institute for Human Neuroscience, Boys Town, Nebraska68010, USA,Department of Pharmacology and Neuroscience, Creighton School of Medicine, Omaha, Nebraska68124, USA
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Lean RE, Lessov-Shlaggar CN, Gerstein ED, Smyser TA, Paul RA, Smyser CD, Rogers CE. Maternal and family factors differentiate profiles of psychiatric impairments in very preterm children at age 5-years. J Child Psychol Psychiatry 2020; 61:157-166. [PMID: 31449335 PMCID: PMC6980170 DOI: 10.1111/jcpp.13116] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Very preterm (VPT; <30 weeks gestation) children are a heterogeneous group, yet the co-occurrence of psychiatric and neurodevelopmental impairments remains unclear. Moreover, the clinical and socio-environmental factors that promote resilient developmental outcomes among VPT children are poorly understood. METHODS One hundred and twenty five children (85 VPT and 40 full-term) underwent neurodevelopmental evaluation at age 5-years. Parents and teachers completed measures of internalizing, externalizing, attention-deficit/hyperactivity (ADHD), and autism symptoms. Psychiatric and neurodevelopmental measures were analyzed using Latent Profile Analysis. Multinomial regression examined the extent that infant, sociodemographic, and family factors, collected prospectively from birth to follow-up, independently differentiated resilient and impaired children. RESULTS Four latent profiles were identified, including a Typically Developing Group which represented 27.1% of the VPT group and 65.0% of the full-term group, an At-Risk Group with mild psychiatric and neurodevelopmental problems (VPT 44.7%, full-term 22.5%), a Psychiatric Group with moderate-to-severe psychiatric ratings (VPT 12.9%, full-term 10.0%), and a school-based Inattentive/Hyperactive Group (VPT 15.3%, full-term 2.5%). Clinical diagnoses were highest among the Psychiatric Group (80%). Factors that differentiated resilient and impaired subgroups of VPT children included prolonged exposure to maternal psychosocial distress (p ≤ .04), current family dysfunction (p ≤ .05), and maternal ADHD symptoms (p ≤ .02), whereas social risk index scores differentiated resilient and impaired full-term children (p < .03). CONCLUSIONS Lower levels of maternal distress, family dysfunction, and maternal ADHD symptoms were associated with resilience among VPT children. Maternal distress and family dysfunction are modifiable factors to be targeted as part of psychiatric interventions embedded in the long-term care of VPT children.
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Affiliation(s)
- Rachel E Lean
- Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Tara A Smyser
- Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel A Paul
- Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Christopher D Smyser
- Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Cynthia E Rogers
- Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
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Liu X, Dalsgaard S, Olsen TM, Li J, Wright RJ, Momen N. Parental asthma occurrence, exacerbations and risk of attention-deficit/hyperactivity disorder. Brain Behav Immun 2019; 82:302-308. [PMID: 31476415 PMCID: PMC7408292 DOI: 10.1016/j.bbi.2019.08.198] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/19/2019] [Accepted: 08/29/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To investigate whether intrauterine exposure to maternal asthma or asthma exacerbations increases the risk of attention-deficit/hyperactivity disorder (ADHD). METHODS Using Danish register data, this cohort study comprised of 961,202 live singletons born in Denmark during 1997-2012. Children were followed to a maximum of 20.0 years from birth until the first of ADHD-diagnosis/prescription, emigration, death, or 31 December 2016. Cox regression models were used to evaluate the association between maternal or paternal asthma, asthma exacerbations and offspring ADHD. RESULTS During 11.4 million person-years of follow-up, 27,780 (2.9%) children were identified as having ADHD. ADHD risk was increased among offspring born to asthmatic mothers (hazard ratio (HR) 1.41, 95% CI: 1.36-1.46) or asthmatic fathers (HR 1.13, 95% CI: 1.08-1.18). Antenatal antiasthma medication treatment did not increase offspring ADHD. However, higher risks were observed among offspring of mothers with asthma exacerbations compared with children of asthmatic mothers with no exacerbations: HR 1.12 (95% CI: 1.00-1.25) for pre-pregnancy exacerbations; 1.21 (95% CI: 1.00-1.47) for exacerbations during pregnancy; and 1.25 (95% CI: 1.08-1.44) for exacerbations after delivery. CONCLUSIONS These results support theories regarding shared genetic and environmental risk factors having a role in the development of ADHD.
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Affiliation(s)
- Xiaoqin Liu
- The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
| | - Søren Dalsgaard
- The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmar,CIRRAU-The Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark,Department for Child and Adolescent Psychiatry, Hospital of Telemark, Kragerø, Norway
| | - Trine-Munk Olsen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmar
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark,Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Rosalind J. Wright
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, USA,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Natalie Momen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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