Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts

Abstract

Objectives: 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. Design: 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.

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

“…Associations have been reported between prepregnancy obesity and intellectual disability, 12,16 lower cognitive performance, 10,13,14,17,21 ADHD, 11,19,20,32 and autism 15 in children. One null study was also reported; however, it was limited by assessing all overweight and obese women as a single group.…”

“…8,9 Recent epidemiologic studies suggest associations between prepregnancy obesity and various neurodevelopmental outcomes. [10][11][12][13][14][15][16][17][18][19][20][21] However, these studies were limited by small sample sizes, insufficient information on confounders and mediators, and imprecise neurodevelopment measures. Additionally, 1 study reported no association.…”

Impact of maternal obesity on offspring obesity and cardiometabolic disease risk

“…This has been little explored in humans beyond childhood. However, there is emerging evidence that maternal obesity impacts on offspring brain function including cognitive function and psychiatric or mood disturbances; children of women who are overweight pre-pregnancy or gain a large amount of weight during pregnancy have a twofold risk of attention deficit hyperactivity disorder symptoms compared to normalweight women (Rodriguez et al 2008), as well as problems with emotional regulation (Rodriguez 2010). These effects are substantial, and thus clinically relevant, if causal.…”

Maternal Psychosocial and Environmental Factors Associated With Infant Impaired Development in Sao Paulo, Brazil: A Population-Based Birth Cohort Study

“…There is some evidence that suggests that mothers who have studied more have a better physical and temporal environmental organization, more opportunities to vary daily stimulation with different availability of tools and games more suitable for their toddlers and greater emotional and verbal link [23]. However, less schooling is an important SES marker.…”

“…Fewer frequent studies that include other pre-partum mental disorders [12][13][14][15], as well as important environmental stressors, as violence. Yet these conditions are highly prevalent in developing countries and in deprived areas of wealthier nations [16][17][18][19][20][21][22][23][24]. In addition to this, most evidence comes from studies that were carried in clinical settings, lacking data on populationbased samples [12]; developmental assessment in epidemiological studies are seldom done through more sophisticated tests that requires trained professionals [3,8]; finally the identification of effect-modifiers (interaction) in these association has been acknowledge as necessary [25].…”