Langley K, Rice F, van den Bree M B M, Thapar A
Department of Psychological Medicine, Cardiff University, Heath Park, Cardiff, UK.
Minerva Pediatr. 2005 Dec;57(6):359-71.
Attention deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder which affects between 3% and 5% of school aged children. Despite much research, little is known regarding the aetiology of the disorder. Maternal cigarette smoking during pregnancy has been linked to a number of negative effects in offspring in infancy, childhood and even into adulthood and has been proposed as a possible risk factor for ADHD. The aim of this review was to discuss the evidence associating maternal smoking during pregnancy and ADHD as well as methodological issues concerning this association. A literature search using PubMed was employed using relevant keywords. The relevant reference sections of articles found were also searched. All English language studies published before June 2005 were assessed. A pooled odds ratio derived from case-control studies was also obtained. Despite methodological limitations, the majority of studies identify maternal smoking during pregnancy as a risk factor for ADHD behaviours. A pooled odds ratio indicates more than a two-fold increase in risk for a diagnosis of ADHD in those individuals whose mothers smoked during pregnancy (odds ratio 2.39, 95% confidence intervals 1.61, 3.52 P<0.001). Maternal smoking during pregnancy is a risk factor for ADHD behaviour and diagnoses, although the mechanisms through which such risks work is unknown.
注意缺陷多动障碍（ADHD）是一种常见的儿童精神疾病，影响着3%至5%的学龄儿童。尽管进行了大量研究，但对于该疾病的病因仍知之甚少。孕期母亲吸烟与后代在婴儿期、儿童期甚至成年期的一系列负面影响有关，并被认为是ADHD的一个可能风险因素。本综述的目的是讨论孕期母亲吸烟与ADHD之间关联的证据以及有关这种关联的方法学问题。使用PubMed进行文献检索，检索词为相关关键词。对所找到文章的相关参考文献部分也进行了检索。对2005年6月之前发表的所有英文研究进行了评估。还获得了病例对照研究得出的合并比值比。尽管存在方法学上的局限性，但大多数研究将孕期母亲吸烟确定为ADHD行为的一个风险因素。合并比值比表明，孕期母亲吸烟的个体被诊断为ADHD的风险增加了两倍多（比值比2.39，95%置信区间1.61, 3.52，P<0.001）。孕期母亲吸烟是ADHD行为和诊断的一个风险因素，尽管这种风险起作用的机制尚不清楚。
