Schmitz Marcelo, Denardin Daniel, Laufer Silva Tatiana, Pianca Thiago, Hutz Mara Helena, Faraone Stephen, Rohde Luis Augusto
Dr. Schmitz, Denardin, Silva, Pianca, Hutz, and Rohde are with the Federal University of Rio Grande do Sul, Brazil; Dr. Faraone is with Upstate Medical University, Syracuse, NY.
Dr. Schmitz, Denardin, Silva, Pianca, Hutz, and Rohde are with the Federal University of Rio Grande do Sul, Brazil; Dr. Faraone is with Upstate Medical University, Syracuse, NY..
J Am Acad Child Adolesc Psychiatry. 2006 Nov;45(11):1338-1345. doi: 10.1097/S0890-8567(09)61916-X.
Few previous studies assessed specifically attention-deficit/hyperactivity disorder, predominantly inattentive subtype (ADHD-I) in nonreferred samples. This study investigated the association between ADHD-I and prenatal exposure to nicotine.
In a case-control study performed between September 2002 and April 2005, we assessed a nonreferred Brazilian sample of 100 children and adolescents with ADHD-I and 100 non-ADHD controls (6-18 years old). Cases and controls, matched by gender and age, were screened using teacher reports in the Swanson, Nolan, and Pelham-IV (SNAP-IV) scale. They were systematically evaluated through structured diagnostic interviews. Prenatal exposure to nicotine and potential confounding factors were evaluated by direct interview with mothers.
Adjusting for confounding factors (maternal ADHD, oppositional defiant disorder, birth weight, and alcohol use during pregnancy), children whose mothers smoked>or=10 cigarettes per day during pregnancy presented a significantly higher odds ratio for ADHD-I than children who were not exposed to nicotine during pregnancy (odds ratio 3.44; 95% confidence interval 1.17-10.06). Dimensional analyses showed significantly higher inattentive scores in subjects whose mothers smoked>or=10 cigarettes per day than in others after adjusting for confounding factors (p=.002).
In a nonreferred sample, the authors expanded to ADHD-I previous findings documenting the association between prenatal exposure to nicotine and broadly defined ADHD in clinical samples.
以往很少有研究专门评估非转诊样本中的注意力缺陷/多动障碍，主要是注意力不集中型（ADHD-I）。本研究调查了ADHD-I与产前尼古丁暴露之间的关联。
在2002年9月至2005年4月进行的一项病例对照研究中，我们评估了一个非转诊的巴西样本，其中包括100名患有ADHD-I的儿童和青少年以及100名非ADHD对照组（6-18岁）。通过教师使用斯旺森、诺兰和佩勒姆第四版（SNAP-IV）量表报告对病例和对照组（按性别和年龄匹配）进行筛查。通过结构化诊断访谈对他们进行系统评估。通过直接与母亲访谈来评估产前尼古丁暴露和潜在混杂因素。
在对混杂因素（母亲患ADHD、对立违抗障碍、出生体重和孕期饮酒）进行调整后，母亲在孕期每天吸烟≥10支的儿童患ADHD-I的比值比显著高于孕期未接触尼古丁的儿童（比值比3.44；95%置信区间1.17-10.06）。维度分析显示，在对混杂因素进行调整后，母亲每天吸烟≥10支的受试者的注意力不集中得分显著高于其他受试者（p = 0.002）。
在一个非转诊样本中，作者扩展了之前的研究结果，这些结果记录了产前尼古丁暴露与临床样本中广义定义的ADHD之间的关联，此次研究结果适用于ADHD-I。
