Yoshimasu Kouichi, Kiyohara Chikako, Minami Takaomi, Yoshikawa Norishige, Kihira Shogo, Toyonaga Koji, Yamamoto Akira, Shinosaki Kazuhiro, Yamashita Hiroshi, Miyashita Kazuhisa
Department of Hygiene, School of Medicine, Wakayama Medical University, 8-1-1 Kimiidera, Wakayama 641-0012, Japan.
Atten Defic Hyperact Disord. 2009 Dec;1(2):223-31. doi: 10.1007/s12402-009-0015-1. Epub 2009 Nov 12.
Although maternal smoking during pregnancy has been shown to be associated with an increased risk of offspring attention-deficit/hyperactivity disorder (ADHD) in Western countries, there is no empirical evidence in non-Caucasian. Purpose of the present study is to examine the relationship between maternal smoking during pregnancy and offspring ADHD in Japanese population. A case-control study design was adopted. A total of 90 pairs of children with ADHD and mothers as well as 270 corresponding control pairs were recruited throughout the study period. A psychiatrist interviewed all the mothers of children with ADHD and control children and elicited information regarding their lifestyles during pregnancy, including active and passive smoking or drinking habits, as well as psychosocial and perinatal factors. Diagnosis of ADHD was made by each physician in charge according to DSM-IV diagnostic criteria. Logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) with adjustments for other possible confounding factors. Maternal active smoking during pregnancy was associated with an approximately twofold increased risk of offspring ADHD, even after adjusting for socioeconomic and perinatal confounding factors (OR 1.8 95% CI 0.9-3.6). However, the association was obviously attenuated when factors regarding parental psychopathological vulnerability were controlled (OR 1.3 95% CI 0.6-2.9). On the other hand, maternal passive smoking during pregnancy failed to show any material association with ADHD. These results suggested that a significant part of the association between maternal smoking during pregnancy, and ADHD might be explained by genetic factors including parental psychopathological vulnerability.
尽管在西方国家，孕期母亲吸烟已被证明与后代患注意力缺陷多动障碍（ADHD）的风险增加有关，但在非白种人中尚无实证依据。本研究的目的是探讨日本人群中孕期母亲吸烟与后代ADHD之间的关系。采用病例对照研究设计。在整个研究期间，共招募了90对患有ADHD的儿童及其母亲，以及270对相应的对照儿童及其母亲。一名精神科医生对所有患有ADHD的儿童和对照儿童的母亲进行了访谈，并收集了她们孕期的生活方式信息，包括主动和被动吸烟或饮酒习惯，以及心理社会和围产期因素。每位主治医生根据《精神疾病诊断与统计手册》第四版（DSM-IV）诊断标准对ADHD进行诊断。采用逻辑回归分析计算比值比（OR）和95%置信区间（CI），并对其他可能的混杂因素进行调整。即使在对社会经济和围产期混杂因素进行调整后，孕期母亲主动吸烟与后代患ADHD的风险增加约两倍相关（OR 1.8，95% CI 0.9 - 3.6）。然而，当控制了父母心理病理易感性因素后，这种关联明显减弱（OR 1.3，95% CI 0.6 - 2.9）。另一方面，孕期母亲被动吸烟与ADHD未显示出任何实质性关联。这些结果表明，孕期母亲吸烟与ADHD之间的关联很大一部分可能由包括父母心理病理易感性在内的遗传因素来解释。
