非临床儿科人群注意缺陷多动障碍的产前和产后危险因素。
Pre- and postnatal risk factors for ADHD in a nonclinical pediatric population.
机构信息
Department of Environmental Health, Boston University School of Public Health, MA 02118, USA.
出版信息
J Atten Disord. 2013 Jan;17(1):47-57. doi: 10.1177/1087054711427563. Epub 2012 Jan 31.
Abstract
OBJECTIVE
The authors characterized pre- and postnatal risk factors for ADHD among a population-based sample of 8-year-old children followed since birth (N = 604).
METHOD
Parents and teachers rated ADHD symptoms, including inattention and impulsivity/hyperactivity. The authors reviewed pediatric medical records for history of an ADHD diagnosis, and parents reported ADHD medication use. The authors analyzed risk factors in relationship to outcomes using multivariable regression models.
RESULTS
Low paternal education, prenatal smoking, prenatal illicit drug use, maternal depression, and low Home Observation for Measurement of the Environment score were associated with greater risk for ADHD behaviors assessed via rating scale. Low income and being male were associated with ADHD diagnosis in medical records and ADHD medication use.
CONCLUSION
The authors found associations between socioeconomic, psychosocial, and prenatal exposures and ADHD-related behavior. Selection bias due to access to care and recall bias from inaccurate report of past exposures is minimized in this large, nonclinical, prospective cohort study.
摘要
目的
作者对一个自出生以来（N=604）就一直跟踪的基于人群的 8 岁儿童样本，描述了 ADHD 的产前和产后危险因素。
方法
父母和老师对 ADHD 症状进行了评定，包括注意力不集中和冲动/多动。作者查阅了儿科病历以了解 ADHD 的诊断史，家长报告了 ADHD 药物使用情况。作者使用多变量回归模型分析了与结果相关的风险因素。
结果
父亲教育程度低、产前吸烟、产前使用非法药物、母亲抑郁和家庭观察评估环境得分低与通过量表评估的 ADHD 行为风险增加有关。低收入和男性与病历中的 ADHD 诊断和 ADHD 药物使用有关。
结论
作者发现了社会经济、心理社会和产前暴露与 ADHD 相关行为之间的关联。在这项大型、非临床、前瞻性队列研究中，由于获得医疗保健的机会和过去暴露的不准确报告导致的选择偏倚最小化。
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