Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California.
Am J Epidemiol. 2018 Sep 1;187(9):1896-1906. doi: 10.1093/aje/kwy098.
Children whose mothers experienced childhood abuse are more likely to suffer various neurodevelopmental deficits. Whether an association exists specifically for attention deficit hyperactivity disorder (ADHD) is unknown. We examined the association of maternal experience of childhood abuse with ADHD in offspring, assessed by maternal report of diagnosis and validated with the ADHD Rating Scale-IV in a subsample, in the Nurses' Health Study II (n = 49,497 mothers; n = 7,607 case offspring; n = 102,151 control offspring). We examined whether 10 adverse perinatal circumstances (e.g., prematurity, smoking) or socioeconomic factors accounted for a possible association. Exposure to abuse was associated with greater prevalence of ADHD in offspring (8.7% of offspring of women exposed to severe abuse vs. 5.5% of offspring of women not abused, P = 0.0001) and with greater risk for ADHD when the model was adjusted for demographic factors (male offspring, risk ratio (RR) = 1.6, 95% confidence interval (CI): 1.3, 1.9; female offspring, RR = 2.3, 95% CI: 1.7, 3.0). After adjustment for perinatal factors, the association of maternal childhood abuse with ADHD in offspring was slightly attenuated (male offspring, RR = 1.5, 95% CI: 1.2, 1.8; female offspring, RR = 2.1, 95% CI: 1.6, 2.8). We identified an association between maternal experience of childhood abuse and risk for ADHD in offspring, which was not explained by several important perinatal risk factors or socioeconomic status.
儿童如果其母亲在儿童时期遭受过虐待，那么他们更有可能出现各种神经发育缺陷。但是否存在专门针对注意缺陷多动障碍（ADHD）的关联尚不清楚。我们通过母亲报告的诊断结果，在护士健康研究 II 中（n = 49,497 名母亲；n = 7,607 例患儿；n = 102,151 名对照患儿），并使用 ADHD 评定量表第四版进行了验证，在子样本中检查了母亲在儿童时期遭受虐待与子女 ADHD 之间的关联。我们检查了 10 种不良围产期情况（例如早产、吸烟）或社会经济因素是否可以解释这种关联。与未遭受虐待的女性相比，遭受严重虐待的女性的子女中 ADHD 的患病率更高（暴露于虐待的子女中 ADHD 的患病率为 8.7%，而未遭受虐待的子女中 ADHD 的患病率为 5.5%，P = 0.0001），并且在调整了人口统计学因素后，模型中 ADHD 的风险比（RR）也更高（男孩，RR = 1.6，95%置信区间（CI）：1.3，1.9；女孩，RR = 2.3，95% CI：1.7，3.0）。调整围产期因素后，母亲儿童时期虐待与子女 ADHD 之间的关联略有减弱（男孩，RR = 1.5，95% CI：1.2，1.8；女孩，RR = 2.1，95% CI：1.6，2.8）。我们发现母亲在儿童时期遭受虐待与子女患 ADHD 的风险之间存在关联，这种关联不能用几个重要的围产期风险因素或社会经济地位来解释。
