a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
b Department of Mental Health , Johns Hopkins School of Public Health , Baltimore , MD , USA.
J Psychosom Obstet Gynaecol. 2019 Sep;40(3):217-225. doi: 10.1080/0167482X.2018.1468434. Epub 2018 May 23.
Examine the association of mothers' psychosocial stressors before and during pregnancy with their children's diagnosis of attention deficit hyperactivity disorder (ADHD). This study included 2140 mother-child pairs who had at least one postnatal pediatric visit at the Boston Medical Center between 2003 and 2015. Child ADHD was determined via (ICD-9) codes documented in electronic medical records. Latent factors of maternal stress and social support and measures of the physical home environment and psychosocial adversities were constructed using exploratory factor analysis. The association between the latent factors and child ADHD diagnosis was examined using multiple logistic regression, controlling for known risk factors for ADHD. Children were 1.45 (95% CI: 1.06, 1.99) and 3.03 (95% CI: 2.19, 4.20) times more likely to receive an ADHD diagnosis if their mother experienced a major stressful event during pregnancy or reported a high level of perceived stress, respectively. The number of family adversities increases the risk of ADHD diagnosis [second quartile: OR = 1.90; CI (1.31, 2.77); third quartile: OR = 1.96 CI (1.34, 2.88); fourth quartile: OR = 2.89 CI (2.01, 4.16)] compared to first quartile. In this prospective, predominantly urban, low-income, minority birth cohort, mothers' psychosocial stress before and during pregnancy appears to be an independent risk factor for the development of ADHD in their children.
探讨母亲在妊娠前后的心理社会压力源与子女注意力缺陷多动障碍（ADHD）诊断之间的关联。本研究纳入了 2140 对母婴对子，这些母婴在 2003 年至 2015 年间至少在波士顿医疗中心接受过一次产后儿科就诊。通过电子病历中记录的（ICD-9）代码确定儿童 ADHD 诊断。使用探索性因子分析构建了母亲压力和社会支持的潜在因素以及物理家庭环境和心理社会逆境的测量指标。使用多变量逻辑回归，控制 ADHD 的已知危险因素，检查潜在因素与儿童 ADHD 诊断之间的关联。如果母亲在妊娠期间经历重大压力事件或报告高水平的感知压力，其子女患 ADHD 的诊断的可能性分别增加 1.45 倍（95%CI：1.06，1.99）和 3.03 倍（95%CI：2.19，4.20）。家庭逆境的数量增加 ADHD 诊断的风险[第二四分位数：OR=1.90；CI（1.31，2.77）；第三四分位数：OR=1.96；CI（1.34，2.88）；第四四分位数：OR=2.89；CI（2.01，4.16）]与第一四分位数相比。在这项前瞻性的、以城市为主、以低收入、少数民族为基础的出生队列中，母亲在妊娠前后的心理社会压力似乎是其子女发生 ADHD 的独立危险因素。
