Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3/Teutori (3rd Floor), 20014, Turku, Finland.
Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA.
Eur Child Adolesc Psychiatry. 2020 Feb;29(2):239-247. doi: 10.1007/s00787-019-01372-y. Epub 2019 Jul 16.
Exposure to infection and inflammation during the fetal period are associated with offspring neuropsychiatric disorders. Few previous studies have examined this association with ADHD with mixed findings. This study aims to examine the association between early gestational maternal C-reactive protein (CRP), prospectively assayed in stored maternal sera and the risk of ADHD in offspring. This study is based on the Finnish Prenatal studies of ADHD (FIPS-ADHD) with a nested case-control design. It includes all singleton-born children in Finland between January 1, 1998 and December 31, 1999 and diagnosed with ADHD. A total of 1079 cases and equal number of controls were matched on date of birth, sex and place of birth. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens, collected during the first and early second trimester of pregnancy. Elevated maternal CRP when analyzed as a continuous variable was not associated with offspring ADHD (OR 1.05, 95% CI 0.96-1.15). No significant associations were seen in the highest quintile of CRP (OR 1.18, 95% CI 0.88-1.58). The results were similar in both sexes as well as among ADHD cases with or without comorbid ASD or conduct disorder. In this first study examining CRP, a biomarker for inflammation, during early pregnancy in relation to offspring ADHD, we report no significant associations. The lack of any association, when considered with positive findings seen in ASD and schizophrenia, and negative findings in bipolar disorder suggests different pathways linking maternal immune activation and development of various neuropsychiatric disorders.
胎儿期暴露于感染和炎症与后代神经精神疾病有关。以前的一些研究用 ADHD 检查了这种关联,但结果存在差异。本研究旨在检查孕早期母体 C 反应蛋白(CRP)与后代 ADHD 风险之间的关系,该蛋白在储存的母体血清中进行前瞻性检测。本研究基于芬兰 ADHD 产前研究(FIPS-ADHD),采用巢式病例对照设计。它包括 1998 年 1 月 1 日至 1999 年 12 月 31 日期间在芬兰出生的所有单胎儿童,并诊断为 ADHD。总共 1079 例病例和相同数量的对照在出生日期、性别和出生地方面进行匹配。使用乳胶免疫测定法从存档的母体血清标本中评估母体 CRP 水平,这些标本是在妊娠早期和早期第二孕期收集的。当作为连续变量进行分析时,升高的母体 CRP 与后代 ADHD 无关(OR 1.05,95%CI 0.96-1.15)。在 CRP 的最高五分位数中未观察到显著关联(OR 1.18,95%CI 0.88-1.58)。在男性和女性以及伴有或不伴有共患 ASD 或品行障碍的 ADHD 病例中,结果均相似。在这项首次研究中,我们检查了妊娠早期 CRP(炎症的生物标志物)与后代 ADHD 之间的关系,未发现显著关联。当考虑到在 ASD 和精神分裂症中发现的阳性结果以及在双相情感障碍中发现的阴性结果时,缺乏任何关联表明母体免疫激活与各种神经精神疾病发展之间存在不同的途径。