父母哮喘发作、加重与注意缺陷多动障碍风险。
Parental asthma occurrence, exacerbations and risk of attention-deficit/hyperactivity disorder.
机构信息
The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
The National Centre for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; CIRRAU-The Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Department for Child and Adolescent Psychiatry, Hospital of Telemark, Kragerø, Norway.
出版信息
Brain Behav Immun. 2019 Nov;82:302-308. doi: 10.1016/j.bbi.2019.08.198. Epub 2019 Aug 30.
OBJECTIVE
To investigate whether intrauterine exposure to maternal asthma or asthma exacerbations increases the risk of attention-deficit/hyperactivity disorder (ADHD).
METHODS
Using Danish register data, this cohort study comprised of 961,202 live singletons born in Denmark during 1997-2012. Children were followed to a maximum of 20.0 years from birth until the first of ADHD-diagnosis/prescription, emigration, death, or 31 December 2016. Cox regression models were used to evaluate the association between maternal or paternal asthma, asthma exacerbations and offspring ADHD.
RESULTS
During 11.4 million person-years of follow-up, 27,780 (2.9%) children were identified as having ADHD. ADHD risk was increased among offspring born to asthmatic mothers (hazard ratio (HR) 1.41, 95% CI: 1.36-1.46) or asthmatic fathers (HR 1.13, 95% CI: 1.08-1.18). Antenatal antiasthma medication treatment did not increase offspring ADHD. However, higher risks were observed among offspring of mothers with asthma exacerbations compared with children of asthmatic mothers with no exacerbations: HR 1.12 (95% CI: 1.00-1.25) for pre-pregnancy exacerbations; 1.21 (95% CI: 1.00-1.47) for exacerbations during pregnancy; and 1.25 (95% CI: 1.08-1.44) for exacerbations after delivery.
CONCLUSIONS
These results support theories regarding shared genetic and environmental risk factors having a role in the development of ADHD.
目的
探讨母体哮喘或哮喘加重是否会增加注意力缺陷多动障碍（ADHD）的风险。
方法
本队列研究使用丹麦登记数据，纳入了 1997 年至 2012 年期间在丹麦出生的 961202 例活产单胎。对儿童进行随访，随访时间最长可达 20 年，从出生至首次 ADHD 诊断/处方、移民、死亡或 2016 年 12 月 31 日。使用 Cox 回归模型评估母亲或父亲哮喘、哮喘加重与后代 ADHD 之间的关联。
结果
在 1140 万个人随访年中，有 27780（2.9%）例儿童被诊断为 ADHD。哮喘母亲（危险比（HR）1.41，95%可信区间：1.36-1.46）或哮喘父亲（HR 1.13，95%可信区间：1.08-1.18）所生子女的 ADHD 风险增加。产前抗哮喘药物治疗并未增加后代 ADHD。然而，与哮喘母亲无加重的儿童相比，母亲哮喘加重的儿童 ADHD 风险更高：孕前加重的 HR 为 1.12（95%可信区间：1.00-1.25）；孕期加重的 HR 为 1.21（95%可信区间：1.00-1.47）；产后加重的 HR 为 1.25（95%可信区间：1.08-1.44）。
结论
这些结果支持了关于 ADHD 的发病机制与共享遗传和环境风险因素有关的理论。
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