Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, NY.
J Pediatr. 2020 May;220:227-236.e1. doi: 10.1016/j.jpeds.2020.01.016. Epub 2020 Feb 14.
To assess relations of prepregnancy maternal and paternal obesity with offspring behavioral problems and psychiatric symptoms at 7-8 years in the Upstate KIDS study, a prospective cohort study.
Maternal body mass index (BMI) was calculated from prepregnancy height and weight provided in vital records or self-report at 4 months postpartum. Mothers reported paternal height and weight. At 7-8 years, mothers indicated if their children had been diagnosed with ADHD or anxiety (n = 1915). Additionally, children's behavior was measured with the Strengths and Difficulties Questionnaire at 7 years of age (n = 1386) and the Vanderbilt ADHD Diagnostic Parent Rating Scale at 8 years of age (n = 1484). Based on Strengths and Difficulties Questionnaire scores, we identified children with borderline behavioral problems. Adjusted risk ratios (aRR) and 95% CIs were estimated with robust multivariable Poisson regression.
Compared with children of mothers with a BMI of <25, children whose mothers had BMI 25-30, 30-35, and ≥35 kg/m had higher risks of reported ADHD (aRR, 1.14, 95% CI, 0.78-1.69; aRR, 1.96, 95% CI, 1.29-2.98; and aRR, 1.82, 95% CI,1.21-2.74, respectively). Risks of hyperactivity problems identified by the Strengths and Difficulties Questionnaire and a positive screen for inattentive or hyperactive/impulsive behavior with the Vanderbilt ADHD Diagnostic Parent Rating Scale were also higher with increasing maternal prepregnancy BMI. Paternal BMI was not associated with child outcomes.
Our findings suggest that maternal, rather than paternal, obesity is associated with maternal report of child ADHD diagnosis and inattentive or hyperactivity problems. Further research is needed to understand how maternal obesity might influence these behavioral changes during or after pregnancy.
在一项前瞻性队列研究——上州儿童研究(Upstate KIDS study)中,评估母亲和父亲孕前肥胖与 7-8 岁子女行为问题和精神症状的关系。
根据产后 4 个月生命记录或自我报告中提供的孕前身高和体重计算出母亲的体重指数(BMI)。母亲报告了父亲的身高和体重。在 7-8 岁时,母亲如果孩子被诊断为 ADHD 或焦虑症(n=1915)。此外,在 7 岁时,通过《长处和困难问卷》(Strengths and Difficulties Questionnaire)测量了儿童的行为(n=1386),在 8 岁时通过《范德比尔特注意力缺陷多动障碍诊断父母评定量表》(Vanderbilt ADHD Diagnostic Parent Rating Scale)测量了儿童的行为(n=1484)。根据《长处和困难问卷》评分,我们确定了有边缘行为问题的儿童。采用稳健多变量泊松回归估计调整后的风险比(aRR)及其 95%置信区间。
与母亲 BMI<25 的儿童相比,母亲 BMI 为 25-30、30-35 和≥35kg/m2 的儿童患 ADHD 的风险更高(aRR,1.14,95%CI,0.78-1.69;aRR,1.96,95%CI,1.29-2.98;aRR,1.82,95%CI,1.21-2.74)。通过《长处和困难问卷》识别出的多动问题风险以及《范德比尔特注意力缺陷多动障碍诊断父母评定量表》提示的注意力不集中或多动/冲动行为阳性的风险也随母亲孕前 BMI 的增加而升高。父亲 BMI 与儿童结局无关。
我们的研究结果表明,肥胖与母亲而非父亲肥胖与母亲报告的子女 ADHD 诊断以及注意力不集中或多动问题有关。需要进一步的研究来了解母亲肥胖如何在怀孕期间或之后影响这些行为变化。