短间隔和长间隔妊娠与 ADHD 风险增加：一项全国性出生队列研究。
Increased Risk of ADHD at Short and Long Interpregnancy Intervals in a National Birth Cohort.
机构信息
Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY.
Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.
出版信息
Paediatr Perinat Epidemiol. 2021 Jul;35(4):392-400. doi: 10.1111/ppe.12657. Epub 2020 Mar 12.
BACKGROUND
Short or long interpregnancy interval (IPI) may adversely impact conditions for foetal development. Whether attention deficit hyperactivity disorder (ADHD) is related to IPI has been largely unexplored.
OBJECTIVES
To examine the association between IPI and ADHD in a large, population-based Finnish study.
METHODS
All children born in Finland between 1991 and 2005 and diagnosed with ADHD (ICD-9 314x or ICD-10 F90.x) from 1995 to 2011 were identified using data from linked national registers. Each subject with ADHD was matched to 4 controls based on sex, date of birth, and place of birth. A total of 9564 subjects with ADHD and 34,479 matched controls were included in analyses. IPI was calculated as the time interval between sibling birth dates minus the gestational age of the second sibling. The association between IPI and ADHD was determined using conditional logistic regression and adjusted for potential confounders.
RESULTS
Relative to births with an IPI of 24 to 59 months, those with the shortest IPI (<6 months) had an increased risk of ADHD (odds ratio [OR] 1.30, 95% confidence interval (CI) 1.12, 1.51) and the ORs for the longer IPI births (60-119 months and ≥120 months) were 1.12 (95% CI 1.02, 1.24) and 1.25 (95% CI 1.08, 1.45), respectively. The association of longer IPI with ADHD was attenuated by adjustment for maternal age at the preceding birth, and comorbid autism spectrum disorders did not explain the associations with ADHD.
CONCLUSIONS
The risk of ADHD is higher among children born following short or long IPIs although further studies are needed to explain this association.
背景
短或长的孕中期间隔（interpregnancy interval，IPI）可能对胎儿发育状况产生不利影响。注意力缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）是否与 IPI 有关，这在很大程度上尚未得到探索。
目的
在一项基于人群的大型芬兰研究中，检验 IPI 与 ADHD 之间的关联。
方法
利用来自全国性登记处的相关数据，确定了 1995 年至 2011 年期间所有在芬兰出生于 1991 年至 2005 年且被诊断为 ADHD（ICD-9 314x 或 ICD-10 F90.x）的儿童。对每个 ADHD 患者，根据性别、出生日期和出生地与 4 名对照进行匹配。共纳入了 9564 名 ADHD 患者和 34479 名匹配对照进行分析。IPI 是通过计算同胞出生日期之间的时间间隔减去第二个同胞的胎龄来计算的。使用条件逻辑回归确定 IPI 与 ADHD 之间的关联，并对潜在混杂因素进行调整。
结果
与 IPI 为 24 至 59 个月的分娩相比，IPI 最短（<6 个月）的分娩发生 ADHD 的风险增加（比值比[odds ratio，OR] 1.30，95%置信区间[confidence interval，CI] 1.12，1.51），较长 IPI 分娩（60-119 个月和≥120 个月）的 OR 分别为 1.12（95% CI 1.02，1.24）和 1.25（95% CI 1.08，1.45）。通过调整前次分娩时母亲的年龄，较长 IPI 与 ADHD 之间的关联减弱，自闭症谱系障碍共病并不能解释与 ADHD 的关联。
结论
尽管需要进一步研究来解释这种关联，但较短或较长 IPI 分娩的儿童发生 ADHD 的风险较高。
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