Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China.
Department of Psychiatry, Fourth People's Hospital of Hefei, Hefei 230022, Anhui, China.
J Affect Disord. 2021 Feb 15;281:390-396. doi: 10.1016/j.jad.2020.12.033. Epub 2020 Dec 13.
Vitamin D has been demonstrated a "neuroprotective" effect, but it is unclear whether early-life adequate vitamin D protect adverse neurodevelopment. We aimed to examine the role of neonatal vitamin D in the association of maternal depression (MD) symptoms with toddlers ADHD.
Participants included 1 125 mother-infant pairs from the China-Anhui Birth Cohort study. MD was assessed by the Center for Epidemiological Studies Depression Scale (CES-D) at 30-34 gestational weeks. Toddlers ADHD was reported by the Conners' Hyperactivity Index (CHI) at 48-54 months postpartum. Multiple logistic regression models were performed to evaluate the association of maternal depressive score and toddlers ADHD while cord blood 25(OH)D levels were stratified.
Toddlers of mothers with higher depression score were at higher risk of ADHD (20.1% vs 11.1%, P = 0.003; adjusted RR=1.75, 95% CI: 1.10-2.81). Among toddlers with neonatal vitamin D deficiency (VDD), ADHD risk was significantly increased with maternal MD (adjusted RR=3.74, 95% CI: 1.49-9.41), but the association was not found in toddlers with neonatal vitamin D adequacy (VDA). Compared to toddlers without MD, toddlers with both MD and neonatal VDD had higher risk of ADHD (adjusted RR=3.10, 95% CI: 1.44-6.63). But the risk did not significantly increase in toddlers with MD and neonatal VDA (adjusted RR=1.53, 95% CI: 0.86-2.72).
Maternal depressive symptoms in early pregnancy and anxious symptoms were needed to include.
This prospective study indicated that the detrimental effect of maternal prenatal depressive symptoms on offspring's ADHD symptoms strengthened in toddlers with neonatal VDD.
维生素 D 已被证明具有“神经保护”作用，但目前尚不清楚生命早期摄入足够的维生素 D 是否能预防不良的神经发育。我们旨在研究新生儿维生素 D 在母亲抑郁症状与幼儿注意缺陷多动障碍（ADHD）之间的关系中的作用。
参与者包括来自中国-安徽出生队列研究的 1125 对母婴。在 30-34 孕周时使用中心流行病学研究抑郁量表（CES-D）评估母亲的抑郁症状。在产后 48-54 个月，通过 Conners' 多动指数（CHI）报告幼儿 ADHD。进行多因素逻辑回归模型来评估母亲抑郁评分与幼儿 ADHD 之间的关系，同时对脐带血 25（OH）D 水平进行分层。
母亲抑郁评分较高的幼儿患 ADHD 的风险更高（20.1%比 11.1%，P=0.003；调整后的 RR=1.75，95%CI：1.10-2.81）。在新生儿维生素 D 缺乏（VDD）的幼儿中，母亲患有 MD 时 ADHD 风险显著增加（调整后的 RR=3.74，95%CI：1.49-9.41），但在新生儿维生素 D 充足（VDA）的幼儿中未发现这种关联。与没有 MD 的幼儿相比，同时患有 MD 和新生儿 VDD 的幼儿患 ADHD 的风险更高（调整后的 RR=3.10，95%CI：1.44-6.63）。但是，在患有 MD 和新生儿 VDA 的幼儿中，这种风险并没有显著增加（调整后的 RR=1.53，95%CI：0.86-2.72）。
需要纳入孕妇妊娠早期的抑郁症状和焦虑症状。
这项前瞻性研究表明，在新生儿 VDD 的幼儿中，母亲产前抑郁症状对后代 ADHD 症状的不利影响增强。
