Howell Meghan P, Jones Christopher W, Herman Cade A, Mayne Celia V, Fernandez Camilo, Theall Katherine P, Esteves Kyle C, Drury Stacy S
Department of Pediatrics, Tulane University School of Medicine, 1430 Tulane Avenue, #8526, New Orleans, Louisiana, 70112, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
BMC Med. 2022 Apr 28;20(1):153. doi: 10.1186/s12916-022-02340-1.
Prenatal maternal tobacco smoking is a predictor of child attention-deficit/hyperactivity disorder (ADHD) and is associated with offspring telomere length (TL). In this study, we examine the relationship between maternal prenatal smoking, infant TL, and maternal report of early childhood symptoms of ADHD.
One-hundred and eighty-one mother-infant dyads were followed prospectively for the infant's first 18 months of life. Prenatal smoking was assessed from maternal report and medical records. TL was measured from infant buccal swab DNA obtained across the first 18 months of life. ADHD symptoms were obtained from maternal report on the Child Behavior Check List. Multiple regression models tested the relation between prenatal smoking and both ADHD symptoms and infant TL. Additional analyses tested whether the change in infant TL influenced the relation between prenatal smoking and ADHD symptoms.
Sixteen percent of mothers reported prenatal smoking. Infant TL at 4, 12, and 18 months of age were correlated. Consistent with previous cross-sectional studies linking shorter offspring TL to maternal prenatal smoking, maternal prenatal smoking predicted greater telomere shortening from four to 18 months of infant age (β = - 5.797, 95% CI [-10.207, -1.386]; p = 0.010). Maternal depression was positively associated with both prenatal smoking (odds ratio (OR): 4.614, 95% CI [1.733, 12.282]; p = 0.002) and child ADHD symptoms (β = 4.713, 95% CI [2.073, 7.354]; p = 0.0006). To prevent confounding, analyses examined the relation between TL, ADHD symptoms, and prenatal smoking only in non-depressed mothers. In non-depressed mothers, infant TL attrition across the first 18 months moderated the relation between smoking and child ADHD.
The findings extend previous studies linking prenatal smoking to shorter infant TL by providing data demonstrating the effect on TL trajectory. The relation between prenatal smoking and early infant ADHD symptoms was moderated by the change in TL. The findings provide novel initial evidence suggesting that TL dynamics are one mechanistic pathway influencing the relation between maternal prenatal smoking and ADHD.
孕期母亲吸烟是儿童注意力缺陷多动障碍（ADHD）的一个预测因素，且与后代端粒长度（TL）相关。在本研究中，我们探究了母亲孕期吸烟、婴儿端粒长度以及母亲报告的儿童早期ADHD症状之间的关系。
对181对母婴进行前瞻性随访，观察婴儿出生后的前18个月。通过母亲报告和医疗记录评估孕期吸烟情况。从婴儿出生后前18个月采集的颊拭子DNA中测量端粒长度。ADHD症状通过母亲对儿童行为检查表的报告获得。多元回归模型检验了孕期吸烟与ADHD症状及婴儿端粒长度之间的关系。额外分析检验了婴儿端粒长度的变化是否影响孕期吸烟与ADHD症状之间的关系。
16%的母亲报告孕期吸烟。婴儿在4个月、12个月和18个月时的端粒长度具有相关性。与之前将后代端粒长度缩短与母亲孕期吸烟联系起来的横断面研究一致，母亲孕期吸烟预示着婴儿从4个月到18个月端粒缩短更明显（β = -5.797，95%置信区间[-10.207，-1.386]；p = \0.010）。母亲抑郁与孕期吸烟（优势比（OR）：4.614，95%置信区间[1.733，12.282]；p = \0.002）及儿童ADHD症状均呈正相关（β = 4.713，95%置信区间[2.073，7.354]；p = \0.0006）。为避免混杂因素影响，分析仅在非抑郁母亲中研究端粒长度、ADHD症状和孕期吸烟之间的关系。在非抑郁母亲中，婴儿出生后前18个月的端粒损耗调节了吸烟与儿童ADHD之间的关系。
本研究结果扩展了先前将孕期吸烟与婴儿端粒长度缩短联系起来的研究，通过提供数据证明了对端粒长度轨迹的影响。孕期吸烟与婴儿早期ADHD症状之间的关系受到端粒长度变化的调节。这些发现提供了新的初步证据，表明端粒动态变化是影响母亲孕期吸烟与ADHD之间关系的一种机制途径。
