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在EDEN出生队列研究中,母亲孕前体重指数与3至8岁后代多动-注意力不集中轨迹的关系。

Maternal pre-pregnancy BMI and offspring hyperactivity-inattention trajectories from 3 to 8 years in the EDEN birth cohort study.

作者信息

Dow Courtney, Galera Cédric, Charles Marie-Aline, Heude Barbara

机构信息

INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France.

Univ. Bordeaux, Inserm, Bordeaux Population Health Center, UMR 1219, 33000, Bordeaux, France.

出版信息

Eur Child Adolesc Psychiatry. 2023 Oct;32(10):2057-2065. doi: 10.1007/s00787-022-02047-x. Epub 2022 Jul 19.

Abstract

Evidence suggests obesity during pregnancy is associated with offspring attention-deficit hyperactivity disorder. However, studies have been limited to evaluating the association at a single age with inadequate data on important maternal lifestyle confounders and unmeasured familial confounding. The objective of this study was to examine the association between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 3, 5 and 8 years. Data came from the EDEN mother-child cohort. Maternal pre-pregnancy BMI status (kg/m) was calculated using pre-pregnancy weight and height (self-reported by mothers or measured by midwives). HIS were assessed by parental-report on the Strengths and Difficulties Questionnaire at 3, 5 and 8 years of age and used to derive developmental trajectories of HIS (n = 1428). Multivariate models were adjusted for confounders including socioeconomic status, maternal lifestyle behaviours (exercise, diet, smoking, alcohol), childcare and a stimulating home environment. Paternal BMI was used as a negative control. Compared to a normal pre-pregnancy BMI, pre-pregnancy maternal obesity was positively associated with increased odds of a high HIS trajectory between 3 and 8 years old in both unadjusted and adjusted logistic regression (adjusted odds ratio [aOR] 1.87 [95% CI 1.12, 3.12]). Pre-pregnancy overweight was not significantly associated after adjustment for confounders (aOR 1.32 [0.87, 2.01]). Maternal pre-pregnancy obesity, but not overweight, was associated with increased likelihood of a high HIS trajectory in children from 3 to 8 years old. This association persisted despite controlling for many important maternal lifestyle factors and paternal BMI. Further research is warranted to identify possible mediators involved.

摘要

有证据表明,孕期肥胖与后代注意力缺陷多动障碍有关。然而,以往研究仅限于评估单一年龄阶段的关联,且关于重要的母亲生活方式混杂因素和未测量的家族混杂因素的数据不足。本研究的目的是探讨母亲孕前体重指数(BMI)与儿童在3岁、5岁和8岁时的多动-注意力不集中症状(HIS)之间的关联。数据来自EDEN母婴队列。母亲孕前BMI状态(kg/m)通过孕前体重和身高计算得出(由母亲自我报告或由助产士测量)。在儿童3岁、5岁和8岁时,通过父母报告的优势与困难问卷对HIS进行评估,并用于得出HIS的发育轨迹(n = 1428)。多变量模型对混杂因素进行了调整,包括社会经济地位、母亲生活方式行为(运动、饮食、吸烟、饮酒)、儿童保育和刺激的家庭环境。父亲BMI用作阴性对照。与孕前正常BMI相比,在未调整和调整后的逻辑回归中,孕前母亲肥胖与3至8岁儿童高HIS轨迹的几率增加呈正相关(调整后的优势比[aOR]为1.87 [95%置信区间1.12, 3.12])。在对混杂因素进行调整后,孕前超重与高HIS轨迹无显著关联(aOR 1.32 [0.87, 2.01])。母亲孕前肥胖而非超重与3至8岁儿童高HIS轨迹的可能性增加有关。尽管控制了许多重要的母亲生活方式因素和父亲BMI,这种关联仍然存在。有必要进行进一步研究以确定可能涉及的中介因素。

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