子宫内暴露于大麻是否与注意力缺陷多动障碍（或不伴多动障碍）的风险相关？魁北克妊娠队列中的一项队列研究。
Is in-utero exposure to cannabis associated with the risk of attention deficit with or without hyperactivity disorder? A cohort study within the Quebec Pregnancy Cohort.
机构信息
Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada.
Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
出版信息
BMJ Open. 2022 Aug 8;12(8):e052220. doi: 10.1136/bmjopen-2021-052220.
IMPORTANCE AND OBJECTIVE
Prenatal cannabis effect on attention deficit with or without hyperactivity disorder (ADHD) remains to be determined. Our aim is to quantify the impact of in-utero exposure to cannabis on the risk of ADHD.
DESIGN
Cohort study.
SETTING
Questionnaires were mailed to women sampled from the Quebec Pregnancy Cohort (QPC). Data from questionnaires were then linked with their QPC (built with administrative health databases, hospital patient charts and birth certificate databases).
PARTICIPANTS
Respondents who gave birth to a singleton live born between January 1998 and December 2003 and were continuously enrolled in the Régie de l'assurance maladie du Québec (RAMQ) medication insurance plan for at least 12 months before the first day of gestation and during pregnancy.
EXPOSURE
In-utero cannabis exposure was based on mothers' answers to the question on cannabis use during pregnancy (yes/no) and categorised as occasionally, regularly exposed and unexposed if they chose one of these categories.
OUTCOMES
ADHD was defined by a diagnosis of ADHD through the RAMQ medical services or MedEcho databases or a prescription filled for ADHD medication through RAMQ pharmaceutical services between birth and the end of the follow-up period. Follow-up started at the birth and ended at the index date (first diagnosis or prescription filled for ADHD), child death (censoring), end of public coverage for medications (censoring) or the end of study period, which was December 2015 (censoring), whichever event came first.
RESULTS
A total of 2408 children met the inclusion criteria. Of these children, 86 (3.6%) were exposed to cannabis in-utero and 241 (10.0%) had an ADHD diagnosis or medication filled. After adjustments for potential confounders, no significant association was found between in-utero cannabis exposure (occasional (1.22 (95% CI 0.63 to 2.19)) or regular (1.22 (95% CI 0.42 to 2.79))) and the risk of ADHD in children.
CONCLUSIONS
In-utero exposure to cannabis seemed to not be associated with the risk ADHD in children.
重要性和目的
产前大麻对注意力缺陷伴多动障碍（ADHD）的影响仍需确定。我们的目的是量化子宫内接触大麻对 ADHD 风险的影响。
设计
队列研究。
地点
问卷调查寄给了从魁北克妊娠队列（QPC）中抽取的女性。然后，将来自问卷的数据与他们的 QPC （利用行政健康数据库、医院患者病历和出生证明数据库建立）相联系。
参与者
1998 年 1 月至 2003 年 12 月期间，生育单胎活产且在妊娠第一天之前至少连续 12 个月连续参加魁北克省健康保险计划（RAMQ）药物保险计划的受访者。
暴露
子宫内大麻暴露是基于母亲在怀孕期间使用大麻的问题回答（是/否），并分为偶尔、经常暴露和未暴露，如果她们选择了这些类别之一。
结果
ADHD 通过 RAMQ 医疗服务或 MedEcho 数据库诊断为 ADHD，或通过 RAMQ 制药服务开出 ADHD 药物处方，从出生到随访期结束期间。随访始于出生，截止日期为索引日期（首次诊断或 ADHD 药物处方）、儿童死亡（删失）、药物公共保险覆盖结束（删失）或研究期结束（删失），以先发生的为准，截至 2015 年 12 月（删失）。
共纳入 2408 名符合条件的儿童。其中 86 名（3.6%）儿童在子宫内接触大麻，241 名（10.0%）儿童被诊断为 ADHD 或开出 ADHD 药物处方。在调整潜在混杂因素后，子宫内接触大麻（偶尔接触（1.22（95%CI 0.63 至 2.19））或经常接触（1.22（95%CI 0.42 至 2.79））与儿童 ADHD 风险之间没有显著关联。
结论
子宫内接触大麻似乎与儿童 ADHD 风险无关。
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