产前睡眠健康与后代多动症症状及相关表型的风险：ECHO队列中时间和性别差异的前瞻性分析

Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort.

作者信息

Lugo-Candelas Claudia, Hwei Tse, Lee Seonjoo, Lucchini Maristella, Smaniotto Aizza Alice, Kahn Linda G, Buss Claudia, O'Connor Thomas G, Ghassabian Akhgar, Padula Amy M, Aschner Judy, Deoni Sean, Margolis Amy E, Canino Glorisa, Monk Catherine, Posner Jonathan, Duarte Cristiane S

机构信息

New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA.

Research Department, Nanit, 122 Grand St, New York, NY, 10013, USA.

出版信息

Lancet Reg Health Am. 2023 Oct 9;27:100609. doi: 10.1016/j.lana.2023.100609. eCollection 2023 Nov.

DOI:10.1016/j.lana.2023.100609

PMID:38106969

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10725065/

Abstract

BACKGROUND

Sleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age.

METHODS

Participants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist.

FINDINGS

Pregnant participants were 32.30 ± 5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms ( = -0.35 [95% CI = -0.57, -0.13], = 0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology ( = 0.66 [95% CI = 0.18, 1.14], = 0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD ( = 1.03 [95% CI = 0.32, 1.03], = 0.037) and in the second trimester with sleep problems ( = 1.53 [95% CI = 0.42, 2.92], = 0.026). We did not document substantial offspring sex moderation.

INTERPRETATION

Poor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment.

FUNDING

NIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award 28545.

摘要

背景

睡眠困难在孕期很常见，但孕期睡眠不佳可能与后代的长期不良后果有关，包括注意力缺陷多动障碍（ADHD）的风险。现有研究较少，且未考察暴露效应的时间或后代性别的调节作用。因此，我们旨在检验以下假设：孕期睡眠健康不佳与4岁左右的后代出现ADHD症状及睡眠问题的风险增加有关。

方法

参与者为794对母婴，他们参与了美国国立卫生研究院（NIH）的儿童健康结果环境影响研究（ECHO）。参与者自行报告孕期的睡眠时间、质量和干扰情况，以及通过儿童行为量表报告孩子的ADHD症状和睡眠问题。

结果

怀孕的参与者年龄为32.30±5.50岁，孩子中46%为女性。44%的怀孕参与者为西班牙裔或拉丁裔；49%为白人。孕中期的睡眠时间与后代的ADHD症状相关（β=-0.35[95%CI=-0.57，-0.13]，p=0.026），即睡眠时间越短，症状越严重。孕中期睡眠质量较差也与ADHD症状增加相关（β=0.66[95%CI=0.18，1.14]，p=0.037）。孕早期睡眠干扰越大与后代ADHD相关（β=1.03[95%CI=0.32，1.03]，p=0.037），孕中期睡眠干扰越大与睡眠问题相关（β=1.53[95%CI=0.42，2.92]，p=0.026）。我们没有发现后代性别有显著的调节作用。

解读

孕期睡眠健康不佳，尤其是孕中期的睡眠质量和时长，可能与后代患神经发育障碍和幼儿期睡眠问题的风险有关。需要进一步研究以了解其中的机制，但我们的研究表明，孕期母亲的睡眠可能是旨在优化早期神经发育的干预措施的一个可调节目标。

资助

NIH拨款U2COD023375、U24OD023382、U24OD023319、UH3OD023320、UH3OD023305、UH3OD023349、UH3OD023313、UH3OD023272、UH3OD023328、UH3OD023290、K08MH117452以及NARSAD青年 investigator奖28545。