Department of Child and Adolescent Psychiatry, Mental Health Hospital and University Clinic, Region of Southern Denmark, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Aust N Z J Psychiatry. 2024 Dec;58(12):1090-1102. doi: 10.1177/00048674241272018. Epub 2024 Aug 16.
Vitamin D status in pregnancy may affect offspring neurodevelopment.
The objective was to investigate the association between serum 25-hydroxyvitamin D in cord blood and pregnancy and symptoms of attention-deficit hyperactivity disorder in 5-year-old offspring.
In Odense Child Cohort, Denmark, 944 mother-child pairs had data on pregnancy or cord serum 25-hydroxyvitamin D and parent-rated attention-deficit hyperactivity disorder symptom score by Child Behavior Checklist for ages 1.5-5 years. Adjusted multiple linear regression and two-stage exposure analyses were performed for serum 25-hydroxyvitamin D associations to the attention-deficit hyperactivity disorder symptom score.
The mean (standard deviation) serum 25-hydroxyvitamin D in cord blood was 48.0 (21.8) nmol/L; early pregnancy was 65.5 (20.2) nmol/L and late pregnancy was 79.3 (25.7) nmol/L. The median (interquartile range) age of child at examination was 5.2 (5.1-5.4) years and median (interquartile range) attention-deficit hyperactivity disorder symptom score was 2 (0-3) points. In adjusted analyses, serum 25-hydroxyvitamin D of <25 nmol/L and <32 nmol/L in cord blood and <25 nmol/L in early pregnancy was associated with 0.9 [95% confidence interval: 0.4, 1.3], 0.5 [0.1, 0.9] and 2.1 [0.8, 3.4] points higher attention-deficit hyperactivity disorder symptom score vs reference. In the two-stage exposure analysis, attention-deficit hyperactivity disorder symptom score decreased by 0.4 points per 25 nmol/L increase in serum 25-hydroxyvitamin D. Moreover, serum 25-hydroxyvitamin D of <25 nmol/L in early pregnancy and cord was associated with a five-fold and a two-fold risk of attention-deficit hyperactivity disorder symptom score ⩾90th percentile, adjusted odds ratio [95% confidence interval] = 4.9 [1.3, 19.0] and 2.2 [1.2, 3.9].
In this cohort, serum 25-hydroxyvitamin D <25 nmol/L in cord blood and early pregnancy were risk factors for higher attention-deficit hyperactivity disorder symptom score in 5-year-old children, suggesting a protective effect of vitamin D on attention-deficit hyperactivity disorder traits at preschool age.
孕妇的维生素 D 状况可能会影响后代的神经发育。
本研究旨在探讨脐带血和妊娠血清 25-羟维生素 D 与 5 岁儿童注意力缺陷多动障碍（ADHD）症状之间的关系。
在丹麦奥登塞儿童队列中，944 对母婴对有妊娠或脐带血清 25-羟维生素 D 和父母评定的 ADHD 症状评分数据，年龄在 1.5-5 岁。采用多元线性回归和两阶段暴露分析方法，分析血清 25-羟维生素 D 与 ADHD 症状评分的相关性。
脐带血中血清 25-羟维生素 D 的平均值（标准差）为 48.0（21.8）nmol/L；孕早期为 65.5（20.2）nmol/L，孕晚期为 79.3（25.7）nmol/L。儿童检查时的中位数（四分位数间距）年龄为 5.2（5.1-5.4）岁，中位数（四分位数间距）ADHD 症状评分为 2（0-3）分。在调整后的分析中，脐带血中血清 25-羟维生素 D<25nmol/L 和<32nmol/L，以及孕早期血清 25-羟维生素 D<25nmol/L，与 ADHD 症状评分高 0.9[95%置信区间：0.4，1.3]、0.5[0.1，0.9]和 2.1[0.8，3.4]分相关。在两阶段暴露分析中，血清 25-羟维生素 D 每增加 25nmol/L，ADHD 症状评分降低 0.4 分。此外，孕早期和脐带血中血清 25-羟维生素 D<25nmol/L 与 ADHD 症状评分≥第 90 百分位数的风险增加 5 倍和 2 倍相关，调整后的比值比（95%置信区间）分别为 4.9[1.3，19.0]和 2.2[1.2，3.9]。
在本队列中，脐带血和孕早期血清 25-羟维生素 D<25nmol/L 是 5 岁儿童 ADHD 症状评分较高的危险因素，提示维生素 D 对学龄前儿童 ADHD 特征有保护作用。
