Feng Yongshen, Li Junyan, Lok Kris Yuet Wan, Chau Pui Hing, Lu Dali, Kwok Jojo Yan Yan
School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Longhua District Maternity & Child Healthcare Hospital, Shenzhen City, Guangdong Province, China.
Eur Child Adolesc Psychiatry. 2025 Jun 23. doi: 10.1007/s00787-025-02792-9.
To estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in preschool children and to examine the relationship between ADHD and pregnancy-related factors across different trimesters in mothers.
The retrospective cohort study enrolled mother-child pairs from 20 kindergartens in the Longhua district, Shenzhen City, China. Adjusted Cox proportional-hazard models were used to estimate hazard ratio (HR) for the risk of pregnancy-related factors on ADHD.
Among 5602 mother-child pairs, 220 mothers (3.9%) were diagnosed with thyroid dysfunction, and 553 (9.9%) children aged 3-7 years were diagnosed with ADHD. In the adjusted model, children of mothers with thyroid dysfunction during pregnancy had a 54.1% higher risk of an ADHD diagnosis (95% CI: 1.050, 2.262) compared to those whose mothers did not have thyroid dysfunction. Higher maternal stress levels during the first trimester of pregnancy are associated with an increased risk of offspring developing ADHD. Compared to children whose mothers experienced significant stress in the first trimester of pregnancy, those whose mothers experienced moderate and minor stress had 36.3% and 42.9% lower risk of ADHD diagnosis, respectively (HR = 0.637, 95%CI: 0.487,0.834 for moderate; HR = 0.571 95% CI: 0.391, 0.833 for minor). However, stress during the second and third trimesters was not significantly associated with the risk of ADHD.
The study demonstrates the need for early ADHD screening in preschoolers and continuous monitoring of maternal thyroid hormone and stress levels during pregnancy. It also emphasizes the importance of implementing preventive and management strategies as part of holistic care for both preschoolers and expectant mothers.
评估学龄前儿童注意力缺陷多动障碍（ADHD）的患病率，并探讨母亲孕期不同阶段ADHD与妊娠相关因素之间的关系。
这项回顾性队列研究纳入了来自中国深圳市龙华区20所幼儿园的母婴对。采用调整后的Cox比例风险模型来估计妊娠相关因素对ADHD风险的风险比（HR）。
在5602对母婴对中，220名母亲（3.9%）被诊断为甲状腺功能障碍，553名3至7岁儿童（9.9%）被诊断为ADHD。在调整模型中，孕期患有甲状腺功能障碍的母亲的孩子被诊断为ADHD的风险比母亲没有甲状腺功能障碍的孩子高54.1%（95%CI：1.050，2.262）。妊娠早期母亲较高的压力水平与后代患ADHD的风险增加有关。与母亲在妊娠早期经历重大压力的孩子相比，母亲经历中度和轻度压力的孩子被诊断为ADHD的风险分别低36.3%和42.9%（中度：HR = 0.637，95%CI：0.487，0.834；轻度：HR = 0.571，95%CI：0.391，0.833）。然而，妊娠中期和晚期的压力与ADHD风险没有显著关联。
该研究表明有必要对学龄前儿童进行早期ADHD筛查，并在孕期持续监测母亲的甲状腺激素和压力水平。它还强调了实施预防和管理策略作为学龄前儿童和准妈妈整体护理一部分的重要性。
