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#Grand Rounds

Could Smoking During Pregnancy Increase Risk for ADHD in Offspring?

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BACKGROUND AND PURPOSE:

  • The cause of Attention-deficit/hyperactivity disorder (ADHD) is not well known but involves a combination of both genetics and environment
  • Environmental exposures include exposure to alcohol, cigarette smoking, lead and other nutritional factors
  • Huang et al. (Pediatrics, 2017) examined the association between maternal smoking during pregnancy and ADHD rates in offspring

METHODS:

  • Systematic Review and meta-analysis
  • Cohort or case-control design
  • Any dose-relationship data for smoking and ADHD risk were also extracted

RESULTS:

  • Data was collected from Fifteen cohort studies and 5 case-control studies with a total 50,044 cases and 2,998,059 participants
  • In 3 cohort studies, sibling analysis was used to control for shared genetic and social confounding
  • Only one study adjusted for paternal smoking and therefore that particular subgroup analysis could not be performed
  • Smoking during pregnancy increased the risk of ADHD in offspring
    • Odds Ratio (OR): 1.60; 95% CI: 1.45–1.76
  • When comparing heavy smokers to light smokers the risk of ADHD was increased in offspring
    • Heavy smokers OR 1.75; 95% CI: 1.51–2.02
    • Light smokers OR 1.54; 95% CI: 1.40–1.70

CONCLUSION:

  • Authors recognize that a limitation of this study was the use of different ADHD assessment tools and lack of objective biological measures for maternal smoking
  • Maternal smoking during pregnancy is associated with a 60% increased odds of ADHD
  • The authors suggest that more high-quality studies are needed

Learn More – Primary Sources:

Maternal Smoking and Attention-Deficit/Hyperactivity Disorder in Offspring: A Meta-analysis

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Related ObG Topics:

Does Smoking During Pregnancy Affect the Fetal Immune System?
Does Low-Level Prenatal Passive Tobacco Exposure Decrease Breastfeeding Duration?
Do Antidepressants During Pregnancy Increase Autism Risk?
SMFM Releases Statement on Acetaminophen Use in Pregnancy

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