Maternal Ferritin Levels during Pregnancy and ADHD Symptoms in 4-Year-Old Children: Results from the INMA–INfancia y Medio Ambiente (Environment and Childhood) Prospective Birth Cohort Study

Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three...

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Published in:	International journal of environmental research and public health Vol. 17; no. 21; p. 7704
Main Authors:	Santa-Marina, Loreto, Lertxundi, Nerea, Andiarena, Ainara, Irizar, Amaia, Sunyer, Jordi, Molinuevo, Amaia, Llop, Sabrina, Julvez, Jordi, Beneito, Andrea, Ibarluzea, Jesús, Imaz, Liher, Ferrin, Maite
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 22.10.2020 MDPI
Subjects:	Age Attention Deficit Disorder with Hyperactivity - blood Attention Deficit Disorder with Hyperactivity - epidemiology Attention deficit hyperactivity disorder Body mass index Breastfeeding & lactation Child & adolescent psychiatry Child, Preschool Childhood Children & youth Cohort analysis Cohort Studies Dopamine Female Ferritins - blood Humans Hyperactivity Impulsivity Iron Male Metabolism Neuropsychology Pathophysiology Phlebotomy Population Pregnancy Prenatal Exposure Delayed Effects - epidemiology Prospective Studies Regression Analysis Sex Factors Spain - epidemiology Womens health Spain ADHD symptoms childhood ferritin status pregnancy
ISSN:	1660-4601, 1661-7827, 1660-4601
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Abstract	Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertile, significant differences were observed between the first tertile (1.98, 20.92) and the second (20.92, 38.79) and third (38.79, 216.5) (μg/L) tertiles. The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.
AbstractList	Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children's ADHD-like symptoms at ages 4-5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = -0.19 (-0.32, -0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = -0.3 (-0.55, -0.5), and for those in the second one, β = -0.37 (-0.6, -0.14). The model stratification by sex also showed this inverse association for boys only, β = -0.21 (-0.34, -0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children's ADHD-like symptoms at ages 4-5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = -0.19 (-0.32, -0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = -0.3 (-0.55, -0.5), and for those in the second one, β = -0.37 (-0.6, -0.14). The model stratification by sex also showed this inverse association for boys only, β = -0.21 (-0.34, -0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms. Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children's ADHD-like symptoms at ages 4-5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = -0.19 (-0.32, -0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = -0.3 (-0.55, -0.5), and for those in the second one, β = -0.37 (-0.6, -0.14). The model stratification by sex also showed this inverse association for boys only, β = -0.21 (-0.34, -0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms. Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms. Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertile, significant differences were observed between the first tertile (1.98, 20.92) and the second (20.92, 38.79) and third (38.79, 216.5) (μg/L) tertiles. The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.
Author	Santa-Marina, Loreto Irizar, Amaia Imaz, Liher Lertxundi, Nerea Sunyer, Jordi Andiarena, Ainara Molinuevo, Amaia Llop, Sabrina Ibarluzea, Jesús Beneito, Andrea Julvez, Jordi Ferrin, Maite
AuthorAffiliation	3 Public Health Division of Gipuzkoa, Basque Government, 20013 San Sebastian, Spain; l-imazgoienetxea@euskadi.eus 5 Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain 10 Biodonostia, Epidemiology and Public Health Area, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastian, Spain 2 Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain; nerea.lertxundi@ehu.eus (N.L.); ainara.andiarena@ehu.eus (A.A.) 11 Haringey Child and Adolescent Mental Health Service, Barnet, Enfield and Haringey NHS Mental Health Trust, London N15 3TH, UK; maiteferrin@yahoo.es 8 Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I–Universitat de València, 08003 València, Spain; beneito_and@gva.es 6 Hospital del Mar Research Institute, 08003 Barcelona, Spain 7 ISGlobal—Instituto de Salud Global de Barcelona–Campus MAR, PRBB,
AuthorAffiliation_xml	– name: 5 Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain – name: 11 Haringey Child and Adolescent Mental Health Service, Barnet, Enfield and Haringey NHS Mental Health Trust, London N15 3TH, UK; maiteferrin@yahoo.es – name: 8 Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I–Universitat de València, 08003 València, Spain; beneito_and@gva.es – name: 12 Recognition Health, London W1G 9RU, UK – name: 2 Biodonostia, Epidemiology and Public Health Area, Environmental Epidemiology and Child Development Group, 20014 San Sebastian, Spain; nerea.lertxundi@ehu.eus (N.L.); ainara.andiarena@ehu.eus (A.A.) – name: 4 Faculty of Psychology, University of the Basque Country (UPV/EHU), Avenida Tolosa 70, 20018 San Sebastian, Spain – name: 9 Institut d′Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain – name: 3 Public Health Division of Gipuzkoa, Basque Government, 20013 San Sebastian, Spain; l-imazgoienetxea@euskadi.eus – name: 7 ISGlobal—Instituto de Salud Global de Barcelona–Campus MAR, PRBB, 08003 Barcelona, Spain – name: 1 Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3–5, 28029 Madrid, Spain; ambien4ss-san@euskadi.eus (L.S.-M.); jordi.sunyer@isglobal.org (J.S.); au-molinuevo@euskadi.eus (A.M.); llop_sab@gva.es (S.L.); jordi.julvez@isglobal.org (J.J.); mambien3-san@euskadi.eus (J.I.) – name: 6 Hospital del Mar Research Institute, 08003 Barcelona, Spain – name: 10 Biodonostia, Epidemiology and Public Health Area, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastian, Spain
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Snippet	Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We...
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SubjectTerms	Age Attention Deficit Disorder with Hyperactivity - blood Attention Deficit Disorder with Hyperactivity - epidemiology Attention deficit hyperactivity disorder Body mass index Breastfeeding & lactation Child & adolescent psychiatry Child, Preschool Childhood Children & youth Cohort analysis Cohort Studies Dopamine Female Ferritins - blood Humans Hyperactivity Impulsivity Iron Male Metabolism Neuropsychology Pathophysiology Phlebotomy Population Pregnancy Prenatal Exposure Delayed Effects - epidemiology Prospective Studies Regression Analysis Sex Factors Spain - epidemiology Womens health
Title	Maternal Ferritin Levels during Pregnancy and ADHD Symptoms in 4-Year-Old Children: Results from the INMA–INfancia y Medio Ambiente (Environment and Childhood) Prospective Birth Cohort Study
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Volume	17
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