Vitamin D in Pregnancy and Attention Deficit Hyperactivity Disorder-like Symptoms in Childhood

Vitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated w...

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Published in:	Epidemiology (Cambridge, Mass.) Vol. 26; no. 4; p. 458
Main Authors:	Morales, Eva, Julvez, Jordi, Torrent, Maties, Ballester, Ferran, Rodríguez-Bernal, Clara L, Andiarena, Ainara, Vegas, Oscar, Castilla, Ane Miren, Rodriguez-Dehli, Cristina, Tardón, Adonina, Sunyer, Jordi
Format:	Journal Article
Language:	English
Published:	United States 01.07.2015
Subjects:	Attention Deficit Disorder with Hyperactivity - epidemiology Calcifediol - blood Child, Preschool Cohort Studies Female Humans Incidence Linear Models Male Pregnancy Pregnancy Complications - blood Pregnancy Complications - epidemiology Pregnancy Trimester, First Prenatal Exposure Delayed Effects - epidemiology Prospective Studies Spain - epidemiology Vitamin D Deficiency - blood Vitamin D Deficiency - epidemiology Spain
ISSN:	1531-5487, 1531-5487
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Abstract	Vitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated with risk of ADHD-like symptoms in offspring. We conducted a prospective study analyzing data from 1,650 mother-child pairs from five birth cohorts embedded in the INMA Project (Spain, 1997-2008). Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [25(OH)D3] at 13 weeks of gestation. Children were assessed by teachers for ADHD-like symptoms at ages 4-5 years using the Diagnostic and Statistical Manual of Mental Disorders ADHD form list. After adjustment, the number of total ADHD-like symptoms in children decreased by 11% per 10 ng/ml increment of maternal 25(OH)D3 concentration (incidence rate ratio [IRR] = 0.89; 95% confidence interval [CI] = 0.80, 0.98). Similarly, the number of symptoms in the ADHD subscales decreased in relation to higher maternal 25(OH)D3 concentration (IRR per 10 ng/ml increment = 0.89; 95% CI = 0.79, 0.99 for the inattention scale; and IRR = 0.88; 95% CI = 0.78, 0.99 for the hyperactivity-impulsivity scale). Using diagnostic criteria, we found an association of increasing maternal 25(OH)D3 with a lower risk of ADHD DSM-IV (relative risk ratio per 10 ng/ml increment = 0.87; 95% CI = 0.72, 1.06) and ICD-10 hyperkinetic disorder (relative risk ratio = 0.72; 95% CI = 0.49, 1.04) in children. Higher maternal circulating levels of 25(OH)D3 in pregnancy are associated with lower risk of developing ADHD-like symptoms in childhood.
AbstractList	Vitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated with risk of ADHD-like symptoms in offspring. We conducted a prospective study analyzing data from 1,650 mother-child pairs from five birth cohorts embedded in the INMA Project (Spain, 1997-2008). Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [25(OH)D3] at 13 weeks of gestation. Children were assessed by teachers for ADHD-like symptoms at ages 4-5 years using the Diagnostic and Statistical Manual of Mental Disorders ADHD form list. After adjustment, the number of total ADHD-like symptoms in children decreased by 11% per 10 ng/ml increment of maternal 25(OH)D3 concentration (incidence rate ratio [IRR] = 0.89; 95% confidence interval [CI] = 0.80, 0.98). Similarly, the number of symptoms in the ADHD subscales decreased in relation to higher maternal 25(OH)D3 concentration (IRR per 10 ng/ml increment = 0.89; 95% CI = 0.79, 0.99 for the inattention scale; and IRR = 0.88; 95% CI = 0.78, 0.99 for the hyperactivity-impulsivity scale). Using diagnostic criteria, we found an association of increasing maternal 25(OH)D3 with a lower risk of ADHD DSM-IV (relative risk ratio per 10 ng/ml increment = 0.87; 95% CI = 0.72, 1.06) and ICD-10 hyperkinetic disorder (relative risk ratio = 0.72; 95% CI = 0.49, 1.04) in children. Higher maternal circulating levels of 25(OH)D3 in pregnancy are associated with lower risk of developing ADHD-like symptoms in childhood. Vitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated with risk of ADHD-like symptoms in offspring.BACKGROUNDVitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated with risk of ADHD-like symptoms in offspring.We conducted a prospective study analyzing data from 1,650 mother-child pairs from five birth cohorts embedded in the INMA Project (Spain, 1997-2008). Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [25(OH)D3] at 13 weeks of gestation. Children were assessed by teachers for ADHD-like symptoms at ages 4-5 years using the Diagnostic and Statistical Manual of Mental Disorders ADHD form list.METHODSWe conducted a prospective study analyzing data from 1,650 mother-child pairs from five birth cohorts embedded in the INMA Project (Spain, 1997-2008). Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [25(OH)D3] at 13 weeks of gestation. Children were assessed by teachers for ADHD-like symptoms at ages 4-5 years using the Diagnostic and Statistical Manual of Mental Disorders ADHD form list.After adjustment, the number of total ADHD-like symptoms in children decreased by 11% per 10 ng/ml increment of maternal 25(OH)D3 concentration (incidence rate ratio [IRR] = 0.89; 95% confidence interval [CI] = 0.80, 0.98). Similarly, the number of symptoms in the ADHD subscales decreased in relation to higher maternal 25(OH)D3 concentration (IRR per 10 ng/ml increment = 0.89; 95% CI = 0.79, 0.99 for the inattention scale; and IRR = 0.88; 95% CI = 0.78, 0.99 for the hyperactivity-impulsivity scale). Using diagnostic criteria, we found an association of increasing maternal 25(OH)D3 with a lower risk of ADHD DSM-IV (relative risk ratio per 10 ng/ml increment = 0.87; 95% CI = 0.72, 1.06) and ICD-10 hyperkinetic disorder (relative risk ratio = 0.72; 95% CI = 0.49, 1.04) in children.RESULTSAfter adjustment, the number of total ADHD-like symptoms in children decreased by 11% per 10 ng/ml increment of maternal 25(OH)D3 concentration (incidence rate ratio [IRR] = 0.89; 95% confidence interval [CI] = 0.80, 0.98). Similarly, the number of symptoms in the ADHD subscales decreased in relation to higher maternal 25(OH)D3 concentration (IRR per 10 ng/ml increment = 0.89; 95% CI = 0.79, 0.99 for the inattention scale; and IRR = 0.88; 95% CI = 0.78, 0.99 for the hyperactivity-impulsivity scale). Using diagnostic criteria, we found an association of increasing maternal 25(OH)D3 with a lower risk of ADHD DSM-IV (relative risk ratio per 10 ng/ml increment = 0.87; 95% CI = 0.72, 1.06) and ICD-10 hyperkinetic disorder (relative risk ratio = 0.72; 95% CI = 0.49, 1.04) in children.Higher maternal circulating levels of 25(OH)D3 in pregnancy are associated with lower risk of developing ADHD-like symptoms in childhood.CONCLUSIONHigher maternal circulating levels of 25(OH)D3 in pregnancy are associated with lower risk of developing ADHD-like symptoms in childhood.
Author	Rodriguez-Dehli, Cristina Tardón, Adonina Morales, Eva Vegas, Oscar Castilla, Ane Miren Sunyer, Jordi Andiarena, Ainara Rodríguez-Bernal, Clara L Ballester, Ferran Julvez, Jordi Torrent, Maties
Author_xml	– sequence: 1 givenname: Eva surname: Morales fullname: Morales, Eva organization: From the aCentre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain; bVirgen de la Arrixaca Universtiy Hospital, IMIB-Arrixaca Research Institute, Murcia, Spain; cCIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; dHospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; eUniversitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; fIB-SALUT, Area de Salut de Menorca, Balearic Islands, Spain; gUniversity of Valencia, Valencia, Spain; hCenter for Public Health Research (CSISP-FISABIO), Valencia, Spain; iDepartment of Basic Psychological Processes and Their Development, Basque Country University UPV/EHU, San Sebastian, Spain; jBiodonostia Institute, San Sebastian, Gipuzkoa, Spain; kPublic Health Laboratory, Basque Government, Bilbao, Spain; lHospital San Agustín, Avilés, Asturias, Spain; and mUniversity of Oviedo, Asturias, Spain – sequence: 2 givenname: Jordi surname: Julvez fullname: Julvez, Jordi – sequence: 3 givenname: Maties surname: Torrent fullname: Torrent, Maties – sequence: 4 givenname: Ferran surname: Ballester fullname: Ballester, Ferran – sequence: 5 givenname: Clara L surname: Rodríguez-Bernal fullname: Rodríguez-Bernal, Clara L – sequence: 6 givenname: Ainara surname: Andiarena fullname: Andiarena, Ainara – sequence: 7 givenname: Oscar surname: Vegas fullname: Vegas, Oscar – sequence: 8 givenname: Ane Miren surname: Castilla fullname: Castilla, Ane Miren – sequence: 9 givenname: Cristina surname: Rodriguez-Dehli fullname: Rodriguez-Dehli, Cristina – sequence: 10 givenname: Adonina surname: Tardón fullname: Tardón, Adonina – sequence: 11 givenname: Jordi surname: Sunyer fullname: Sunyer, Jordi
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SubjectTerms	Attention Deficit Disorder with Hyperactivity - epidemiology Calcifediol - blood Child, Preschool Cohort Studies Female Humans Incidence Linear Models Male Pregnancy Pregnancy Complications - blood Pregnancy Complications - epidemiology Pregnancy Trimester, First Prenatal Exposure Delayed Effects - epidemiology Prospective Studies Spain - epidemiology Vitamin D Deficiency - blood Vitamin D Deficiency - epidemiology
Title	Vitamin D in Pregnancy and Attention Deficit Hyperactivity Disorder-like Symptoms in Childhood
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