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Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children

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Abstract

The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother–child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having a child with ADHD was significantly increased if the mother was overweight (HR = 1.28 [95% CI 1.15;1.48]), obese (HR = 1.47 [95% CI 1.26;1.71]) or severely obese (HR = 1.95 [95% CI 1.58;2.40]). The same pattern was seen for the combined ADHD and ASD group. Regarding ASD, an increased risk was observed in underweight (HR = 1.30 [95% CI 1.01;1.69]) and obese (HR = 1.39 [95% CI 1.11;1.75]) mothers. Subgroup analysis revealed that the association in the ADHD group could mostly be attributable to the hyperactive group. Maternal obesity before pregnancy is a risk factor for ADHD in children. Maternal obesity as well as underweight may also be associated with an increased risk for ASD.

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Acknowledgements

This project was funded by the Lundbeck Foundation, Familien Hede Nielsens Fond, and the Central Denmark Region. The Danish National Research Foundation has established the Danish Epidemiology Science Centre that initiated and created the Danish National Birth Cohort. The cohort is furthermore a result of a major grant from this foundation. Additional support for the Danish National Birth Cohort was obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Insurance Foundation. The authors thank Leif Spange Mortensen, MSc, for statistical support.

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  1. Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark

    Christina Hebsgaard Andersen, Per Hove Thomsen & Sanne Lemcke

  2. Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Ellen Aagaard Nohr

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  1. Christina Hebsgaard Andersen
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Per Hove Thomsen has received speaker’s honoraria from Shire, Novartis, and HB-Pharma within the last 3 years. He is not a member of any advisory boards nor does he hold any stocks. The other authors have no conflicts of interests to declare.

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Andersen, C.H., Thomsen, P.H., Nohr, E.A. et al. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children. Eur Child Adolesc Psychiatry 27, 139–148 (2018). https://doi.org/10.1007/s00787-017-1027-6

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