Are Maternal Genitourinary Infection and Pre-Eclampsia Associated With ADHD in School-Aged Children?

Mann, Joshua R.; McDermott, Suzanne

doi:10.1177/1087054710370566

Cited by 96 publications

(104 citation statements)

References 29 publications

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“…35,44,45 Our study contradicts some of these findings in that we found no association with acute events around delivery except for the rare event of cord prolapse in girls, also suggested in a recent study. 11 Maternal preeclampsia and genitourinary tract infections have been associated with other neurodevelopmental disorders, including ADHD, 12,46 where an inflammatory cascade affecting fetal brain development has been suggested. In our fully adjusted model, both preeclampsia and maternal genitourinary tract infections were associated with an elevated risk of ADHD irrespective of gender.…”

Section: Discussionmentioning

confidence: 99%

“…10 Others have suggested that the strong genetic risk for ADHD can be moderated or mediated by prenatal (eg, exposure to maternal stress, alcohol, nicotine, lead, preeclampsia, and maternal urinary tract infection [UTI]), perinatal (prematurity, low birth weight, anoxic-ischemic encephalopathy, meningitis, encephalitis), and postnatal (viral meningitis, encephalitis, cerebral trauma) factors. 6,8,9,11,12 However, population studies have shown varying results, from no elevated risk or low risk for ADHD due to perinatal factors 13,14 to an elevated risk associated with prematurity and postterm babies. 15,16 Recently there has been a focus on early term births (37-38 weeks' gestation), which may also increase the risk of ADHD.…”

mentioning

confidence: 99%

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Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

Silva

Colvin

Hagemann³

et al. 2014

Pediatrics

190

181

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BACKGROUND: Early environmental risk factors associated with attention-deficit/hyperactivity disorder (ADHD) have been increasingly suggested. Our study investigates the maternal, pregnancy, and newborn risk factors by gender for children prescribed stimulant medication for treatment of ADHD in Western Australia. METHODS: This is a population-based, record linkage case–control study. The records of all non-Aboriginal children and adolescents born in Western Australia and aged <25 years who were diagnosed with ADHD and prescribed stimulant medication (cases = 12 991) were linked to the Midwives Notification System (MNS) to obtain maternal, pregnancy, and birth information. The control population of 30 071 children was randomly selected from the MNS. RESULTS: Mothers of children with ADHD were significantly more likely to be younger, be single, have smoked in pregnancy, have labor induced, and experience threatened preterm labor, preeclampsia, urinary tract infection in pregnancy, or early term delivery irrespective of the gender of the child, compared with the control group. In the fully adjusted model, a novel finding was of a possible protective effect of oxytocin augmentation in girls. Low birth weight, postterm pregnancy, small for gestational age infant, fetal distress, and low Apgar scores were not identified as risk factors. CONCLUSIONS: Smoking in pregnancy, maternal urinary tract infection, being induced, and experiencing threatened preterm labor increase the risk of ADHD, with little gender difference, although oxytocin augmentation of labor appears protective for girls. Early term deliveries marginally increased the risk of ADHD. Studies designed to disentangle possible mechanisms, confounders, or moderators of these risk factors are warranted.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

Silva

Colvin

Hagemann³

et al. 2014

Pediatrics

190

181

View full text Add to dashboard Cite

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“…The relationship between exposure to prenatal maternal infection and the risk of ADHD has been examined in a study by Mann and McDermott [39]. The researchers focused on maternal genitourinary infection and pre-eclampsia and the offspring's risk of ADHD.…”

Section: Other Mental Disordersmentioning

confidence: 99%

“…Some studies [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41] additionally collected exposure data by interviewing mothers during or shortly after pregnancy or using their medical records. Thereafter, several studies [42,43,44,45,46,47,48,49] used a more rigorous way of estimating maternal exposure by investigating prospectively collected maternal sera of offspring with psychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Inflammation, Infections and Mental Disorders

Flinkkilä

Keski‐Rahkonen

Marttunen³

et al. 2016

Psychopathology

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Background: The objective of this descriptive review is to summarize the current scientific evidence on the effect of prenatal exposure to maternal infection and immune response on the offspring's risk for mental disorders (schizophrenia spectrum disorders, autism spectrum disorders, attention-deficit hyperactivity disorder, anorexia nervosa, and mood disorders). Sampling and Methods: Studies were searched from PubMed and Ovid MEDLINE (R) databases with the following keywords: ‘prenatal exposure delayed effects' and ‘infection', and ‘inflammation' and ‘mental disorders'. A comprehensive manual search, including a search from the reference list of included articles, was also performed. Results: Prenatal exposure to maternal influenza appears to increase the offspring's risk for schizophrenia spectrum disorders, although studies are not fully consistent. Prenatal exposure to maternal fever and elevated cytokine levels seems to be related to the elevated risk for autism spectrum disorders in the offspring. No replicated findings of an association between prenatal infectious exposure and other mental disorders exist. Conclusions: Evidence for the effect of prenatal exposure to maternal infection on risk for mental disorders exists for several different infections, suggesting that common factors occurring in infections (e.g. elevated cytokine levels and fever), rather than the infectious agent itself, might be the underlying factor in increasing the risk for mental disorders. Additionally, it is likely that genetic liability to these disorders operates in conjunction with the exposure. Therefore, genetically sensitive study designs are needed in future studies.

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“…Finalmente, Mann y cols., en informes independientes pero con los mismos pacientes seguidos para evaluar la asociación entre PE y parálisis cerebral, plantean que la PE también es un factor de riesgo para el trastorno de déficit de atención e hiperactividad (TDAH) 41 y las enfermedades del espectro autista (EA). 42 En el primer caso, encontraron que el 6,2% de los niños y niñas con diagnóstico de TDAH eran producto de embarazos con PE, frente al 5,5% de los otros 76 810 niños y niñas sin TDAH; el OR luego de ajustar por los factores de confusión fue de 1,19 (IC95% 1,07-1,32), siendo mayor si, además de la PE, la madre sufrió de cualquier infección genitourinaria durante la gestación (OR 1,53, IC95% 1,32-1,77).…”

Section: Trastornos Neurológicos Y De La Salud Mentalunclassified

El pronóstico de los hijos de madres con preeclampsia. Parte 2: efectos a largo plazo

et al. 2011

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RESUMENLa preeclampsia es una entidad que afecta un 4-8% de las gestaciones y compromete tanto a las madres como a sus hijos. Los hijos se ven afectados no solo por las complicaciones derivadas de la prematurez que muchos sufren, sino también por los problemas que enfrentan mucho más allá del período perinatal. En esta segunda parte se presenta la evidencia disponible en la bibliografía mundial sobre los efectos de la preeclampsia sobre la vida extrauterina. Se da especial atención a los datos surgidos de estudios de cohortes, algunos de los cuales llegan hasta los 60 años de seguimiento. Desde esta perspectiva, se ha encontrado que estos niños tiene mayor riesgo de presentar con más frecuencia, gravedad y precocidad trastornos cardiovasculares, y se plantea que algo similar puede ocurrir para trastornos neuropsiquiátricos u oncológicos. Palabras clave: preeclampsia, hipertensión arterial, infarto agudo de miocardio, apoplejía, cáncer de mama. SUMMARYPreeclampsia affects between 4% to 8% of all human pregnancies. It compromised both mothers and offspring beyond perinatal period. This is the second of two papers devoted to show the available evidence about the effect of preeclampsia on offsprings beyond perinatal period from cohort studies, some over 60-years follow-up. From this perspective, these children are at great risk to develop cardiovascular disorders as hypertension, as well as other disorders, as cancer or neuropsychiatric ones. INTRODUCCIÓNLa preeclampsia (PE) es un trastorno de la gestación humana 1 que altera profundamente las condiciones de salud de la madre, tanto a corto como a largo plazo.2 La PE suele considerarse como causa importante de morbilidad neonatal por la gran cantidad de nacimientos antes del término de la gestación 3 o por la afectación sobre el peso al nacer. Recibido: 15-8-201115-8- Aceptado: 24-8-2011 ser hijo de una madre con PE durante la gestación, ni mucho menos sobre el impacto en una gestación alterna. 5Esto es particularmente relevante dado que en la patogenia de la PE están implicados múltiples factores genéti-cos e inmunológicos, tanto de la madre como de su producto, 6 muchos de ellos heredables, y que igualmente están relacionados con los eventos cardiovasculares que se presentan en la vida adulta. 7La presente revisión pretende señalar la evidencia disponible sobre el pronóstico más allá del período neonatal de los hijos de mujeres con PE, con especial énfasis en los estudios de cohortes.8 Este artículo continúa otro previo en el que se explora el impacto de la PE en la vida neonatal. La idea es identificar algunos campos en donde es menester trabajar para adelantar los estudios e intervenciones necesarios para esclarecer las dudas o vacíos existentes; esto permitirá reducir en nuestro medio el impacto de la PE sobre la población. 9La preeclampsia y la vida postneonatal Wu y cols. 10 analizaron la historia clínica de más de un millón y medio de partos únicos en Dinamarca. Encontraron que los daneses hijos de mujeres con PE, independientemente de la edad gestacional...

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Are Maternal Genitourinary Infection and Pre-Eclampsia Associated With ADHD in School-Aged Children?

Abstract: Maternal GU infection appeared to be associated with increased risk of ADHD, and based on the findings it was concluded that further research is needed to describe the mechanism(s) underlying the association.

Cited by 96 publications

References 29 publications

Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

Prenatal Inflammation, Infections and Mental Disorders

El pronóstico de los hijos de madres con preeclampsia. Parte 2: efectos a largo plazo

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