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Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study

Published online by Cambridge University Press:  18 April 2018

L. Vizzini Open the ORCID record for L. Vizzini [Opens in a new window] ,
M. Popovic ,
D. Zugna ,
B. Vitiello ,
M. Trevisan ,
C. Pizzi ,
F. Rusconi ,
L. Gagliardi ,
F. Merletti  and
L. Richiardi
L. Vizzini*
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
M. Popovic
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
D. Zugna
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
B. Vitiello
Affiliation:
Division of Child and Adolescent Psychiatry, University of Turin, Turin, Italy
M. Trevisan
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
C. Pizzi
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
F. Rusconi
Affiliation:
Epidemiology Unit, Anna Meyer Children's University Hospital, Florence, Italy
L. Gagliardi
Affiliation:
Woman and Child Health Department, Pediatric and Neonatology Division, Ospedale della Versilia, Viareggio, Italy
F. Merletti
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
L. Richiardi
Affiliation:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
*
*Address for correspondence: L. Vizzini, Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy. (Email: loredana.vizzini@gmail.com)
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Abstract

Aims.

Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother–child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms.

Methods.

The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente’) cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive–impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy.

Results.

The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3–27.9%), sleep disorders (35.7%; 95% CI 10.7–66.5%) and depression (17.5%; 95% CI 3.2–33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period.

Conclusions.

Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

Keywords

Attention-deficit/hyperactivity disordermental healthprospective studyrisk factors
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 5 , October 2019 , pp. 521 - 531
Copyright
Copyright © Cambridge University Press 2018 

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References

Arnett, AB, Pennington, BF, Willcutt, EG, DeFries, JC, Olson, RK (2015). Sex differences in ADHD symptom severity. Journal of Child Psychology and Psychiatry 56, 632–639.Google Scholar
Association American Psychiatric (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. DSM IV. American Psychiatric Association: Washington, DC.Google Scholar
Association American Psychiatric (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. DSM V. American Psychiatric Association: Washington, DC.Google Scholar
Bazalakova, M (2017). Sleep disorders in pregnancy. Seminars in Neurology 37, 661–668.Google Scholar
Beijers, R, Buitelaar, JK, de Weerth, C (2014). Mechanisms underlying the effects of prenatal psychosocial stress on child outcomes: beyond the HPA axis. European Child and Adolescent Psychiatry 23, 943–956.Google Scholar
Bendiksen, B, Aase, H, Diep, LM, Svensson, E, Friis, S, Zeiner, P (2015). The associations between pre- and postnatal maternal symptoms of distress and preschooler's symptoms of ADHD, oppositional defiant disorder, conduct disorder, and anxiety. Journal of Attention Disorders.Google Scholar
Bin, YS, Cistulli, PA, Ford, JB (2016). Population-based study of sleep apnea in pregnancy and maternal and infant outcomes. Journal of Clinical Sleep Medicine 12, 871–877.Google Scholar
Bourjeily, G, Danilack, VA, Bublitz, MH, Lipkind, H, Muri, J, Caldwell, D, Tong, I, Rosene-Montella, K (2017). Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort. Sleep Medicine 38, 50–57.Google Scholar
Buuren, S, Groothuis-Oudshoorn, K (2011). Mice: multivariate imputation by chained equations in R. Journal of Statistical Software 45, 1–67.Google Scholar
Clavarino, AM, Mamun, AA, O'Callaghan, M, Aird, R, Bor, W, O'Callaghan, F, Williams, GM, Marrington, S, Najman, JM, Alati, R (2010). Maternal anxiety and attention problems in children at 5 and 14 years. Journal of Attention Disorders 13, 658–667.Google Scholar
Dykens, EM (2000). Psychopathology in children with intellectual disability. Journal of Child Psychology and Psychiatry 41, 407–417.Google Scholar
Faraone, SV, Monuteaux, MC, Biederman, J, Cohan, SL, Mick, E (2003). Does parental ADHD bias maternal reports of ADHD symptoms in children? Journal of Consulting and Clinical Psychology 71, 168–175.Google Scholar
Faraone, SV, Perlis, RH, Doyle, AE, Smoller, JW, Goralnick, JJ, Holmgren, MA, Sklar, P (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry 57, 1313–1323.Google Scholar
Felder, JN, Baer, RJ, Rand, L, Jelliffe-Pawlowski, LL, Prather, AA (2017). Sleep disorder diagnosis during pregnancy and risk of preterm birth. Obstetrics and Gynecology 130, 573–581.Google Scholar
Foulon, S, Pingault, JB, Larroque, B, Melchior, M, Falissard, B, Cote, SM (2015). Developmental predictors of inattention-hyperactivity from pregnancy to early childhood. PLoS ONE 10, e0125996.Google Scholar
Fried, EI, van Borkulo, CD, Cramer, AO, Boschloo, L, Schoevers, RA, Borsboom, D (2017). Mental disorders as networks of problems: a review of recent insights. Social Psychiatry and Psychiatric Epidemiology 52, 1–10.Google Scholar
Gallucci, F, Bird, HR, Berardi, C, Gallai, V, Pfanner, P, Weinberg, A (1993). Symptoms of attention-deficit hyperactivity disorder in an Italian school sample: findings of a pilot study. Journal of the American Academy of Child & Adolescent Psychiatry 32, 1051–1058.Google Scholar
Gelaye, B, Rondon, MB, Araya, R, Williams, MA (2016). Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. The Lancet. Psychiatry 3, 973–982.Google Scholar
Glover, V (2011). Annual research review: prenatal stress and the origins of psychopathology: an evolutionary perspective. Journal of Child Psychology and Psychiatry 52, 356–367.Google Scholar
Glover, V (2015). Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Advances in Neurobiology 10, 269–283.Google Scholar
Goodman, R, Stevenson, J (1989). A twin study of hyperactivity--II. The aetiological role of genes, family relationships and perinatal adversity. Journal of Child Psychology and Psychiatry 30, 691–709.Google Scholar
Grote, NK, Bridge, JA, Gavin, AR, Melville, JL, Iyengar, S, Katon, WJ (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry 67, 1012–1024.Google Scholar
Harold, GT, Leve, LD, Barrett, D, Elam, K, Neiderhiser, JM, Natsuaki, MN, Shaw, DS, Reiss, D, Thapar, A (2013). Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry 54, 1038–1046.Google Scholar
Howard, LM, Molyneaux, E, Dennis, CL, Rochat, T, Stein, A, Milgrom, J (2014). Non-psychotic mental disorders in the perinatal period. Lancet 384, 1775–1788.Google Scholar
Larsson, H, Anckarsater, H, Rastam, M, Chang, Z, Lichtenstein, P (2012). Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs. Journal of Child Psychology and Psychiatry 53, 73–80.Google Scholar
McCoy, BM, Rickert, ME, Class, QA, Larsson, H, Lichtenstein, P, D'Onofrio, BM (2014). Mediators of the association between parental severe mental illness and offspring neurodevelopmental problems. Annals of Epidemiology 24, 629–634, 634 e1.Google Scholar
Najman, JM, Williams, GM, Nikles, J, Spence, S, Bor, W, O'Callaghan, M, Le Brocque, R, Andersen, MJ (2000). Mothers’ mental illness and child behavior problems: cause-effect association or observation bias? Journal of the American Academy of Child & Adolescent Psychiatry 39, 592–602.Google Scholar
Nigg, J, Nikolas, M, Burt, SA (2010). Measured gene-by-environment interaction in relation to attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry 49, 863–873.Google Scholar
Obel, C, Zhu, JL, Olsen, J, Breining, S, Li, J, Gronborg, TK, Gissler, M, Rutter, M (2016). The risk of attention deficit hyperactivity disorder in children exposed to maternal smoking during pregnancy – a re-examination using a sibling design. Journal of Child Psychology and Psychiatry 57, 532–537.Google Scholar
Palagini, L, Gemignani, A, Banti, S, Manconi, M, Mauri, M, Riemann, D (2014). Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep Medicine 15, 853–859.Google Scholar
Pizzi, C (2016). Technical Report: Follow-up response rates https://www.progettoninfea.it/attachments/39).Google Scholar
Pizzi, C, De Stavola, BL, Pearce, N, Lazzarato, F, Ghiotti, P, Merletti, F, Richiardi, L (2012). Selection bias and patterns of confounding in cohort studies: the case of the NINFEA web-based birth cohort. Journal of Epidemiology and Community Health 66, 976–981.Google Scholar
Polderman, TJ, Boomsma, DI, Bartels, M, Verhulst, FC, Huizink, AC (2010). A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatrica Scandinavica 122, 271–284.Google Scholar
Polderman, TJ, Huizink, AC, Verhulst, FC, van Beijsterveldt, CE, Boomsma, DI, Bartels, M (2011). A genetic study on attention problems and academic skills: results of a longitudinal study in twins. Journal of the Canadian Academy of Child & Adolescent Psychiatry 20, 22–34.Google Scholar
Polo-Kantola, P, Aukia, L, Karlsson, H, Karlsson, L, Paavonen, EJ (2017). Sleep quality during pregnancy: associations with depressive and anxiety symptoms. Acta Obstetricia et Gynecologica Scandinavica 96, 198–206.Google Scholar
Progetto Ninfea (2005). Questionario 1, Scheda: Anamnesi generale http://www.progettoninfea.it/inspector/q1_11_anamnesi_generale/fields?klass=Q1%3A%3AGeneralCaseHistory.Google Scholar
R Core Team (2016). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. R Core Team: Vienna, Austria. Retrieved from https://www.R-project.org/.Google Scholar
Richiardi, L, Baussano, I, Vizzini, L, Douwes, J, Pearce, N, Merletti, F, Cohort, N (2007). Feasibility of recruiting a birth cohort through the internet: the experience of the NINFEA cohort. European Journal of Epidemiology 22, 831–837.Google Scholar
Rijlaarsdam, J, Cecil, CA, Walton, E, Mesirow, MS, Relton, CL, Gaunt, TR, McArdle, W, Barker, ED (2017). Prenatal unhealthy diet, insulin-like growth factor 2 gene (IGF2) methylation, and attention deficit hyperactivity disorder symptoms in youth with early-onset conduct problems. Journal of Child Psychology and Psychiatry 58, 19–27.Google Scholar
Rothman, KJ, Gallacher, JE, Hatch, EE (2013). Why representativeness should be avoided. International Journal of Epidemiology 42, 1012–1014.Google Scholar
Sayal, K, Heron, J, Draper, E, Alati, R, Lewis, SJ, Fraser, R, Barrow, M, Golding, J, Emond, A, Davey Smith, G, Gray, R (2014). Prenatal exposure to binge pattern of alcohol consumption: mental health and learning outcomes at age 11. European Child and Adolescent Psychiatry 23, 891–899.Google Scholar
Simon, V, Czobor, P, Balint, S, Meszaros, A, Bitter, I (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. The British Journal of Psychiatry 194, 204–211.Google Scholar
Stein, A, Pearson, RM, Goodman, SH, Rapa, E, Rahman, A, McCallum, M, Howard, LM, Pariante, CM (2014). Effects of perinatal mental disorders on the fetus and child. Lancet 384, 1800–1819.Google Scholar
Storebo, OJ, Rasmussen, PD, Simonsen, E (2016). Association between insecure attachment and ADHD: environmental mediating factors. Journal of Attention Disorders 20, 187–196.Google Scholar
Tandon, M, Si, X, Belden, A, Luby, J (2009). Attention-deficit/hyperactivity disorder in preschool children: an investigation of validation based on visual attention performance. Journal of Child and Adolescent Psychopharmacology 19, 137–146.Google Scholar
Thapar, A, Cooper, M (2016). Attention deficit hyperactivity disorder. Lancet 387, 1240–1250.Google Scholar
Thapar, A, Holmes, J, Poulton, K, Harrington, R (1999). Genetic basis of attention deficit and hyperactivity. The British Journal of Psychiatry 174, 105–111.Google Scholar
Thapar, A, Harrington, R, Ross, K, McGuffin, P (2000). Does the definition of ADHD affect heritability? Journal of the American Academy of Child & Adolescent Psychiatry 39, 1528–1536.Google Scholar
Törnqvist, L, Vartia, P, Vartia, YO (1985). How should relative changes be measured? The American Statistician 39, 43–46.Google Scholar
Van Batenburg-Eddes, T, Brion, MJ, Henrichs, J, Jaddoe, VW, Hofman, A, Verhulst, FC, Lawlor, DA, Davey Smith, G, Tiemeier, H (2013). Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study. Journal of Child Psychology and Psychiatry 54, 591–600.Google Scholar
van de Loo, KF, van Gelder, MM, Roukema, J, Roeleveld, N, Merkus, PJ, Verhaak, CM (2016). Prenatal maternal psychological stress and childhood asthma and wheezing: a meta-analysis. European Respiratory Journal 47, 133–146.Google Scholar
Van den Bergh, BR, Mulder, EJ, Mennes, M, Glover, V (2005). Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neuroscience and Biobehavioral Reviews 29, 237–258.Google Scholar
Van den Bergh, BRH, van den Heuvel, MI, Lahti, M, Braeken, M, de Rooij, SR, Entringer, S, Hoyer, D, Roseboom, T, Raikkonen, K, King, S, Schwab, M (2017). Prenatal developmental origins of behavior and mental health: the influence of maternal stress in pregnancy. Neuroscience and Biobehavioral Reviews.Google Scholar
Washbrook, E, Propper, C, Sayal, K (2013). Pre-school hyperactivity/attention problems and educational outcomes in adolescence: prospective longitudinal study. The British Journal of Psychiatry 203, 265–271.Google Scholar
Webb, R, Ayers, S (2015). Cognitive biases in processing infant emotion by women with depression, anxiety and post-traumatic stress disorder in pregnancy or after birth: a systematic review. Cognition & Emotion 29, 1278–1294.Google Scholar
Wolford, E, Lahti, M, Tuovinen, S, Lahti, J, Lipsanen, J, Savolainen, K, Heinonen, K, Hamalainen, E, Kajantie, E, Pesonen, AK, Villa, PM, Laivuori, H, Reynolds, RM, Raikkonen, K (2017). Maternal depressive symptoms during and after pregnancy are associated with attention-deficit/hyperactivity disorder symptoms in their 3- to 6-year-old children. PLoS ONE 12, e0190248.Google Scholar
Zwirs, BW, Burger, H, Buitelaar, JK, Schulpen, TW (2006). Ethnic differences in parental detection of externalizing disorders. European Child and Adolescent Psychiatry 15, 418–426.Google Scholar
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