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. 2019 Dec 7;24(1):74.
doi: 10.1186/s12199-019-0834-4.

Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children's Health

Machiko Minatoya  1   2 , Atsuko Araki  1 , Sachiko Itoh  1 , Keiko Yamazaki  1 , Sumitaka Kobayashi  1 , Chihiro Miyashita  1 , Seiko Sasaki  3 , Reiko Kishi  4
Affiliations

Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children's Health

Machiko Minatoya et al. Environ Health Prev Med. .

Abstract

Background: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated.

Methods: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker).

Results: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys.

Conclusion: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.

Keywords: ADHD; Birth cohort; Passive smoking; Prenatal tobacco exposure; SDQ.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Selection of study population. Among children born between April 2008 and April 2012 (n = 6804), 3081 returned follow-up questionnaires by May 2017. Among 3801, maternal cotinine levels at the third trimester was available for 3216. These 3216 were categorized into four groups based on the maternal cotinine levels
Fig. 2
Fig. 2
Frequency distribution of maternal cotinine levels in the third trimester. The distribution of log 10 transformed maternal cotinine levels at the third trimester was described
See this image and copyright information in PMC

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