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Prenatal Cotinine Levels and ADHD Among Offspring
Andre Sourander1,2,3, Minna Sucksdorff4,5, Roshan Chudal4
1Department of Child Psychiatry, University of Turku, Turku, Finland; andsou@utu.fi.
Maternal nicotine exposure during pregnancy, measured by cotinine levels, is linked to an increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring. This study confirms a dose-response relationship, highlighting the impact of prenatal nicotine exposure.
Area of Science:
- Neuroscience
- Public Health
- Genetics
Background:
- Previous research linked maternal smoking to offspring ADHD using self-reports.
- No studies had quantitatively measured nicotine exposure via cotinine levels in relation to offspring ADHD.
Purpose of the Study:
- To investigate the association between maternal nicotine exposure during pregnancy, measured by serum cotinine levels, and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring.
Main Methods:
- A population-based study identified 1079 ADHD cases and 1079 matched controls born between 1998-1999 from Finnish nationwide registers.
- Maternal serum cotinine levels were quantified using immunoassays from samples collected during the first and second trimesters.
Main Results:
- A significant dose-response association was found between increasing maternal cotinine levels and offspring ADHD.
- Heavy nicotine exposure (cotinine >50 ng/mL) showed an adjusted odds ratio of 2.21 for ADHD.
- The highest decile of cotinine levels corresponded to an adjusted odds ratio of 3.34 for offspring ADHD.
Conclusions:
- Prenatal nicotine exposure demonstrates a significant association and a dose-response relationship with offspring ADHD.
- Further research is recommended to explore environmental, genetic, and epigenetic factors alongside maternal smoking.
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