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Hyperactivity disorder in children related to traffic-based air pollution during pregnancy
Ping Shih1, Ching-Chun Huang2, Shih-Chun Pan3
1Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
Insights
Prenatal exposure to nitric oxide (NO), a component of air pollution, is linked to an increased risk of hyperactivity disorder in children. This finding highlights potential environmental factors influencing childhood neurobehavioral development.
Area of Science:
- Environmental Health
- Neurodevelopmental Disorders
- Pediatric Health
Background:
- Attention-deficit hyperactivity disorder (ADHD) is a common childhood neurobehavioral disorder.
- Hyperactivity is more prevalent than inattention in early childhood ADHD.
- Limited evidence suggests a link between gestational air pollution exposure and childhood ADHD.
Purpose of the Study:
- To investigate the association between gestational air pollution exposure and hyperactivity disorder in childhood.
- Utilizing a population-based birth cohort in Taiwan.
Main Methods:
- The Taiwan Birth Cohort Study included 16,376 mother-infant pairs.
- Hyperactivity diagnosis was assessed at age 8.
- Gestational air pollutant exposure was estimated using kriging; logistic regression analyzed associations.
Main Results:
- A significant association was found between prenatal exposure to nitrogen oxides (NOx) and hyperactivity.
- Specifically, prenatal exposure to nitric oxide (NO) was significantly related to hyperactivity.
- No significant association was observed with particulate matter or sulfur dioxide.
Conclusions:
- Childhood hyperactivity disorder is positively associated with prenatal exposure to nitric oxide (NO).
- Further research is warranted to confirm the hazardous effects of NO and explore underlying mechanisms.
Background:
Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders in childhood globally. Between the two components of ADHD, hyperactivity disorder is more prevalent than inattention during early childhood. Although some investigations have implied a relationship between childhood ADHD and gestational exposure to air pollution, the evidence is limited. The aim of this study was to investigate the association between gestational exposure to air pollution exposure and hyperactivity disorder in childhood in a population-based birth cohort.
Methods:
The Taiwan Birth Cohort Study started from all deliveries of Taiwan in 2005 by the birth registry, and recruited representative 12% of all mother-infant pairs by two-stage stratified sampling. At age of 8 years in each child, their main caretaker was inquired whether the child had ever received a hyperactivity diagnosis from a physician or other specialist, like special needs educator. Exposure to air pollutants during gestation was estimated through ordinary kriging based on data from air monitoring stations of Environmental Protection Administration, Taiwan. Logistic regression was used to determine adjusted odds ratios (aORs) of hyperactivity disorder in relation to air pollutants.
Results:
A total of 16,376 mother-infant pairs were included in the final analysis; 374 (2.3%) of the children had received a diagnosis of hyperactivity before 8 years of age. The occurrence of hyperactivity was significantly related to prenatal nitrogen oxide (NOx), but not to particulate matter 10 μm or less in diameter or sulfur dioxide. Further analysis to separate effects by nitrogen dioxide (NO2) and/or nitric oxide (NO) showed that only NO was significantly related to hyperactivity [aOR per interquartile range (3.14 ppb): 1.26, 95% confidence interval: 1.09-1.46].
Conclusions:
In conclusion, our study found childhood hyperactivity disorder to be positively associated with prenatal NO exposure. Further confirmation on potential hazardous effects of NO and investigation on potential mechanisms are warranted.
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