Parental asthma occurrence, exacerbations and risk of attention-deficit/hyperactivity disorder

Brain Behav Immun. 2019 Nov:82:302-308. doi: 10.1016/j.bbi.2019.08.198. Epub 2019 Aug 30.

Abstract

Objective: To investigate whether intrauterine exposure to maternal asthma or asthma exacerbations increases the risk of attention-deficit/hyperactivity disorder (ADHD).

Methods: Using Danish register data, this cohort study comprised of 961,202 live singletons born in Denmark during 1997-2012. Children were followed to a maximum of 20.0 years from birth until the first of ADHD-diagnosis/prescription, emigration, death, or 31 December 2016. Cox regression models were used to evaluate the association between maternal or paternal asthma, asthma exacerbations and offspring ADHD.

Results: During 11.4 million person-years of follow-up, 27,780 (2.9%) children were identified as having ADHD. ADHD risk was increased among offspring born to asthmatic mothers (hazard ratio (HR) 1.41, 95% CI: 1.36-1.46) or asthmatic fathers (HR 1.13, 95% CI: 1.08-1.18). Antenatal antiasthma medication treatment did not increase offspring ADHD. However, higher risks were observed among offspring of mothers with asthma exacerbations compared with children of asthmatic mothers with no exacerbations: HR 1.12 (95% CI: 1.00-1.25) for pre-pregnancy exacerbations; 1.21 (95% CI: 1.00-1.47) for exacerbations during pregnancy; and 1.25 (95% CI: 1.08-1.44) for exacerbations after delivery.

Conclusions: These results support theories regarding shared genetic and environmental risk factors having a role in the development of ADHD.

Keywords: Asthma; Attention-deficit/hyperactivity disorder; Cohort studies; Registries.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Asthma / complications*
  • Asthma / metabolism*
  • Attention Deficit Disorder with Hyperactivity / etiology*
  • Attention Deficit Disorder with Hyperactivity / immunology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Denmark
  • Female
  • Humans
  • Male
  • Maternal Exposure / adverse effects
  • Maternal-Fetal Exchange / physiology
  • Parents
  • Pregnancy
  • Prenatal Exposure Delayed Effects / immunology
  • Prenatal Exposure Delayed Effects / metabolism
  • Proportional Hazards Models
  • Registries
  • Risk Factors