Maternal prepregnancy body mass index and offspring attention-deficit/hyperactivity disorder

a quasi-experimental sibling-comparison, population-based design

Erica D. Musser, Michael T. Willoughby, Suzanne Wright, Elinor Sullivan, Diane Stadler, Brent F. Olson, Robert D. Steiner, Joel Nigg

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: High maternal prepregnancy body mass index (BMI) has been associated with increased risk of offspring attention-deficit/hyperactivity disorder (ADHD). However, whether this effect is attributable to maternal or familial level confounds has been little examined. Methods: The present study sought to examine these associations, utilizing data from the medical records of a health care system which treats 350,000 patients annually and a sibling-comparison design in a sample of 4,682 children born to 3,645 mothers. Results: When examining the overall maternal effect, a linear association was observed between maternal prepregnancy BMI and child ADHD [b = 0.04, 95% confidence interval (95% CI) = 0.02–0.06, p =.0003], such that a one-unit (i.e. 1 kg/m2) increase in prepregnancy BMI was associated with a 4% increase in the odds of ADHD (exp b = 1.04). However, when the model was reparameterized to take full advantage of the sibling design to allow for the examination of both maternal and child-specific effects, the child-specific prepregnancy BMI effect was not reliably different from zero (b = −0.08, 95% CI = −0.23 to 0.06, p =.24). In contrast, at the maternal-level, average prepregnancy BMI was a reliably non-zero predictor of child ADHD (b = 0.04, 95% CI = 0.02–0.06, p <.0001) with each one-unit increase in maternal prepregnancy BMI associated with a 4.2% increase in the odds of ADHD (exp b = 1.04, 95% CI = 1.02–1.06). Conclusions: The association between maternal prepregnancy BMI and offspring ADHD may be better accounted for by familial or maternal confounds rather than a direct causal effect of BMI.

Original languageEnglish (US)
Pages (from-to)240-247
Number of pages8
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Volume58
Issue number3
DOIs
StatePublished - Mar 1 2017

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Attention Deficit Disorder with Hyperactivity
Siblings
Body Mass Index
Mothers
Population
Confidence Intervals
Medical Records
Delivery of Health Care

Keywords

  • Attention-deficit/hyperactivity disorder
  • maternal BMI
  • quasi-experimental design

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Maternal prepregnancy body mass index and offspring attention-deficit/hyperactivity disorder : a quasi-experimental sibling-comparison, population-based design. / Musser, Erica D.; Willoughby, Michael T.; Wright, Suzanne; Sullivan, Elinor; Stadler, Diane; Olson, Brent F.; Steiner, Robert D.; Nigg, Joel.

In: Journal of Child Psychology and Psychiatry and Allied Disciplines, Vol. 58, No. 3, 01.03.2017, p. 240-247.

Research output: Contribution to journalArticle

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title = "Maternal prepregnancy body mass index and offspring attention-deficit/hyperactivity disorder: a quasi-experimental sibling-comparison, population-based design",
abstract = "Background: High maternal prepregnancy body mass index (BMI) has been associated with increased risk of offspring attention-deficit/hyperactivity disorder (ADHD). However, whether this effect is attributable to maternal or familial level confounds has been little examined. Methods: The present study sought to examine these associations, utilizing data from the medical records of a health care system which treats 350,000 patients annually and a sibling-comparison design in a sample of 4,682 children born to 3,645 mothers. Results: When examining the overall maternal effect, a linear association was observed between maternal prepregnancy BMI and child ADHD [b = 0.04, 95{\%} confidence interval (95{\%} CI) = 0.02–0.06, p =.0003], such that a one-unit (i.e. 1 kg/m2) increase in prepregnancy BMI was associated with a 4{\%} increase in the odds of ADHD (exp b = 1.04). However, when the model was reparameterized to take full advantage of the sibling design to allow for the examination of both maternal and child-specific effects, the child-specific prepregnancy BMI effect was not reliably different from zero (b = −0.08, 95{\%} CI = −0.23 to 0.06, p =.24). In contrast, at the maternal-level, average prepregnancy BMI was a reliably non-zero predictor of child ADHD (b = 0.04, 95{\%} CI = 0.02–0.06, p <.0001) with each one-unit increase in maternal prepregnancy BMI associated with a 4.2{\%} increase in the odds of ADHD (exp b = 1.04, 95{\%} CI = 1.02–1.06). Conclusions: The association between maternal prepregnancy BMI and offspring ADHD may be better accounted for by familial or maternal confounds rather than a direct causal effect of BMI.",
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AU - Wright, Suzanne

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