Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe

作者：Forns Joan; Sunyer Jordi; Garcia Esteban Raquel; Porta Daniela; Ghassabian Akhgar; Giorgis Allemand Lise; Gong Tong; Gehring Ulrike; Sorensen Mette; Standl Marie; Sugiri Dorothee; Almqvist Catarina; Andiarena Ainara; Badaloni Chiara; Beelen Rob; Berdel Dietrich; Cesaroni Giulia; Charles Marie Aline; Eriksen Kirsten Thorup; Estarlich Marisa; Fernandez Mariana F; Forhan Anne; Jaddoe Vincent W V; Korek Michal; Lichtenstein Paul; Lertxundi Aitana

来源：Epidemiology, 2018, 29(5): 618-626.

DOI：10.1097/EDE.0000000000000874

• attention deficit disorder with hyperactivity
• child development
• environmental pollution
• longitudinal studies
• meta-analysis
• nitrogen oxides
• particulate matter
• prospective studies

Background: Exposure to air pollution during pregnancy may increase attention-deficit/hyperactivity disorder (ADHD) symptoms in children, but findings have been inconsistent. We aimed to study this association in a collaborative study of eight European population-based birth/child cohorts, including 29,127 mother-child pairs.
Methods: Air pollution concentrations (nitrogen dioxide [NO2] and particulate matter [PM]) were estimated at the birth address by land-use regression models based on monitoring campaigns performed between 2008 and 2011. We extrapolated concentrations back in time to exact pregnancy periods. Teachers or parents assessed ADHD symptoms at 3-10 years of age. We classified children as having ADHD symptoms within the borderline/clinical range and within the clinical range using validated cutoffs. We combined all adjusted area-specific effect estimates using random-effects meta-analysis and multiple imputations and applied inverse probability-weighting methods to correct for loss to follow-up.
Results: We classified a total of 2,801 children as having ADHD symptoms within the borderline/clinical range, and 1,590 within the clinical range. Exposure to air pollution during pregnancy was not associated with a higher odds of ADHD symptoms within the borderline/clinical range (e.g., adjusted odds ratio [OR] for ADHD symptoms of 0.95, 95% confidence interval [CI] = 0.89, 1.01 per 10 mu g/m(3) increase in NO2 and 0.98, 95% CI = 0.80, 1.19 per 5 mu g/m(3) increase in PM2.5). We observed similar associations for ADHD within the clinical range.
Conclusions: There was no evidence for an increase in risk of ADHD symptoms with increasing prenatal air pollution levels in children aged 3-10 years. See video abstract at, http://links.lww.com/EDE/B379.

• 出版日期2018-9