Association of sweetened carbonated beverage consumption during pregnancy and ADHD symptoms in the offspring: a study from the Norwegian Mother, Father and Child Cohort Study (MoBa)

Liv Grimstvedt Kvalvik,Ingeborg Forthun,Catharina Hartman,Jannicke Igland,Jan Haavik,Kari Klungsøyr,Berit Skretting Solberg,Henrik Larsson,Alejandro Arias Vasquez,Stefan Johansson,Ida Henriette Caspersen,Lizanne Johanna Stephanie Schweren,Anne Lise Brantsæter,Lin Li

doi:10.1007/s00394-022-02798-y

Abstract

PurposeIntrauterine exposures influence offspring health and development. Here we investigated maternal intake of sweetened carbonated beverages (SCB) during pregnancy and its association with ADHD symptoms in the offspring.MethodsThis study was based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway. Maternal diet mid-pregnancy was assessed using a food frequency questionnaire (FFQ). All mothers who responded to the FFQ and a questionnaire when their child was 8 years of age were included (n = 39,870). The exposure was defined as maternal intake (daily servings) of SCB, using no daily intake as reference. Outcome was offspring ADHD symptoms, evaluated as a continuous standardized ADHD score and as a binary outcome of six or more ADHD symptoms vs. five symptoms or less. Associations were analysed using log-binomial regression and linear mixed regression models with adjustment for covariates.ResultsThe adjusted regression coefficients for the standardized ADHD offspring symptom score were 0.31 [95% confidence intervals (0.001, 0.62)] and 0.46 (0.15, 0.77) for maternal daily intake of ≥ 1 glasses of SCB, when the models included adjustments for total energy intake or energy intake from other sources than SCBs and sweet drinks, respectively. The corresponding adjusted relative risks were 1.16 (1.004, 1.34) and 1.21. (1.05, 1.39) for drinking ≥ 1 glasses daily.ConclusionIn a large pregnancy cohort with offspring followed until 8 years of age, we found an association between maternal daily intake of SCB and offspring ADHD symptoms. These results suggest a weak positive relationship between prenatal exposure to SCB and offspring ADHD.

Highlights

Neurodevelopmental disorders typically become apparent during childhood but are an important cause of long-term disability [1]
Based on data from a large cohort study, we aimed to investigate whether intake of sugar- or artificially sweetened carbonated beverages (SCB) during pregnancy is associated with increased Attention-deficit/hyperactivity disorder (ADHD) symptoms in offspring at 8 years of age
For the standardized ADHD score, the regression coefficient for offspring of mothers who drank 1 or more serving of SCB daily in pregnancy compared to mothers with no daily intake of SCB was 0.87 (95% confidence intervals (CI) 0.57–1.17)

Summary

Introduction

Neurodevelopmental disorders typically become apparent during childhood but are an important cause of long-term disability [1]. Attention-deficit/hyperactivity disorder (ADHD) is the most common of these conditions, with prevalence estimates around 3–4% among children and adolescents in Norway [1,2,3] and worldwide. ADHD is defined according to a set of characteristic symptoms, including hyperactivity, inattention and impulsivity [5, 6]. These are dimensional traits, observed at various levels in all humans. To qualify for an ADHD diagnosis, these traits, or symptoms, must be age inappropriate and extreme in such a way that they interfere with and impair a person’s daily life; at school, at work or in social settings. ADHD is a complex multifactorial disorder where heritability is estimated to be approximately 74% based on twin studies [7]. The heritability of less than 100% indicates that both genes and environment contribute to

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