Abstract
Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.
Highlights
Attention deficit/hyperactivity disorder (ADHD) is the most frequent childhood-onset neuropsychiatric condition, with an estimated worldwide prevalence of approximately 5% in school-aged children [1]
The present study assessed the association between maternal ferritin levels during pregnancy and ADHD symptoms in their offspring when the children reached 4–5 years of age
Our results support the evidence from another prospective population-based study, which showed a negative association between iron deficiency during pregnancy and cognitive, social and emotional development [27], and a longitudinal study [35], where low umbilical cord serum ferritin levels were associated with poorer performance in mental and psychomotor tests in children at years of age
Summary
Attention deficit/hyperactivity disorder (ADHD) is the most frequent childhood-onset neuropsychiatric condition, with an estimated worldwide prevalence of approximately 5% in school-aged children [1]. ADHD symptoms tend to persist into adulthood in as many as 65% of cases [2]. Despite ADHD being the most studied neuropsychiatric condition in child psychiatry worldwide [3], the etiological factors [4] are not well understood [5]. No specific etiology has been identified for ADHD, and findings are consistent with a multifactorial model [6]. The range of etiologies related to prenatal and perinatal risk factors, genetics and neurobiological deficits that have been proposed may all be involved in the pathophysiology of ADHD [7]
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