Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan

Mariko Itoh; Sumitaka Kobayashi; Shinkichi Nishihara; Chihiro Miyashita; Keiko Yamazaki; Naomi Tamura; Satoshi Suyama; Atsuko Ikeda; Sachiko Itoh; Yu Ait Bamai; Takeshi Yamaguchi; Hideyuki Masuda; Sharon Hanley; Reiko Kishi

doi:10.1136/bmjopen-2024-087406

Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan

Mariko Itoh
, Sumitaka Kobayashi
, Shinkichi Nishihara
, Chihiro Miyashita
, Keiko Yamazaki
, Naomi Tamura
, Satoshi Suyama
, Atsuko Ikeda
, Sachiko Itoh
, Yu Ait Bamai
, Takeshi Yamaguchi
, Hideyuki Masuda
, Sharon Hanley
, Reiko Kishi^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

1 Downloads (Pure)

Abstract

Objectives To examine the association between maternal plasma cotinine concentrations during pregnancy and attention-deficit/hyperactivity disorder (ADHD) related characteristics in children. Design Prospective birth cohort study from the Hokkaido Study on Environment and Children's Health. Setting Hokkaido, Japan. Participants A total of 7217 children were included in the analysis. Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained. Main outcome measures ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age. Results The mothers were classified into three groups according to plasma cotinine levels (median=0.22 ng/mL) - non-smokers (≤0.21 ng/mL), passive smokers (0.22-11.48 ng/mL) and active smokers (≥11.49 ng/mL). ADHD was suspected in 302 (8.6%), 334 (10.9%) and 90 (14.5%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95% CI=1.19-1.86 and adjusted RR=1.20, 95% CI=1.03-1.40 for the active and passive smoking groups, respectively). Conclusion This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.

Original language	English
Article number	e087406
Number of pages	10
Journal	BMJ Open
Volume	14
Issue number	12
Early online date	26 Dec 2024
DOIs	https://doi.org/10.1136/bmjopen-2024-087406
Publication status	Published - Dec 2024

Bibliographical note

Acknowledgements
We are deeply grateful to the participating mothers and infants and the staff at the 37 hospitals in Hokkaido, Japan, for their cooperation in this study. We also thank Dr. Hiroyoshi Iwata at the Center for Environmental and Health Sciences of Hokkaido University for his advice in making the submission.

Data Availability Statement

Data availability
Data are available upon reasonable request. The datasets generated and/or analyzed during the current study are not publicly available because the study involves human participants with a nondisclosure provision of individual data stated in the written informed consent in order to prevent compromise of study participants’ privacy but are available from the corresponding author upon reasonable request.

Supplementary information
Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online (https://doi.org/10.1136/bmjopen-2024-087406).

Funding

This work was supported by Scientific Research from the Japan Society for the Promotion of Sciences, the Ministry of Education, Culture, Sports, Science and Technology (grant numbers: 19H01071, 21K19618, 15K08795, 20K10445, and 26893002), the Japan Agency for Medical Research and Development (AMED) (grant number: 21gk0110039h0003), as well as Ministry of Internal Affairs and Communications (MIC) (grant number: MI10001) in Japan.

Funders	Funder number
Japan Society for the Promotion of Sciences
Ministry of Education, Culture, Sports, Science and Technology of Japan	19H01071, 21K19618, 15K08795, 20K10445, 26893002
Japan Agency for Medical Research and Development	21gk0110039h0003
Ministry of Internal Affairs and Communications	MI10001

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Developmental neurology & neurodisability
EPIDEMIOLOGIC STUDIES
Pregnancy
Tobacco Use

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Cite this

Itoh, M., Kobayashi, S., Nishihara, S., Miyashita, C., Yamazaki, K., Tamura, N., Suyama, S., Ikeda, A., Itoh, S., Ait Bamai, Y., Yamaguchi, T., Masuda, H., Hanley, S., & Kishi, R. (2024). Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan. BMJ Open, 14(12), Article e087406. https://doi.org/10.1136/bmjopen-2024-087406

Itoh, M, Kobayashi, S, Nishihara, S, Miyashita, C, Yamazaki, K, Tamura, N, Suyama, S, Ikeda, A, Itoh, S, Ait Bamai, Y, Yamaguchi, T, Masuda, H, Hanley, S & Kishi, R 2024, 'Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan', BMJ Open, vol. 14, no. 12, e087406. https://doi.org/10.1136/bmjopen-2024-087406

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title = "Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan",

abstract = "Objectives To examine the association between maternal plasma cotinine concentrations during pregnancy and attention-deficit/hyperactivity disorder (ADHD) related characteristics in children. Design Prospective birth cohort study from the Hokkaido Study on Environment and Children's Health. Setting Hokkaido, Japan. Participants A total of 7217 children were included in the analysis. Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained. Main outcome measures ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age. Results The mothers were classified into three groups according to plasma cotinine levels (median=0.22 ng/mL) - non-smokers (≤0.21 ng/mL), passive smokers (0.22-11.48 ng/mL) and active smokers (≥11.49 ng/mL). ADHD was suspected in 302 (8.6\%), 334 (10.9\%) and 90 (14.5\%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95\% CI=1.19-1.86 and adjusted RR=1.20, 95\% CI=1.03-1.40 for the active and passive smoking groups, respectively). Conclusion This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.",

keywords = "Developmental neurology \& neurodisability, EPIDEMIOLOGIC STUDIES, Pregnancy, Tobacco Use",

author = "Mariko Itoh and Sumitaka Kobayashi and Shinkichi Nishihara and Chihiro Miyashita and Keiko Yamazaki and Naomi Tamura and Satoshi Suyama and Atsuko Ikeda and Sachiko Itoh and \{Ait Bamai\}, Yu and Takeshi Yamaguchi and Hideyuki Masuda and Sharon Hanley and Reiko Kishi",

note = "Acknowledgements We are deeply grateful to the participating mothers and infants and the staff at the 37 hospitals in Hokkaido, Japan, for their cooperation in this study. We also thank Dr. Hiroyoshi Iwata at the Center for Environmental and Health Sciences of Hokkaido University for his advice in making the submission.",

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month = dec,

doi = "10.1136/bmjopen-2024-087406",

language = "English",

volume = "14",

journal = "BMJ Open",

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TY - JOUR

T1 - Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years

T2 - A birth cohort in Japan

AU - Itoh, Mariko

AU - Kobayashi, Sumitaka

AU - Nishihara, Shinkichi

AU - Miyashita, Chihiro

AU - Yamazaki, Keiko

AU - Tamura, Naomi

AU - Suyama, Satoshi

AU - Ikeda, Atsuko

AU - Itoh, Sachiko

AU - Ait Bamai, Yu

AU - Yamaguchi, Takeshi

AU - Masuda, Hideyuki

AU - Hanley, Sharon

AU - Kishi, Reiko

N1 - Acknowledgements We are deeply grateful to the participating mothers and infants and the staff at the 37 hospitals in Hokkaido, Japan, for their cooperation in this study. We also thank Dr. Hiroyoshi Iwata at the Center for Environmental and Health Sciences of Hokkaido University for his advice in making the submission.

PY - 2024/12

Y1 - 2024/12

N2 - Objectives To examine the association between maternal plasma cotinine concentrations during pregnancy and attention-deficit/hyperactivity disorder (ADHD) related characteristics in children. Design Prospective birth cohort study from the Hokkaido Study on Environment and Children's Health. Setting Hokkaido, Japan. Participants A total of 7217 children were included in the analysis. Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained. Main outcome measures ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age. Results The mothers were classified into three groups according to plasma cotinine levels (median=0.22 ng/mL) - non-smokers (≤0.21 ng/mL), passive smokers (0.22-11.48 ng/mL) and active smokers (≥11.49 ng/mL). ADHD was suspected in 302 (8.6%), 334 (10.9%) and 90 (14.5%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95% CI=1.19-1.86 and adjusted RR=1.20, 95% CI=1.03-1.40 for the active and passive smoking groups, respectively). Conclusion This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.

AB - Objectives To examine the association between maternal plasma cotinine concentrations during pregnancy and attention-deficit/hyperactivity disorder (ADHD) related characteristics in children. Design Prospective birth cohort study from the Hokkaido Study on Environment and Children's Health. Setting Hokkaido, Japan. Participants A total of 7217 children were included in the analysis. Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained. Main outcome measures ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age. Results The mothers were classified into three groups according to plasma cotinine levels (median=0.22 ng/mL) - non-smokers (≤0.21 ng/mL), passive smokers (0.22-11.48 ng/mL) and active smokers (≥11.49 ng/mL). ADHD was suspected in 302 (8.6%), 334 (10.9%) and 90 (14.5%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95% CI=1.19-1.86 and adjusted RR=1.20, 95% CI=1.03-1.40 for the active and passive smoking groups, respectively). Conclusion This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.

KW - Developmental neurology & neurodisability

KW - EPIDEMIOLOGIC STUDIES

KW - Pregnancy

KW - Tobacco Use

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DO - 10.1136/bmjopen-2024-087406

M3 - Article

C2 - 39725438

AN - SCOPUS:85213916830

SN - 2044-6055

VL - 14

JO - BMJ Open

JF - BMJ Open

IS - 12

M1 - e087406

ER -

Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: A birth cohort in Japan

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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Cite this