Smoking during pregnancy and ADHD risk: A genetically informed, multiple-rater approach

• Type of Material: Article
• Authors: Valerie S. Knopik, Rhode Island Hospital; Kristine Marceau, Rhode Island Hospital; L. Cinnamon Bidwell, University of Colorado at Boulder; Rohan H. Palmer, Emory University; Taylor F. Smith, Rhode Island Hospital; Alexandre Todorov, Washington University, St. Louis; Allison Schettini Evans, Brown University; Andrew C. Heath, Washington University, St. Louis
• Language: English
• Date: 2016-10-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1002/ajmg.b.32421
• Title of Journal or Parent Work: American Journal of Medical Genetics Part B: Neuropsychiatric Genetics
• ISSN: 1552-4841
• Volume: 171
• Issue: 7
• Start Page: 971
• End Page: 981
• Grant/Funding Information: Dr. Palmer is supported by K01 AA021113 and L30 TR001045.; Dr. Marceau is supported by T32 DA016184 (Rohsenow) and T32 MH019927 (Spirito).; This work was supported by NIH grants: DA023134 (Knopik); DA17671 (Knopik); AA07728 (Heath); AA09022 (Heath); AA11998 (Heath); HD049024 (Heath); AA017688 (Heath); AA021492 (Heath); MH 083823 (Todorov).; Dr. Bidwell is supported by K23 DA033302.
• Keywords: Female; CBCL; Smoking; Attention Deficit Disorder with Hyperactivity; Conners; smoking during pregnancy; multiple reporters; Prenatal Exposure Delayed Effects; sibling comparison design; Reproducibility of Results; Male; Child; Adolescent; ADHD; Adult; Pregnancy; Humans; Risk Factors; Siblings; genetics
• Research Categories: Biology, Genetics; Psychology, Developmental; Health Sciences, Mental Health

Abstract

Maternal smoking during pregnancy (SDP) is a significant public health concern with adverse consequences to the health and well-being of the developing child, including behavioral outcomes such as Attention–Deficit Hyperactivity Disorder (ADHD). There is substantial interest in understanding the nature of this reported association, particularly in light of more recent genetically informed studies that suggest that the SDP-ADHD link is less clear than once thought. In a sample of families (N = 173) specifically selected for sibling pairs discordant for prenatal smoking exposure, we use a sibling-comparison approach that controls for shared genetic and familial influences to assess the effects of SDP on ADHD symptom dimensions. ADHD was measured by both parent and teacher report on the Conners report forms and the Child Behavior Checklist/Teacher Report Form (CBCL/TRF). Results for the CBCL/TRF Total ADHD score are consistent with prior genetically informed approaches and suggest that previously reported associations between SDP and ADHD are largely due to familial confounding rather than causal teratogenic effects. However, results from the Conners parent report suggest a potentially causal effect of SDP on hyperactive/impulsive and, to a lesser extent, total ADHD symptoms; SDP results in increased parent-reported hyperactive/impulsive and total ADHD symptoms even after accounting for genetic and familial confounding factors. This suggests that the Conners assessment (parent-report) may provide a sensitive measure for use in studies examining child specific SDP effects on continuous and dimensional aspects of ADHD.