RESUMO
OBJECTIVE: To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioral disorders. STUDY DESIGN: We studied 47 491 children enrolled in the Danish National Birth Cohort between 1996 and 2002. Data on maternal coffee and tea consumption was collected at 15 and 30 weeks of gestation. When the child was 11 years old, the Strength and Difficulties Questionnaire was filled in by children, parents, and teachers. We estimated risk ratios (RRs) for offspring behavioral disorders. RESULTS: At 15 weeks of gestation 3% and 4% of the pregnant women consumed ≥8 cups/d of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR 1.47; 95% CI 1.18-1.83), conduct-oppositional disorders (RR 1.22; 95% CI 1.01-1.48), and any psychiatric disorder (RR 1.23; 95% CI 1.08-1.40). Maternal tea consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of anxiety-depressive disorders (RR 1.28; 95% CI 1.09-1.52) and any psychiatric disorder (RR 1.24; 95% CI 1.11-1.40). An increased risk of hyperactivity-inattention disorder was observed with increasing daily caffeine consumption at 15 weeks of gestation. CONCLUSION: High maternal caffeine consumption from coffee and tea at 15 weeks of gestation was associated with behavioral disorders in 11-year-old offspring. We hypothesize that caffeine exposure may affect the fetal brain and program for behavioral disorders later in life. The fetal brain seems to be more sensitive to caffeine exposure at 15 weeks of pregnancy compared with 30 weeks of gestation.
Assuntos
Cafeína/efeitos adversos , Transtornos do Comportamento Infantil/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adolescente , Adulto , Criança , Transtornos do Comportamento Infantil/etiologia , Estudos de Coortes , Dinamarca , Feminino , Humanos , Razão de Chances , Gravidez , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To examine whether low Apgar scores at 5 minutes are associated with increased risks of attention deficit hyperactivity disorder (ADHD). STUDY DESIGN: We conducted a nationwide population-based cohort study of all 980 902 singletons born in Denmark from 1988 to 2001. All children were monitored from 3 years of age until a first International Classification of Diseases diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first. We used Cox regression models to examine the association between Apgar scores at 5 minutes and ADHD. RESULTS: Apgar scores were inversely associated with risk of ADHD (hazard ratio 0.92; 95% CI: 0.88-0.96, P trend < .001). Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with Apgar scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15 to 2.11) and 63% higher for those with Apgar scores of 5 to 6 (95% CI: 1.25 to 2.11). CONCLUSIONS: A low Apgar score was associated with an increased risk of ADHD in childhood. Low Apgar scores and ADHD may share common causes or a low Apgar score reflects at least one causal pathway leading to ADHD.