Prenatal Cotinine Levels and ADHD Among Offspring
Open accessAbstract
OBJECTIVES: An association between maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder (ADHD) has been shown across several studies based on self-reports. No previous studies have investigated the association of nicotine exposure measured by cotinine levels during pregnancy and offspring ADHD. METHODS: and 1079 matched controls were identified from Finnish nationwide registers. Maternal cotinine levels were measured by using quantitative immunoassays from maternal serum specimens collected during the first and second trimesters of pregnancy and archived in the national biobank. RESULTS: There was a significant association between increasing log-transformed maternal cotinine levels and offspring ADHD. The odds ratio was 1.09 (95% confidence interval [CI] 1.06-1.12) when adjusting for maternal socioeconomic status, maternal age, maternal psychopathology, paternal age, paternal psychopathology, and child's birth weight for gestational age. In the categorical analyses with cotinine levels in 3 groups, heavy nicotine exposure (cotinine level >50 ng/mL) was associated with offspring ADHD, with an odds ratio of 2.21 (95% CI 1.63-2.99) in the adjusted analyses. Analyses by deciles of cotinine levels revealed that the adjusted odds for offspring ADHD in the highest decile was 3.34 (95% CI 2.02-5.52). CONCLUSIONS: The study reveals an association with and a dose-response relationship between nicotine exposure during pregnancy and offspring ADHD. Future studies incorporating maternal smoking and environmental, genetic, and epigenetic factors are warranted.
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Offspring exposed to heavy nicotine exposure during gestation (cotinine >50 ng/mL) had increased risk (OR 2.21; 95% CI 1.63-2.99) for ADHD compared with offspring not exposed to maternal smoking during pregnancy when adjusting for demographic variables.
“Their results indicated that offspring exposed to heavy nicotine exposure during gestation (cotinine level >50 ng/mL) had an increased risk (OR: 2.21; 95% CI 1.63–2.99) for ADHD as compared to offspring not exposed to maternal smoking during pregnancy when adjusting for demographic variables”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [69]
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Animal models of attention-deficit/hyperactivity disorder: Diversity and validity
Nehme, S. B. S., Sánchez‐Sarasúa, S., Medrano, M., Bouchatta, O., Bitar, T., Alameddine, A., Galineau, L., Brunault, P., Kerekes, N., Sánchez‐Pérez, A. M., et al. (2025) · Pharmacological Reviews · doi:10.1016/j.pharmr.2025.100108
- Authors
- Sourander, A., Sucksdorff, M., Chudal, R., Surcel, H.-M., Hinkka-Yli-Salomäki, S., Gyllenberg, D., Cheslack-Postava, K., & Brown, A. S.
- Affiliations
- Department of Child Psychiatry, University of Turku, Turku, Finland;
- University of Turku (FI)
- Oulu University Hospital (FI)
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, New York;
- Columbia University Irving Medical Center (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2019-03-01
- Volume
- 143
- Issue
- 3
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC6398365
- OpenAlex
- W2916421355
- Cited by
- 48
- References
- 43
- Citations by year
- 2025: 4 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 9 · 2020: 11 · 2019: 2
- FWCI
- 7.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- National Institute of Environmental Health Sciences (R01ES028125)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- prenatal nicotine exposure, smoking during pregnancy, cotinine, attention deficit hyperactivity disorder, dose-response relationship, maternal serum biomarkers, birth weight for gestational age
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Cotinine, Female, Finland, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Biomarkers, Case-Control Studies
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