Background Low levels of circulating 25-hydroxy-vitamin D [25(OH)D] have been shown to associate with prevalent attention-deficit/hyperactivity disorder (ADHD), but few studies have examined the association between 25(OH)D during fetal development and risk of childhood ADHD. Methods Maternal plasma 25(OH)D was measured at 10–18 and 32–38 weeks of gestation, with sufficiency defined as 25(OH)D ≥ 30 ng/ml. Offspring ADHD status between ages 6–9 years was measured by parent report of clinical ADHD diagnosis among 680 mother-child pairs from the Vitamin D Antenatal Asthma Reduction Trial. Association between maternal 25(OH)D and child ADHD was assessed using logistic regression, adjusting for maternal age, race and ethnicity. Effect modification by offspring sex was also assessed. Results No associations between maternal 25(OH)D at 10–18 weeks of gestation and offspring ADHD were observed. In the third trimester, we observed associations between maternal vitamin D sufficiency and offspring ADHD [odds ratio (OR) 0.47, 95% confidence interval (CI) 0.26–0.84], in addition to maternal 25(OH)D sufficiency category, comparing the deficient (OR 0.34, 95% CI 0.12–0.94), insufficient (OR 0.41, 95% CI 0.15–1.10) and sufficient (OR 0.20, 95% CI 0.08–0.54) categories against highly deficient 25(OH)D, respectively. Stratified analyses revealed a protective association for sufficient maternal 25(OH)D and child ADHD among males (OR 0.47, 95% CI 0.23–0.94); the synergy index for additive effect modification of risk was 1.78 (95% CI 0.62–5.08). Conclusions Higher levels of maternal vitamin D in the third trimester are associated with lower risk of ADHD in offspring, with modest evidence for a stronger effect among male offspring. However, larger studies will be necessary to confirm these findings.

中文翻译：

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母体维生素 D 的循环水平和后代 ADHD 的风险：维生素 D 产前哮喘减少试验的结果

背景 低水平的循环 25-羟基维生素 D [25(OH)D] 已被证明与普遍的注意力缺陷/多动障碍 (ADHD) 相关，但很少有研究检查胎儿期间 25(OH)D 之间的关联儿童多动症的发展和风险。方法 在妊娠 10-18 周和 32-38 周测量母体血浆 25(OH)D，充分定义为 25(OH)D ≥ 30 ng/ml。来自维生素 D 产前哮喘减少试验的 680 对母子对临床 ADHD 诊断的父母报告测量了 6-9 岁的后代 ADHD 状态。使用逻辑回归评估母亲 25(OH)D 与儿童 ADHD 之间的关联，并根据母亲年龄、种族和民族进行调整。还评估了后代性别的影响修正。结果 未观察到妊娠 10-18 周时母体 25(OH)D 与后代 ADHD 之间的关联。在妊娠晚期，我们观察到母体维生素 D 充足与后代 ADHD 之间的关联 [优势比 (OR) 0.47, 95% 置信区间 (CI) 0.26-0.84]，除了母体 25(OH)D 充足类别，比较了缺乏（OR 0.34, 95% CI 0.12–0.94）、不足（OR 0.41, 95% CI 0.15–1.10）和充足（OR 0.20, 95% CI 0.08–0.54）类别分别针对高度缺乏的25（OH）D。分层分析显示，男性中足够的母亲 25(OH)D 和儿童 ADHD 存在保护性关联（OR 0.47，95% CI 0.23–0.94）；风险加性效应修正的协同指数为 1.78（95% CI 0.62–5.08）。结论 妊娠晚期母体维生素 D 水平较高与后代 ADHD 风险较低相关，有适度证据表明男性后代的影响更强。然而，需要更大规模的研究来证实这些发现。