Pre-Pregnancy Weight and Symptoms of Attention Deficit Hyperactivity Disorder and Executive Functioning Behaviors in Preschool Children.

Abstract

This study examines pre-pregnancy Body Mass Index (BMI) and gestational weight gain (GWG) in relation to early childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and related executive self-regulation behaviors. The analyses sample (n = 331) included a subsample of participants from a birth cohort recruited from prenatal clinics and hospital facilities from April 2005 to June 2011 in Durham, North Carolina. Pre-pregnancy BMI was calculated from weight at the last menstrual period and height was extracted from medical records. Gestational weight gain was calculated from pre-pregnancy weight and weight measured at the time of delivery. ADHD symptoms and executive self-regulation behaviors were assessed by maternal report (mean age = 3 years). Multivariable regression methods with inverse probability weighting (IPW) were used to evaluate associations accounting for sample selection bias and confounding. Pre-pregnancy BMI at levels ≥35 was positively associated with higher ADHD symptoms and worse executive self-regulation behaviors (inhibitory control and attention). Compared to adequate GWG, less than adequate GWG was related to more ADHD hyperactive-impulsive symptoms, whereas greater than adequate GWG was related to more problematic behaviors related to working memory and planning. The findings support a link between maternal weight and child neurodevelopment. Continued research that help identify biological mechanisms are needed.

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Citation

Published Version (Please cite this version)

10.3390/ijerph16040667

Publication Info

Fuemmeler, Bernard F, Nancy Zucker, Yaou Sheng, Carmen E Sanchez, Rachel Maguire, Susan K Murphy, Scott H Kollins, Cathrine Hoyo, et al. (2019). Pre-Pregnancy Weight and Symptoms of Attention Deficit Hyperactivity Disorder and Executive Functioning Behaviors in Preschool Children. International journal of environmental research and public health, 16(4). pp. 667–667. 10.3390/ijerph16040667 Retrieved from https://hdl.handle.net/10161/18196.

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Scholars@Duke

Zucker

Nancy Lee Zucker

Professor in Psychiatry and Behavioral Sciences

Our laboratory studies individuals who have difficulty detecting, interpreting, and/or using signals from their body to guide adaptive behavior towards themselves and their environment.  We explore how disruptions in these capacities contribute to psychosomatic disorders such as functional abdominal pain or anorexia nervosa and how the adaptive development of these capacities helps individuals to know themselves, trust themselves, and flourish.

Our primary populations of study are individuals struggling with eating disorders and feeding disorders of childhood: conditions that are sine quo non for dysregulation of basic motivational drives or conditions in which disruption in these processes may be more likely: such as the presence of pediatric pain. Several conditions are of particular focus due to the presence of profound deficits in interoception or/and integration of internal arousal: anorexia nervosa, a disorder notable for extreme, determined, rigid, and repetitive behaviors promoting malnourishment and the inability to use signals of interoception and proprioception in the service of goal-directed actions, Avoidant Restrictive Food Intake Disorder (ARFID), children with "sensory superpowers" who may be hypersensitive to somatic signals and external sensory features; and pediatric functional abdominal pain, children who may become afraid of their bodies' messages due to generalization of fear of pain to innocuous sensations. Study of children allows us to ask different questions about disorder etiology, maintenance, and course as we can minimize the impact of malnutrition on brain function and perhaps better characterize prior learning history. What we most passionate about is using this conceptualization to design and test novel treatments that enable individuals across the lifespan to feel safe in their bodies and to achieve this in a way that is fun.

Our parallel line of research examines how individuals’ sense others when they have difficulties sensing themselves. Increasing evidence suggests that we understand others via embodied enactments of our own experiences. These findings have profound implications for individuals who have dysfunction in the experience of their bodies as it suggests limited capacities to truly understand others’ experiences. By studying these processes in parallel, we hope to better understand how this interaction between sensing ourselves and others unfolds.

Murphy

Susan Kay Murphy

Associate Professor in Obstetrics and Gynecology

Dr. Murphy is a tenured Associate Professor in the Department of Obstetrics and Gynecology and serves as Chief of the Division of Reproductive Sciences. As a molecular biologist with training in human epigenetics, her research interests are largely centered around the role of epigenetic modifications in health and disease. 

Dr. Murphy has ongoing projects on gynecologic malignancies, including approaches to eradicate ovarian cancer cells that survive chemotherapy and later give rise to recurrent disease. Dr. Murphy is actively involved in many collaborative projects relating to the Developmental Origins of Health and Disease (DOHaD).

Her lab is currently working on preconception environmental exposures in males, particularly on the impact of cannabis on the sperm epigenome and the potential heritability of these effects. They are also studying the epigenetic and health effects of in utero exposures, with primary focus on children from the Newborn Epigenetics STudy (NEST), a pregnancy cohort she co-founded who were recruited from central North Carolina between 2005 and 2011. Dr. Murphy and her colleagues continue to follow NEST children to determine relationships between prenatal exposures and later health outcomes.


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