|Institution:||University of Pittsburgh|
|Full text PDF:||http://d-scholarship.pitt.edu/25511/1/Dissertation_PUGH_S_8_2015.pdf|
Attention-deficit hyperactivity disorder (ADHD) is the most prevalent developmental disability in the United States and can compromise a child’s behavioral and intellectual development. We used a longitudinal birth cohort from Pittsburgh, PA to study maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in relation to 1) offspring intelligence and executive function at age ten 2) offspring behavior and ADHD symptoms at age ten 3) offspring academic achievement at ages six, ten, and fourteen. Mother-child pairs (n=763) from the Maternal Health Practices and Child Development pregnancy cohort were followed from <21 weeks gestation to 14 years postpartum. Self-reported total GWG was classified using gestational-age standardized z-score charts and BMI was categorized in accordance with the World Health Organization (WHO) criteria. Validated assessment tools were used to measure child intelligence, executive function, and behaviors consistent with attention-deficit hyperactivity disorder (ADHD) as well as academic achievement. Compared with children of normal weight mothers, offspring of obese mothers had 3.2 lower IQ points (95% CI: -5.6, -0.8), were 12.7 seconds slower on the executive function scale (95% CI: 2.8, 22.7), and had increased problem behaviors consistent with ADHD including withdrawn or somatic complaints (adj β: 4.9 points, 95% CI: 1.7, 8.1), delinquent or aggressive behaviors (adj β: 4.2 points, 95% CI: 1.1, 7.3), and attention problems (adj β: 3.5 points, 95% CI: 1.2, 5.8) after adjusting for confounders. Academic achievement was also lower among children of obese mothers, compared with children of normal weight mothers. In generalized estimating equation models, high GWG was significantly associated with a 4 point decrease in reading (adjβ: -3.75, 95% CI: -7.1, -0.4) and spelling scores (adjβ: -3.90, 95% CI: -7.8, -0.2) at ages 6, 10, and 14. There was a non-significant trend towards lower offspring domain-specific cognition with high maternal GWG. This dissertation is important to public health because pre-pregnancy BMI and GWG are potentially modifiable factors and a reduction in obesity and excessive GWG could alleviate, although not eliminate, the burden of ADHD and related impairments in the population.