Maternal Glucocorticoid Exposure Not Associated With ADHD in Offspring

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The cause of ADHD is multifaceted and may involve risk factors common to ADHD and indications for glucocorticoid treatment.
The cause of ADHD is multifaceted and may involve risk factors common to ADHD and indications for glucocorticoid treatment.

In a nationwide cohort study published in BMJ Open, prenatal exposure to glucocorticoids was not associated with attention-deficit/hyperactivity disorder (ADHD) in offspring. 

Using national Danish registries, the risk for ADHD was compared among the children of women who received glucocorticoids during pregnancy (n=42,099), received glucocorticoids prior to pregnancy but not during pregnancy (n=177,165), or never used glucocorticoids (n=656,732). Siblings with prenatal exposure to glucocorticoids were also compared with siblings with no exposure.

Of the 42,099 children with prenatal exposure to glucocorticoids, 5319 were exposed to systemic glucocorticoids and 36,780 were exposed to inhaled/local glucocorticoids.

At 10 years of age, the cumulative incidence of ADHD was 2.65% for children who were exposed to glucocorticoids and 2.03% for children who were not exposed.

Although prenatal exposure was associated with ADHD compared with no exposure (hazard ratio [HR] 1.43 for systemic and 1.23 for local/inhaled), the study authors explained that the analysis of former users (HR 1.25) and the sibling design (HR 1.03) suggested that the findings were a result of confounding factors. Moreover, no difference in risk was observed after adjusting for dose or timing of exposure.

The study authors concluded that “the cause of ADHD is multifaceted and may involve risk factors common to ADHD and indications for [glucocorticoid] treatment, as well as environmental and genetic factors. Based on our sibling design, prenatal exposure to [glucocorticoids] does not appear to be a risk factor for developing ADHD.”

Reference

Laugesen K, Byrjalsen A, Frøslev T, Olsen MS, Sørensen HT. Use of glucocorticoids during pregnancy and risk of attention-deficit/hyperactivity disorder in offspring: a nationwide Danish cohort study. BMJ Open. 2017;7:e016825.

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