Elevated level of prenatal testosterone and vitamin D3 deficiency during pregnancy, in the presence of prenatal maternal stress, and their association with the development of attention deficit hyperactivity disorder (ADHD)-like symptoms in toddlers.

INTRODUCTION: To investigate the hypothesis that the presence of prenatal maternal stress, increased level of prenatal testosterone, and low level of vitamin D3 in pregnancy is associated with the development of ADHD-like symptoms in toddlers (< 2 years old). MATERIAL AND METHODS: The study group comprised 53 pregnant women and 53 infants of these pregnancies. The population cohort of 53 pregnant women were recruited at their 35th to 37th week of pregnancy and investigated prospectively. The participants were selected through targeted selection. Maternal experience of stressful life events was assessed by stress standardised questionnaires, prenatal testosterone was determined in the mothers' saliva by using the immune enzymatic (ELISA) method, and maternal plasma D vitamin was measured using the ECLIA method, during pregnancy. When the age of the offspring was 6 months and then less than 2 years, the mothers completed the child behaviour and temperament checklist. RESULTS: A small but statistically significant association was found between the common symptom complex of ADHD and the level of testosterone and vitamin D3, in the presence of prenatal maternal stress. Multiple regression analysis showed that maternal stressful events during pregnancy significantly predicted ADHD behaviours in offspring. CONCLUSIONS: The study supported the hypothesis that prenatal maternal stress, increased level of prenatal testosterone, and low level of vitamin D3 during pregnancy increases the risk of development of ADHD-like symptoms in toddlers (< 2 years old). Also, the obtained results support the hypothesis that the influence of prenatal factors causes ADHD-like symptoms in offspring through a programming effect.

Elevated level of testosterone in amniotic fluid during prenatal stress and its association with development of Attention-Deficit/Hyperactivity Disorder (ADHD) like symptoms in toddlers.

AIM OF THE STUDY: To investigate the "prenatal testosterone hypothesis", according to which, high level of testosterone associated with the development of ADHD like symptoms in younger children, and to investigate whether maternal stress during pregnancy in-creases the risk of developing ADHD like symptoms in early childhood. DESIGN: This was a prospective study with three measurement periods: the first one during pregnancy (12 to 25 weeks of gestation); the second period involved the assessment of infants of this pregnancy at the age of 6 months and the third one the assessment of the same infants at the age of 18 months. The research plan is approved by "David Tvildiani Medical University" Research Ethics Committee. The study does not contain serious predictable risks as the expected benefit overweighs them. MATERIAL AND METHODS: The study group is presented by 40 pregnant women and 40 infants of these pregnancies. Pregnant women were asked about their perceived stress levels, critical life events of the past year and pregnancy-specific stress levels using standardized questionnaires. Child's temperament and behavioral regulation were assessed using the questionnaires. Amniotic fluid was collected undergoing amniocentesis. Total testosterone in amniotic fluid was measured by radioimmunoassay. RESULTS: Although statistically significant relationship was identified between hyperactivity, also impulsiveness symptoms and pre-natal stress, no statistically significant relationship was identified between testosterone level and hyperactivity, also impulsivity symptoms, as well as between testosterone level and prenatal stress level. CONCLUSIONS: The performed study did not support the "hypothesis about prenatal testosterone", because there was a significant negative correlation between the frequency of hyperactivity symptoms and testosterone level.