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1.
Psychother Psychosom ; 92(2): 113-123, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36907183

RESUMO

INTRODUCTION: The use of benzodiazepines and/or z-drugs in women of childbearing age has increased. OBJECTIVE: The aim of the study was to evaluate whether gestational benzodiazepine and/or z-drug exposure is associated with adverse birth and neurodevelopmental outcomes. METHODS: A population-based cohort including mother-child pairs from 2001 to 2018 in Hong Kong was analysed to compare gestationally exposed and nonexposed children on the risk of preterm birth, small for gestational age, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) through logistic/Cox proportional hazards regression with a 95% confidence interval (CI). Sibling-matched analyses and negative control analyses were applied. RESULTS: When comparing gestationally exposed with gestationally nonexposed children, the weighted odds ratio (wOR) was 1.10 (95% CI = 0.97-1.25) for preterm birth and 1.03 (95% CI = 0.76-1.39) for small for gestational age, while the weighted hazard ratio (wHR) was 1.40 (95% CI = 1.13-1.73) for ASD and 1.15 (95% CI = 0.94-1.40) for ADHD. Sibling-matched analyses showed no association between gestationally exposed children and their gestationally nonexposed siblings for all outcomes (preterm birth: wOR = 0.84, 95% CI = 0.66-1.06; small for gestational age: wOR = 1.02, 95% CI = 0.50-2.09; ASD: wHR = 1.10, 95% CI = 0.70-1.72; ADHD: wHR = 1.04, 95% CI = 0.57-1.90). Similarly, no significant differences were observed when comparing children whose mothers took benzodiazepines and/or z-drugs during pregnancy to children whose mothers took benzodiazepines and/or z-drugs before but not during pregnancy for all outcomes. CONCLUSIONS: The findings do not support a causal relationship between gestational benzodiazepines and/or z-drugs exposure and preterm birth, small for gestational age, ASD, or ADHD. Clinicians and pregnant women should carefully balance the known risks of benzodiazepines and/or z-drugs use against those of untreated anxiety and sleep problems.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal , Humanos , Recém-Nascido , Gravidez , Feminino , Benzodiazepinas/efeitos adversos , Estudos de Coortes , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/tratamento farmacológico , Transtorno do Espectro Autista/induzido quimicamente , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/complicações , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/induzido quimicamente
3.
Dev Sci ; 8(2): 105-14, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15720368

RESUMO

In this paper we examine the current status of the science of ADHD from a theoretical point of view. While the field has reached the point at which a number of causal models have been proposed, it remains some distance away from demonstrating the viability of such models empirically. We identify a number of existing barriers and make proposals as to the best way for these to be overcome in future studies. These include the need to work across multiple levels of analysis in multidisciplinary teams; the need to recognize the existence of, and then model, causal heterogeneity; the need to integrate environmental and social processes into models of genetic and neurobiological influence; and the need to model developmental processes in a dynamic fashion. Such a model of science, although difficult to achieve, has the potential to provide the sort of framework for programmatic model-based research required if the power and sophistication of new neuroscience technologies are to be effectively exploited.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Modelos Neurológicos , Neurociências/tendências , Fenótipo , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/genética , Cognição/fisiologia , Variação Genética , Humanos , Neurotransmissores/fisiologia , Transdução de Sinais/fisiologia , Meio Social
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