مقاله انگلیسی رایگان در مورد تأثیر بیماری کرون در دوران بارداری بر کودکان مبتلا به ADHD – الزویر 2022

Abstract

1. Introduction

2. Methods

3. Results

4. Discussion

5. Conclusion

Author contribution

Registration of research studies

Acknowledgement

References

Abstract

Background
Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) in pregnant women. Although studies have shown that certain maternal autoimmune diseases are associated with attention deficit hyperactivity disorder (ADHD) in children, no studies have found a relationship specifically between and IDA in pregnant women with IBD and ADHD in their children. This review aims identify a relationship between maternal Crohn’s disease (CD) with IDA and ADHD in children.

Materials and methods
A review of existing literature was conducted using PubMed to search for articles on pregnant women with CD and IDA and children with ADHD. The studies included nested case-control studies, cohort studies, cross-sectional studies, case-control studies, and literature reviews published from 2012 to 2021.

Results
Among 876 articles generated, 11 studies were chosen for this review. Inclusion criteria consisted of no animal studies, meta-analysis or systematic reviews followed by ADHD related topics and maternal CD and IDA. The findings show that ADHD in progeny may be attributed to maternal CD. Although no studies have shown that IDA in mothers with CD is related to ADHD in offspring, several studies have shown a positive correlation between maternal IDA and ADHD in offspring. Some studies suggest inflammation in IBD during pregnancy can inflame the central nervous system, leading to ADHD in offspring.

Conclusion
IDA is a prevalent complication in CD, and inadequate iron levels are associated with neurodevelopmental problems, such as ADHD. Iron therapy for pregnant mothers diagnosed with CD is suggested to prevent ADHD in offspring.

Introduction

     Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood, affecting approximately 8.4% of US children between 2 and 17 years of age [1,2]. Symptoms of ADHD include losing items, disorganization, an inability to pay attention and concentrate, forgetting things quickly, and struggling to complete activities [2]. Evidence links the disorder’s etiology to multiple factors, including genetics, environmental aspects and certain maternal autoimmune disorders such as psoriasis, rheumatoid arthritis, asthma and others [3,4].

     Although studies have shown an association between certain maternal autoimmune diseases and ADHD in offspring, not much is known about how maternal inflammatory bowel diseases (IBDs), such as Crohn’s disease (CD), affect neurodevelopment in progeny. It was recently estimated that approximately 1.5 million people have IBD, including ulcerative colitis, in the United States, causing considerable health and financial loss every year [5]. In most cases, the development of anemia is caused by iron deficiency, and results have shown that nearly 27% of people treated for CD have iron deficiency anemia (IDA) [4]. Furthermore, women with CD are at higher risk of anemia than men with CD possibly due to blood loss during menstruations [6].

Results

     This review attempted to answer the question, “Is there a relationship between IDA in maternal CD and ADHD?” The search resulted in 11 studies (Appendix 1). These studies include 2 literature reviews [7,8], 4 cohort studies, 3 cross-sectional studies, 1 case-control study, and 1 nested case-control study.

3.1. Case-control studies

    We found one case-control study [9] assessing the link between iron deficiency and ADHD in children (n = 630) from 5 to 18 years of age in Qatar. The findings indicated that mean ferritin levels were significantly lower in children with ADHD than in the control group (36.26 ± 5.93, 38.19 ± 5.61, respectively; p ≤ .01). Ferritin levels in children without ADHD were within the normal range. The researchers suggested that iron deficiency is linked to cognitive impairment, instability in psychomotor aspects in children, and difficulties in learning because of impairment within the central dopaminergic pathway. In summary, the study found that iron deficiency was strongly associated with ADHD symptoms, and these findings revealed the need for careful examination and possibly early intervention of iron supplementation in affected children to reduce the risk of ADHD.