Association between Maternal Adverse Childhood Experiences and Attention-Deficit/Hyperactivity Disorder in the Offspring: The Mediating Role of Antepartum Health Risks

Objectives This study aimed to examine the effect of maternal adverse childhood experiences (ACEs) on the attention-deficit/hyper-activity disorder (ADHD) symptoms in the offspring and to examine the mediating role of antepartum health risk on the intergenera-tional transmission of maternal ACEs. Methods The participants consisted of 461 mother-child dyads. Mothers completed the ACEs questionnaire and Diagnostic Predictive Scales. Multivariate logistic regression analysis was used to estimate the risk of ADHD symptoms in the offspring of mothers with ACEs and the mediating effect of antepartum health risks by path analysis. Results In all, 35.4% (n=163) had at least one maternal ACE, and 11.1% (n=51) had three or more. Compared to the non-ADHD symp-tom group, the group of offspring with ADHD symptoms showed a significant association with maternal ACE score (p<0.001) and an-tepartum health risks (p<0.001). Multivariate analysis further showed a significant association between the sum of maternal ACEs [odds ratio (OR)=1.264, 95% confidence interval (CI)= 1.060-1.516, p=0.009], antepartum health risks (OR=1.236, 95% CI=1.036-1.475, p= 0.019), and ADHD symptoms in the offspring. In the mediation model in which the mother's ACE score affected the offspring's ADHD symptoms, partial mediation through antepartum health risks was found to be significant (B=0.041, 95% CI=0.011-0.124). Conclusion Maternal ACEs are significantly related to the incidence of ADHD symptoms in the offspring and antepartum health risks exert an indirect effect. These findings suggest that maternal ACEs have a negative impact on the offspring's brain development through intergenerational transmission, resulting in neurodevelopmental disorders such as ADHD.