University of Oulu

Chudal, R., Brown, A.S., Gyllenberg, D. et al. Maternal serum C-reactive protein (CRP) and offspring attention deficit hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 29, 239–247 (2020).

Maternal serum C-reactive protein (CRP) and offspring attention deficit hyperactivity disorder (ADHD)

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Author: Chudal, Roshan1; Brown, Alan S.2,3; Gyllenberg, David1,4,5;
Organizations: 1Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3/Teutori (3rd Floor), 20014, Turku, Finland
2Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
3Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
4Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
5National Institutes of Health and Welfare, Helsinki, Finland
6Faculty of Medicine, Medical Research Center, University of Oulu, Oulu, Finland
7Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland
8Department of Child Psychiatry, Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Springer Nature, 2020
Publish Date: 2020-03-30


Exposure to infection and inflammation during the fetal period are associated with offspring neuropsychiatric disorders. Few previous studies have examined this association with ADHD with mixed findings. This study aims to examine the association between early gestational maternal C-reactive protein (CRP), prospectively assayed in stored maternal sera and the risk of ADHD in offspring. This study is based on the Finnish Prenatal studies of ADHD (FIPS-ADHD) with a nested case–control design. It includes all singleton-born children in Finland between January 1, 1998 and December 31, 1999 and diagnosed with ADHD. A total of 1079 cases and equal number of controls were matched on date of birth, sex and place of birth. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens, collected during the first and early second trimester of pregnancy. Elevated maternal CRP when analyzed as a continuous variable was not associated with offspring ADHD (OR 1.05, 95% CI 0.96–1.15). No significant associations were seen in the highest quintile of CRP (OR 1.18, 95% CI 0.88–1.58). The results were similar in both sexes as well as among ADHD cases with or without comorbid ASD or conduct disorder. In this first study examining CRP, a biomarker for inflammation, during early pregnancy in relation to offspring ADHD, we report no significant associations. The lack of any association, when considered with positive findings seen in ASD and schizophrenia, and negative findings in bipolar disorder suggests different pathways linking maternal immune activation and development of various neuropsychiatric disorders.

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Series: European child & adolescent psychiatry
ISSN: 1018-8827
ISSN-E: 1435-165X
ISSN-L: 1018-8827
Volume: 29
Pages: 239 - 247
DOI: 10.1007/s00787-019-01372-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: This study was supported by the following funding sources: Academy of Finland, decision number 308552, and National Institute of Environmental Health Sciences, Grant number: 5R01ES028125. Dr. Gyllenberg has received funding from the Brain and Behavior Research Foundation, the Academy of Finland and the Finnish Medical Foundation. This study belongs to the Finnish Psychiatric Birth Cohort Consortium (PSYCOHORTS) funded by Academy of Finland.
Copyright information: © The Author(s) 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.