Authors’ conclusions: the study reveals a strong association, and a dose-dependent response, between exposure to prenatal nicotine and the diagnosis of attention deficit hyperactivity disorder in the children of exposed mothers. Future studies that incorporate maternal smoking, environmental and epigenetic factors would be justified.
Reviewers’ commentary: according to the results seen above, the consumption of tobacco by women during pregnancy would be a risk factor for the development during childhood of attention deficit hyperactivity disorder in offspring. These results, although of modest magnitude, would be applicable to our environment, with the simple reinforcement of the recommendation to suppress tobacco during pregnancy. This would mean a theoretical 8.2% reduction in the number of diagnoses of attention deficit hyperactivity disorder. Although from this study we can not assume causality, the dose-effect relationship reinforces the existing evidence.