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Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mothers were classified into three groups according to plasma cotinine levels (median=0.22\u2009ng\/mL)\u2014non-smokers (\u22640.21\u2009ng\/mL), passive smokers (0.22\u201311.48\u2009ng\/mL) and active smokers (\u226511.49\u2009ng\/mL). ADHD was suspected in 302 (8.6%), 334 (10.9%) and 90 (14.5%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95%\u2009CI=1.19\u20131.86\u2009and adjusted RR=1.20, 95%\u2009CI=1.03\u20131.40 for the active and passive smoking groups, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087406","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:50:55Z","timestamp":1735199455000},"page":"e087406","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between prenatal tobacco exposure and 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