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[ Clinical research A variety of clinical studies have sought to determine whether there is an association between PNE and ones risk for ADHD [ n = 100 cases, 100 controls) by Howell et al., for example, found prenatal maternal tobacco smoking to be a predictor of childhood ADHD and to be associated with shortened infant telomere length when controlling for maternal depression [ n = 19,940) found that maternal smoking increased ones risk for ADHD by 2.64 times (95% CI 1.454.80) and paternal smoking during pregnancy to increase ones risk for ADHD by 1.17 times (95% CI 1.981.39) [ n = 1,079) sought to control for recall bias related to self-reported data by examining the relationship between levels of maternal cotinine levels during pregnancy and risk of ADHD in offspring [ n = 3,216) analyzing maternal cotinine levels during pregnancy and ones risk for ADHD found that maternal active smoking (cotinine level 11.49 ng/mL) during pregnancy was significantly associated with an increased risk of total difficulties (OR = 1.67) while maternal low- and high-passive smoking (cotinine level 0.220.51 ng/mL and 0.5211.48 ng/mL respectively) increased the risk (OR = 1.11, 1.25, respectively) but was not statistically significant [ Multiple meta-analyses and systematic reviews have also addressed the association between PNE and ADHD [ n = 17,304), for example, found that maternal smoking during pregnancy was associated with an increased risk of ADHD (pooled RR = 1.58, 95% CI = [1.33, 1.88]) [ n = 3,076,173) also found that maternal smoking cessation during the first trimester was significantly associated with ADHD in offspring when adjusted for covariates (aOR 1.292, 95% CI 1.1251.484) [ n = 50,044 cases, 2,998,059 total) found that smoking during pregnancy increased the risk of offspring ADHD (OR: 1.60