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Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and

Kati Heinonen1, Katri Räikkönen, Anu-Katriina Pesonen

  • 1Institute of Behavioral Science, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland. kati.heinonen@helsinki.fi

BMC Pediatrics
|December 17, 2010
PubMed

Insights

Being born small for gestational age (SGA), not preterm birth, is linked to attention deficit/hyperactivity disorder (ADHD) symptoms. This finding highlights intrauterine growth restriction as a risk factor for ADHD symptoms in children.

Area of Science:

  • Perinatal epidemiology
  • Child psychology
  • Developmental neuroscience

Background:

  • The relationship between birth status and attention deficit/hyperactivity disorder (ADHD) symptoms is not fully understood.
  • It is unclear whether preterm birth or being small for gestational age poses a greater risk for ADHD symptoms.

Purpose of the Study:

  • To investigate the independent associations of preterm birth and small for gestational age (SGA) status with ADHD symptoms in children.
  • To determine if birth size adjusted for gestational age influences ADHD symptom development.

Main Methods:

  • A longitudinal birth cohort study in Finland included 828 children followed up to 56 months.
  • Infants were categorized by gestational age and birth weight adjusted for gestational age (small for gestational age [SGA] vs. appropriate for gestational age [AGA]).
  • Parent-rated ADHD symptoms were analyzed using multiple linear and logistic regression, controlling for potential confounders.

Main Results:

  • Preterm birth (<37 weeks gestation) or lower gestational age was not significantly associated with ADHD symptoms.
  • Small for gestational age (SGA) status and lower birth weight standard deviation (SD) scores were independently associated with higher ADHD symptoms.
  • Children born SGA were 3.6 times more likely to exceed the clinical cut-off for ADHD symptoms compared to those born AGA.

Conclusions:

  • Intrauterine growth restriction, indicated by SGA status and lower birth weight, appears to be a significant risk factor for ADHD symptoms.
  • Prematurity or lower gestational age alone does not seem to be the primary driver of ADHD symptoms in this cohort.
  • These findings suggest focusing on fetal growth monitoring to identify children at risk for developing ADHD symptoms.
Abstract

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