Trajectories of growth and symptoms of attention-deficit/hyperactivity disorder in children: a longitudinal study
Kati Heinonen1, Katri Räikkönen, Anu-Katriina Pesonen
1Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland. kati.heinonen@helsinki.fi
Insights
Slower prenatal growth, including smaller head circumference, is linked to higher attention deficit/hyperactivity disorder (ADHD) symptoms in children. Lack of head circumference catch-up growth may also be a risk factor.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Neurodevelopmental Disorders
Background:
- Prenatal growth is empirically linked to attention deficit/hyperactivity disorder (ADHD).
- Limited data exists on postnatal growth's association with ADHD symptoms.
Purpose of the Study:
- To investigate the association between prenatal and postnatal growth up to 56 months and ADHD symptoms in children.
Main Methods:
- Longitudinal regional birth cohort study of 893 children followed to 56 months.
- Analysis using multiple linear regression and repeated-measures analyses of covariance.
Main Results:
- Lower birth weight, thinner body-mass index, shorter length, and smaller head circumference (adjusted for gestation) correlated with higher ADHD symptom scores at 56 months.
- Consistently smaller head circumference from birth to 56 months was associated with higher ADHD symptom scores.
- Associations remained significant after adjusting for pre- and neonatal factors and were not sex-modified.
Conclusions:
- Slower prenatal growth in weight, BMI, length, and head circumference may increase the risk of childhood ADHD symptoms.
- Consistently smaller head circumference from birth to 56 months, indicating a potential lack of catch-up growth, may predispose children to higher ADHD symptoms.
Background:
Empirical evidence suggests that prenatal growth is associated with attention deficit/hyperactivity disorder (ADHD) and its symptoms. Data on the importance of postnatal growth is, however scanty. We studied whether pre- and postnatal growth up to 56 months is associated with symptoms of ADHD in children.
Method:
A longitudinal regional birth cohort study comprising 893 children followed up to 56 months. The associations between pre- and postnatal growth and parent-rated ADHD symptoms of the child were analyzed with multiple linear regression analyses and repeated-measures analyzes of covariance.
Results:
Children born lighter, thinner, shorter, and with a smaller head circumference, adjusted for length of gestation, received higher parent-rated ADHD symptoms scores at 56 months. Further, smaller head circumference throughout the period of growth from birth up to 56 months was related to higher ADHD symptoms scores. The associations changed only little after adjusting for several pre- and neonatal factors. The associations were not modified by sex and there were no evidence of non-linear associations.
Conclusions:
Slower prenatal growth in weight, body-mass index, length, and head circumference may pose a risk for higher ADHD symptoms in childhood. The consistently smaller head circumference from birth up to 56 months characterizing children with higher ADHD symptoms may point to a lack of catch-up growth in head circumference in childhood as a predisposing factor.
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