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The relationship between attention deficit hyperactivity disorder and premature infants in Taiwanese: a case control
Shih-Ming Chu1, Ming-Horng Tsai, Fan-Ming Hwang
1Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Premature infants show more severe attention-deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. Lower gestational age and birth weight are significantly correlated with increased ADHD severity, indicating a link between prematurity and neurodevelopmental disorders.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychiatry
Background:
- Neonatal intensive care unit (NICU) survivors are at increased risk for neurobehavioral disorders.
- Attention-deficit/hyperactivity disorder (ADHD) is a common concern in preterm infants.
- This study investigates the relationship between prematurity and ADHD in Taiwanese children.
Purpose of the Study:
- To explore the correlation between prematurity and ADHD.
- To assess the severity of ADHD symptoms in school-aged children born preterm.
- To identify specific factors of prematurity associated with ADHD.
Main Methods:
- A case-control study involving 195 children diagnosed with ADHD and 212 healthy controls (aged 6-12 years).
- Assessment using the ADHD-Rating scale and Clinical Global Impression (CGI) severity scale by child psychiatrists.
- Collection of demographic data, birth history, and perinatal factors.
Main Results:
- Children with ADHD exhibited significantly higher rates of prematurity and low birth weight (<2500 g) compared to controls (P=0.003).
- A negative correlation was found between gestational age and ADHD symptom severity scores (P<0.05).
- Low birth weight showed a significant correlation with CGI severity scores (P=0.018).
Conclusions:
- Premature infants demonstrate more severe ADHD symptoms at school age.
- Gestational age and birth weight are significant factors associated with ADHD severity in preterm survivors.
- Further research is needed to understand the pathogenesis of preterm birth's impact on ADHD development.
Background:
Preterm survivors from the neonatal intensive care unit (NICU) are considered to be at risk for some neurobehavioral disorders such as attention-deficit/hyperactivity disorder (ADHD). The current study aimed to explore the relationship between ADHD and premature infants in Taiwan.
Methods:
A total of 195 children (157 males and 38 females) diagnosed with ADHD based on DSM-IV and aged between 6 to 12 years and a control group of 212 (164 males, 48 females) age- and sex-matched healthy children were enrolled. The ADHD-Rating scale and CGI severity were performed by child psychiatrists. Demographic data of the children, including birth history, perinatal neurological and respiratory problems were collected to facilitate the investigation of whether a correlation exists between ADHD and prematurity.
Results:
The ADHD group had a significantly higher rate of prematurity and significantly higher rate of low birth body weight (defined as <2500 g) than the control group (both P=0.003). Pearson correlation showed a significantly negative correlation between gestational age and ADHD-RS score, inattentive score, hyperactivity and CGI-S score (P=0.004, 0.013, 0.015 and 0.002, respectively). However, only a CGI-S score (P=0.018) showed a significantly correlation between low birth weight and ADHD.
Conclusions:
Premature infants have significantly more severe symptoms of ADHD at school age and they were highly correlated. Further study is necessary to determine the main effect and pathogenesis of moderate as well as extreme preterm birth on the development of ADHD.
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