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Antecedents of Attention-Deficit/Hyperactivity Disorder Symptoms in Children Born Extremely Preterm

Samantha Johnson1, Puja Kochhar, Enid Hennessy

  • 1*Department of Health Sciences, University of Leicester, Leicester, United Kingdom; †School of Medicine, University of Nottingham, Nottingham, United Kingdom; ‡Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; §Institute for Women's Health, University College London, London, United Kingdom; ‖Department of Psychology and Health Sciences Research Institute, University of Warwick, Coventry, United Kingdom.

Journal of Developmental and Behavioral Pediatrics : JDBP
|April 21, 2016
PubMed

Insights

Children born extremely preterm face higher risks for attention-deficit/hyperactivity disorder (ADHD) symptoms, particularly inattention. Early assessments of neurodevelopment and behavior can identify at-risk extremely preterm children.

Area of Science:

  • Pediatrics
  • Neurodevelopmental Disorders
  • Perinatal Medicine

Background:

  • Children born extremely preterm (EP; <26-wk gestation) exhibit increased risks for neurodevelopmental challenges.
  • Attention-deficit/hyperactivity disorder (ADHD) symptoms are a significant concern in this population.

Purpose of the Study:

  • To investigate the antecedents of attention-deficit/hyperactivity disorder (ADHD) symptoms in children born extremely preterm (EP).
  • To differentiate predictors for inattention versus hyperactivity/impulsivity in EP children.

Main Methods:

  • The EPICure study followed EP infants born in 1995 in the UK and Ireland.
  • Neurodevelopmental outcomes were assessed at 2.5, 6, and 11 years.
  • Parent and teacher-reported ADHD symptoms (inattention, hyperactivity/impulsivity) were evaluated at 11 years using the DuPaul Rating Scale IV.
  • Regression analyses identified predictors of ADHD symptoms.

Main Results:

  • EP children showed significantly higher rates of inattention and hyperactivity/impulsivity compared to controls.
  • Inattention at 11 years was predicted by smaller head circumference, lower IQ, peer relationship problems (at 6 years), and motor development (at 2.5 years).
  • Hyperactivity/impulsivity was predicted by lower IQ, conduct problems, ADHD symptoms (at 6 years), externalizing problems (at 2.5 years), and non-white maternal ethnicity.

Conclusions:

  • Extremely preterm children are at elevated risk for ADHD symptoms, with inattention being more prominent.
  • Antecedents of ADHD symptoms vary by domain, with attention deficits linked to poor brain growth and neurological function.
  • Early cognitive and behavioral assessments are crucial for identifying EP children at risk for inattention.
Abstract

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