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Maternal psychosocial stress and children's ADHD diagnosis: a prospective birth cohort study
Lauren Okano1, Yuelong Ji1, Anne W Riley1,2,3
1a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
Insights
Maternal stress during pregnancy is linked to a higher risk of attention deficit hyperactivity disorder (ADHD) in children. This study highlights psychosocial stressors as independent risk factors for childhood ADHD development.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Maternal Health
Background:
- Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder.
- Maternal psychosocial factors during pregnancy are increasingly recognized for their impact on child development.
- Understanding prenatal risk factors is crucial for early intervention and prevention strategies for ADHD.
Purpose of the Study:
- To investigate the association between maternal psychosocial stressors before and during pregnancy and the subsequent diagnosis of ADHD in their children.
- To identify specific types of maternal stress and adversities that may increase the risk of ADHD.
- To control for known risk factors in assessing the independent contribution of maternal stress.
Main Methods:
- A prospective cohort study of 2140 mother-child pairs with data collected between 2003 and 2015.
- Child ADHD diagnosis was identified using International Classification of Diseases, Ninth Revision (ICD-9) codes from electronic medical records.
- Exploratory factor analysis was used to construct latent factors for maternal stress, social support, and environmental adversities, followed by logistic regression analysis.
Main Results:
- Children were 1.45 times more likely to be diagnosed with ADHD if their mother experienced a major stressful event during pregnancy.
- Mothers reporting high perceived stress during pregnancy showed a 3.03 times increased likelihood of their child receiving an ADHD diagnosis.
- Increased numbers of family adversities were significantly associated with a higher risk of ADHD diagnosis in children.
Conclusions:
- Maternal psychosocial stress before and during pregnancy is an independent risk factor for the development of ADHD in children.
- These findings are particularly relevant for urban, low-income, and minority birth cohorts.
- The study underscores the importance of addressing maternal mental health and reducing psychosocial stressors during pregnancy to mitigate ADHD risk.
Abstract:
Objective: Examine the association of mothers' psychosocial stressors before and during pregnancy with their children's diagnosis of attention deficit hyperactivity disorder (ADHD). Methods: This study included 2140 mother-child pairs who had at least one postnatal pediatric visit at the Boston Medical Center between 2003 and 2015. Child ADHD was determined via International Classification of Diseases, Ninth Revision (ICD-9) codes documented in electronic medical records. Latent factors of maternal stress and social support and measures of the physical home environment and psychosocial adversities were constructed using exploratory factor analysis. The association between the latent factors and child ADHD diagnosis was examined using multiple logistic regression, controlling for known risk factors for ADHD. Results: Children were 1.45 (95% CI: 1.06, 1.99) and 3.03 (95% CI: 2.19, 4.20) times more likely to receive an ADHD diagnosis if their mother experienced a major stressful event during pregnancy or reported a high level of perceived stress, respectively. The number of family adversities increases the risk of ADHD diagnosis [second quartile: OR = 1.90; CI (1.31, 2.77); third quartile: OR = 1.96 CI (1.34, 2.88); fourth quartile: OR = 2.89 CI (2.01, 4.16)] compared to first quartile. Conclusions: In this prospective, predominantly urban, low-income, minority birth cohort, mothers' psychosocial stress before and during pregnancy appears to be an independent risk factor for the development of ADHD in their children.