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Attention-Deficit Hyperactivity Disorder Risk: Interaction Between Parental Age and Maternal History of
Xinhui Wang1, Mayra P Martinez1, Ting Chow1
1Departments of Research & Evaluation and.
Insights
Maternal attention-deficit/hyperactivity disorder (ADHD) history significantly amplifies the risk of ADHD in children born to young parents. This heightened risk is primarily seen when mothers have a history of ADHD.
Area of Science:
- Pediatrics
- Genetics
- Psychiatry
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder.
- Parental factors, including maternal ADHD history and young parental age, are implicated in ADHD risk.
- The interplay between these factors requires further investigation.
Purpose of the Study:
- To examine the combined effect of maternal ADHD history and young parental age on the risk of ADHD in offspring.
- To determine if young parental age poses a greater ADHD risk for children with a maternal history of ADHD.
Main Methods:
- A prospective cohort study of 321,272 children born between 1995 and 2012.
- Utilized electronic medical records for follow-up until ADHD diagnosis or end of 2017.
- Employed Cox regression to assess risks and interactions, adjusting for confounders.
Main Results:
- Children with at least one parent under 20 had a 1.14 Hazard Ratio (HR) for ADHD if no maternal ADHD history.
- This HR increased to 1.92 for children with a maternal history of ADHD.
- A significant interaction (p < 0.005) was found between maternal ADHD history and young parental age.
Conclusions:
- Young parenthood significantly elevates ADHD risk in offspring, particularly when a maternal history of ADHD is present.
- The findings highlight the critical role of maternal ADHD history in moderating the impact of young parental age on child ADHD risk.
Objective:
To assess the interaction between maternal attention-deficit/hyperactivity disorder (ADHD) history and young parental age on child's ADHD risk.
Methods:
The study included 321,272 singleton children born between 1995 and 2012 from hospitals within a single integrated health care organization. The children were prospectively followed up through electronic medical record systems from birth until the first date of the following: date of clinical diagnosis of ADHD, last date of continuous health plan membership, death due to any cause, or December 31, 2017. Risks of ADHD associated with a maternal history of ADHD before pregnancy and young parental age were assessed by using Cox regression adjusting for potential confounders.
Results:
The children were followed up for a median (interquartile range) of 8.9 (6.2, 13.6) years from birth. Among them, 5.1% had ADHD diagnosis, 1.8% had a maternal history of ADHD before the pregnancy, and 4.4% had mothers <20 years and 2.3% had fathers <20 years at date of birth. The hazard ratio (HR) of ADHD in children associated with parental age <20 years varied by maternal history of ADHD (p < 0.005 for both multiplicative and additive interactions). For children without a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.14 (95% confidence interval 1.04-1.24). However, for children with a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.92 (95% confidence interval 1.31-2.82).
Conclusion:
High ADHD risk in offspring associated with young parenthood was predominantly observed among children with a maternal history of ADHD.
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