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Attention deficit hyperactivity and autism spectrum disorders in patients with anorectal malformations

Tomas Wester1,2, Anna Gunnarsdottir1,2, Charlotte Skoglund3

  • 1Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|September 9, 2021
PubMed

Insights

Children with anorectal malformations have a significantly higher risk of developing attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) compared to their peers. This finding highlights potential neurodevelopmental concerns associated with anorectal malformations.

Area of Science:

  • Pediatric Surgery
  • Neurodevelopmental Pediatrics
  • Public Health

Background:

  • Anorectal malformations (ARM) are congenital anomalies that can have long-term health implications.
  • Neurodevelopmental disorders, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD), represent a significant public health concern.
  • Previous research has suggested potential links between congenital conditions and neurodevelopmental outcomes, but specific data for ARM require further investigation.

Purpose of the Study:

  • To investigate the association between anorectal malformations and the risk of neurodevelopmental disorders.
  • To compare the incidence of ADHD and ASD in patients with ARM versus a control group.
  • To quantify the risk using population-based data.

Main Methods:

  • A population-based cohort study was conducted using Swedish national registers (1997-2012).
  • Patients diagnosed with anorectal malformation were identified and matched with five controls.
  • Neurodevelopmental disorders (ADHD, ASD) were assessed using register data, with ADHD medication prescriptions serving as a proxy for ADHD diagnosis. Conditional logistic regression was employed to calculate adjusted odds ratios (OR) and 95% confidence intervals (95% CI).

Main Results:

  • The study included 515 patients with ARM and 2560 controls.
  • Patients with ARM exhibited a significantly higher risk for ADHD (OR 3.01) and ASD (OR 3.07) compared to controls.
  • A higher prevalence of ADHD medication prescriptions was observed in the ARM group (OR 2.26).

Conclusions:

  • Individuals with anorectal malformations demonstrate an elevated risk of developing attention deficit hyperactivity disorder and autism spectrum disorders.
  • These findings underscore the importance of neurodevelopmental screening in children with ARM.
  • Further research into the underlying mechanisms and potential interventions is warranted.
Abstract

Keywords:
anorectal malformationattention deficit hyperactivity disorderautism spectrum disorder

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