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Association of Attention Deficit/Hyperactivity Disorder With Events Occurring During Pregnancy and Perinatal Period
Jianbo Liu1, Yuqiong He2,3, Yanmei Shen2,3
1Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of Mental Health, Shenzhen University, Shenzhen, China.
Insights
Pregnancy and perinatal complications like threatened abortion and neonatal asphyxia are linked to attention deficit/hyperactivity disorder (ADHD). Specific factors like instrumental delivery and low birth weight also pose risks for ADHD in certain subgroups.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychiatry
Background:
- The connection between prenatal and perinatal events and the development of attention deficit/hyperactivity disorder (ADHD) remains incompletely understood.
- Investigating these early-life factors is crucial for understanding ADHD etiology.
Purpose of the Study:
- To investigate the association between pregnancy and perinatal events and the occurrence of ADHD.
- To identify specific risk factors during pregnancy and childbirth that may contribute to ADHD development.
Main Methods:
- A two-phase cross-sectional study involving 3,418 students from 13 schools.
- Utilized the Child Behavior Checklist (CBCL) for initial screening.
- Employed the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and DSM-IV criteria for diagnosis.
Main Results:
- Threatened abortion (TA) and neonatal asphyxia (NA) were positively associated with ADHD.
- TA was a risk factor for ADHD without comorbidity.
- Instrumental delivery and NA were risk factors for ADHD with comorbidity.
- TA and NA were risk factors for ADHD in males; low birth weight (LBW) was a risk factor in females.
Conclusions:
- Threatened abortion is a risk factor for ADHD without comorbid conditions.
- Instrumental delivery and neonatal asphyxia are risk factors for ADHD with comorbid conditions.
- Specific perinatal factors like TA, NA, and LBW are significant risk factors for ADHD, with variations observed between sexes and comorbidity status.
Abstract:
Background: The relationship of events occurring during pregnancy and perinatal period with attention deficit/hyperactivity disorder (ADHD) is not clear. Thus, the focus of the current study was to examine the effects of events occurring during pregnancy and perinatal period on ADHD. Methods: A two-phase cross-sectional study was performed across 13 schools in Changsha and Yiyang cities from March to December, 2014. We preliminarily screened all students using CBCL and established the diagnosis using Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A total of 3,418 questionnaires were effectively completed in this study. Results: History of threatened abortion (TA) [odds ratio (OR): 1.707 (1.201-2.426)] (vs. No-TA) and neonatal asphyxia (NA) [OR: 2.497(1.225-5.09)] (vs. health) showed a positive association with ADHD. On subgroup analysis, TA [OR: 2.216 (1.458-3.369)] (vs. No-TA) was a risk factor for ADHD without comorbidity; instrumental delivery [OR: 2.748 (1.057-7.142)] (vs. natural birth) and NA [OR: 2.789 (1.222-6.361)] (vs. health) were risk factors for ADHD in the subgroup of ADHD with comorbidity; TA (vs. no-TA) and NA (vs. health) were risk factors for ADHD among male students [ORs: 2.232 (1.439-3.462) and 2.808 (1.115-7.068), respectively], while low birth weight (LBW) (vs. normal birth weight) was a risk factor [OR: 2.054 (1.063-3.967)] for ADHD among female students. Conclusion: TA was a risk factor for ADHD in the absence of comorbid conditions; instrumental delivery and NA were risk factors for ADHD in the subgroup of ADHD with comorbidity; TA and NA were risk factors for ADHD among male students. LBW was a risk factor for ADHD among female students.
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