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Association between birth weight and neurodevelopmental disorders assessed using the Korean National Health Insurance
In Gyu Song1,2, Han-Suk Kim3, Yoon-Min Cho4
1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Low birth weight (LBW) in infants is linked to higher risks of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Even babies under 2.5 kg showed increased odds of these neurodevelopmental disorders.
Area of Science:
- Neuroscience
- Pediatrics
- Public Health
Background:
- Low birth weight (LBW) is a known risk factor for neurodevelopmental disorders, but the association with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) requires further investigation.
- Existing research on the link between LBW and neurodevelopmental outcomes is debated, necessitating large-scale studies to clarify these risks.
Purpose of the Study:
- To investigate the association between infant birth weight and the risk of developing ADHD and ASD in school-aged children.
- To determine if birth weight categories, particularly those below 2.5 kg, correlate with increased odds of ADHD and ASD diagnoses.
Main Methods:
- Retrospective cohort study utilizing Korean National Health Insurance claims data.
- Inclusion of 2,143,652 children born between 2008 and 2012.
- Analysis of ADHD and ASD diagnoses based on birth weight categories, with subgroup analysis excluding perinatal diseases.
Main Results:
- Infants with birth weights <1.5 kg, 1.5-1.9 kg, and 2.0-2.4 kg showed significantly increased odds of ADHD.
- Infants with birth weights 1.5-1.9 kg and 2.0-2.4 kg had substantially higher odds of ASD.
- These associations persisted even in children without perinatal diseases, indicating birth weight as an independent risk factor.
Conclusions:
- Infants born with birth weights below 2.5 kg are at an elevated risk for both ADHD and ASD.
- The findings underscore the importance of close clinical monitoring and follow-up for all low birth weight infants.
- This study highlights birth weight as a critical factor in the development of neurodevelopmental disorders, irrespective of perinatal complications.
Abstract:
The risk of neurodevelopmental disorders in low birth weight (LBW) infants has gained recognition but remains debatable. We investigated the risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-aged children according to their birth weight. We conducted a retrospective cohort study using the Korean National Health Insurance claims data of 2,143,652 children who were born between 2008 and 2012. Gestational age of infants was not available; thus, outcomes were not adjusted with it. Not only infants with birth weights of < 1.5 kg, but also 2.0-2.4 kg and 1.5-1.9 kg were associated with having ADHD; odds ratio (OR), 1.41 (95% confidence interval [CI] 1.33-1.50), and 1.49 (95% CI 1.33-1.66), respectively. The OR in infants with birth weights of 2.0-2.4 kg and 1.5-1.9 kg was 1.91 (95% CI 1.79-2.05) and 3.25 (95% CI 2.95-3.59), respectively, indicating increased odds of having ASD. Subgroup analysis for children without perinatal diseases showed similar results. In this national cohort, infants with birth weights of < 2.5 kg were associated with ADHD and ASD, regardless of perinatal history. Children born with LBW need detailed clinical follow-up.
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