Preterm or early term birth and risk of attention-deficit/hyperactivity disorder: a national cohort and co-sibling

Casey Crump1, Jan Sundquist2, Kristina Sundquist2

  • 1Departments of Family Medicine and Community Health and of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.

Annals of Epidemiology
|August 30, 2023
PubMed

Insights

Preterm and early term births increase the risk of attention-deficit/hyperactivity disorder (ADHD) in children, regardless of shared familial factors. This risk affects both males and females, highlighting the importance of birth timing for neurodevelopmental outcomes.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Genetics

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
  • Preterm birth and early term birth are known risk factors for adverse neurodevelopmental outcomes.

Purpose of the Study:

  • To investigate the association between preterm and early term birth and the risk of ADHD.
  • To explore potential sex-specific differences in this association.

Main Methods:

  • A large national cohort study of singleton births in Sweden (1973-2013) was conducted.
  • Infant survivors were followed up for ADHD diagnoses and medication records through 2018.
  • Poisson regression and co-sibling analyses were used to assess risks and control for confounding factors.

Main Results:

  • ADHD prevalence was higher in preterm (6.1%) and early term (5.2%) births compared to full-term births (4.5%).
  • Preterm birth was associated with a 28% increased risk of ADHD (PR=1.28), and early term birth with a 12% increased risk (PR=1.12), with similar risks for males and females.
  • These associations remained significant after adjusting for sociodemographic, perinatal, and shared familial factors.

Conclusions:

  • Preterm and early term birth are independent risk factors for ADHD in both males and females.
  • The findings underscore the vulnerability of infants born prematurely or early term to neurodevelopmental challenges like ADHD.
Abstract

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