Related Experiment Video
Updated: Jul 17, 2025

Author Spotlight: Collecting the Brain and Serum from the Same Mice Fetus to Study Brain Tumor Development
Published on: May 17, 2024
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.
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.
Purpose:
To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences.
Methods:
A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973-2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors.
Results:
ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22-27 weeks), 7.0% for moderately preterm (28-33 weeks), 5.7% for late preterm (34-36 weeks), 6.1% for all preterm (<37 weeks), 5.2% for early term (37-38 weeks), and 4.5% for full-term (39-41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15-2.57), 1.28 (1.25-1.31), and 1.12 (1.10-1.13) among males, and 2.46 (2.17-2.78), 1.24 (1.20-1.28), and 1.08 (1.06-1.10) among females (P < .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18-1.24; and 1.39; 1.34-1.43, respectively).
Conclusions:
In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.
More Related Videos
19:15Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
Related Concept Videos
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
Conduct Disorder
Human Genetics
The complex relationship between genetics and psychology is observable through common biological components such...
Socioemotional Development during Infancy
Primary Temperament Types
Behavioral Genetics and Its Designs
The primary methodologies used in behavior genetics include family studies, twin studies, and adoption studies, each providing unique...