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Postpartum Depression Increases the Risk of Childhood Attention Deficit Hyperactivity Disorder Diagnosis
Darios Getahun1,2, Michael J Fassett3,4, Nana A Mensah5,6
1Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, 2nd Floor, Pasadena, CA, 91101, USA. Darios.T.Getahun@kp.org.
Insights
Mothers experiencing Postpartum Depression (PPD) have children with a higher risk of developing Attention Deficit Hyperactivity Disorder (ADHD). This association was observed across various demographics, suggesting PPD as a potential indicator for early ADHD intervention.
Area of Science:
- Perinatal Psychiatry
- Child Neurology
- Developmental Pediatrics
Background:
- Postpartum Depression (PPD) is a significant adverse pregnancy outcome.
- The correlation between maternal PPD and the development of Attention Deficit Hyperactivity Disorder (ADHD) in offspring requires further investigation.
- Understanding this link is crucial for early identification and intervention strategies.
Purpose of the Study:
- To determine if maternal Postpartum Depression (PPD) increases the risk of Attention Deficit Hyperactivity Disorder (ADHD) in children.
- To analyze how child's sex, race/ethnicity, and gestational age modify the association between PPD and ADHD.
- To identify potential early warning signs for ADHD in children born to mothers with PPD.
Main Methods:
- Retrospective cohort study utilizing electronic health records of 229,860 singleton births.
- Inclusion criteria: children aged 3-12 years, delivered between 01/01/2010-12/31/2019.
- Ascertainment of PPD and ADHD using ICD-9-CM/ICD-10-CM codes and pharmacy records; incidence rates and adjusted hazard ratios (aHR) calculated.
Main Results:
- Children of mothers with PPD had a significantly higher incidence of ADHD (8.85/1000 person-years) compared to those without PPD (5.18/1000 person-years), with an aHR of 1.76 (95% CI: 1.66-1.86).
- PPD was associated with increased ADHD risk in children born prematurely (29-32 weeks: aHR=1.61; 33-36 weeks: aHR=1.72).
- The association between PPD and increased ADHD risk was consistent across all racial/ethnic groups and both sexes.
Conclusions:
- Maternal Postpartum Depression (PPD) is associated with an elevated risk of Attention Deficit Hyperactivity Disorder (ADHD) in offspring.
- PPD may serve as a valuable indicator for identifying children who could benefit from early ADHD surveillance and intervention.
- Further research is necessary to elucidate a potential causal relationship or shared risk factors between PPD and ADHD.
Abstract:
Postpartum Depression (PPD) is a common adverse pregnancy outcome, but the extent to which PPD correlates with attention deficit hyperactivity disorder (ADHD) in the offspring is unclear. Therefore, we examined if children of mothers who experienced PPD are at risk for developing ADHD and how this association may be modified by the child's sex, race/ethnicity, and gestational age at delivery. A retrospective cohort study of singleton-born children aged 3-12 years and delivered in Kaiser Permanente Southern California hospitals between 01/01/2010-12/31/2019 (n = 229,860) was performed using electronic health records. ICD- 9-CM and ICD- 10-CM codes and pharmacy records were used to ascertain exposure and outcomes of interest. Incidence rates and adjusted hazard ratios (aHR) were estimated to quantify the association between PPD and childhood ADHD. Children of women with PPD were more likely to be diagnosed with ADHD than children of women without PPD (8.85 vs. 5.18/1000 person-years, aHR = 1.76, confidence interval (CI): 1.66-1.86). Among women who delivered at 29-32 and 33-36 weeks of gestation, PPD was associated with 1.61-fold (95% CI: 1.06-2.57) and 1.72-fold (95% CI: 1.44-2.06) increased risk of ADHD, respectively, compared to pregnancies without a history of PPD. PPD was associated with an increased ADHD risk for all racial/ethnic groups and both child sex categories. PPD may help identify at-risk children who could benefit from earlier surveillance and interventions. Additional studies are needed to determine if PPD has a causal relationship with ADHD or if these conditions have a common risk factor.
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