Related Experiment Videos
Pregnancy, delivery and infancy complications and attention deficit hyperactivity disorder: issues of
S Milberger1, J Biederman, S V Faraone
1Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA.
Insights
Pregnancy, delivery, and infancy complications (PDICs) are linked to attention deficit hyperactivity disorder (ADHD) in boys. Specific chronic exposure complications, not genetics, appear to be key factors.
Area of Science:
- Neurodevelopmental Disorders
- Pediatric Psychiatry
- Genetics and Genomics
Background:
- Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder.
- The etiology of ADHD involves genetic and environmental factors.
- The role of pregnancy, delivery, and infancy complications (PDICs) in ADHD development requires further investigation.
Purpose of the Study:
- To evaluate the association between PDICs and ADHD in a cohort of boys.
- To explore the relationship between PDICs and ADHD comorbidities and familial patterns.
- To identify specific PDICs contributing to ADHD etiology.
Main Methods:
- Case-control study involving boys aged 6-17 with ADHD (n=140) and controls (n=120).
- First-degree biologic relatives were included to assess familial patterns.
- Mothers provided standardized, blinded information on PDICs.
- Linear and logistic regression models were used for statistical analysis.
Main Results:
- A significant positive association was found between ADHD and PDICs in probands.
- PDICs were also associated with ADHD correlates, including impaired cognitive functioning and poor school performance.
- Specific complications reflecting chronic exposure (maternal bleeding, smoking, family problems, illicit drug use) were significant predictors.
- No interaction between genetic factors and PDICs was identified.
Conclusions:
- Findings support an association between ADHD and PDICs.
- Specific chronic exposure complications during pregnancy are implicated in ADHD etiology.
- Results may guide clinical focus towards particular perinatal complications in ADHD assessment.
Abstract:
We evaluated the role of pregnancy, delivery, and infancy complications (PDICs) in the etiology of attention deficit hyperactivity disorder (ADHD) and addressed issues of comorbidity and familiarity by testing multiple hypotheses. Subjects were 6-17-year-old boys with DSM-III-R ADHD (n = 140) and normal controls (n = 120) and their first-degree biologic relatives. Information on PDICs was obtained from mothers in a standardized manner blind to the proband's clinical status. Using linear and logistic regression models, a positive association was found between ADHD and PDICs in the probands. Additionally, PDICs were associated with the correlates of ADHD (i.e., impaired cognitive functioning and poor school performance). Moreover, it was those specific complications that reflect chronic exposure, such as maternal bleeding, smoking, family problems, and illicit drug use during pregnancy that accounted for these findings. No interaction between genetic factors and PDICs were found. Our findings add to the literature supporting an association between ADHD and PDICs. Our results may help clinicians focus on particular complications rather than the wide range of possible perinatal complications.