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Early preterm birth tied to ADHD in preschoolers
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Early preterm birth was associated with ADHD in children aged 5 years and inattentive symptoms in children aged 8 years, according to recently published study results in JAMA Pediatrics.
“Our results suggest that being born early preterm increases the risk of symptoms of ADHD in preschool-age children, and the risk of inattentive symptoms in school-aged children,” Helga Ask, PhD, senior researcher, Department of Mental Disorders, Norwegian Institute of Public Health, told Infectious Diseases in Children. “Our conclusions are strengthened by using a sibling comparison design, comparing ADHD symptoms in siblings with a different length of pregnancy in the same stomach (adjusting for shared genetic and environmental factors).”
Ask and colleagues recruited pregnant women between 1999 and 2008 from across Norway for a prospective cohort study. The researchers used data from the Norwegian Mother and Child Cohort Study to compare results of the cohort study with siblings.
Data analysis conducted between Oct. 1, 2012, and March 16, 2018, compared children and siblings by gestational age group, including early preterm (delivery at weeks 22-33), late preterm (weeks 34-36), early term (weeks 37-38), delivery at gestational week 39, reference group (week 40), delivery at week 41 and late-term (delivery after week 41).
The researchers defined the main outcome measures as maternally reported symptoms of ADHD in children aged 5 years and hyperactivity/impulsivity in children aged 8 years.
The study included 113,227 children (48.7% girls), with 28% born at gestational week 40. There were 33,081 siblings (48.4% girls), with 29.3% born at gestational week 40.
The researchers found that children born early preterm displayed more symptoms of ADHD, inattention and hyperactivity/impulsivity compared with term-born children.
When they were compared with the reference group of children born at gestational age 40 weeks, early preterm children scored higher on ADHD at 5 years of age, with a mean score of 0.24 standardized difference (95% CI, 0.14-0.34), on inattention at 8 years of age (0.33 SD; 95% CI, 0.24-0.42) and on hyperactivity/impulsivity (0.23 SD; 95% CI, 0.14-0.32).
Symptoms of ADHD in children aged 5 years were more strongly associated with girls, with early preterm girls having a mean score of 0.8 SD higher compared with term-born sisters (95% CI, 0.12-1.46).
“Our findings indicate that children born early preterm could be the target for selective prevention programs,” Ask said. “They should be followed up to detect families and children in need of guidance or treatment. Early identification and detection could prevent the development of ADHD symptoms in children.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
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