Associations between birth weight and attention‐deficit/hyperactivity disorder symptom severity: indirect effects via primary neuropsychological functions

Abstract

Background ADHD has a range of aetiological origins which are associated with a number of disruptions in neuropsychological functioning. This study aims to examine how low birth weight, a proxy measure for a range of environmental complications during gestation, predicts ADHD symptom severity in preschool-aged children indirectly via neuropsychological functioning. Methods 197 preschool-aged children were recruited as part of a larger longitudinal study. Two neuropsychological factors were derived from NEPSY domain scores. One, referred to as ‘Primary Neuropsychological Function,’ loaded highly with Sensorimotor and Visuospatial scores. The other, termed ‘Higher-Order Function’ loaded highly with Language and Memory domain scores. Executive functioning split evenly across the two. Analyses examined whether these neuropsychological factors allowed for an indirect association between birth weight and ADHD symptom severity. Results While both factors were associated with symptom severity, only the Primary Neuropsychological Factor was associated with birth weight. Furthermore, birth weight was indirectly associated to symptom severity via this factor. Conclusions These data indicate that birth weight is indirectly associated with ADHD severity via disruption of neuropsychological functions that are more primary in function as opposed to functions that play a higher-order role in utilising and integrating the primary functions.

Sex moderates the impact of birth weight on child externalizing psychopathology.

“…Previous studies examining the association between LBW and ADHD have been inconsistent in controlling for prenatal substance use (Anderson et al, 2011; Botting et al, 1997; Class et al, 2014; Elgen, Sommerfelt, & Markestad, 2002; Elgen, Holsten, & Odberg, 2013; Hack et al, 2009; Halmoy, Klungsoyr, Skjaerven, & Haavik, 2012; Hatch, Healey, & Halperin, 2014; Szatmari et al, 1990). Additionally, more recent findings have indicated that prenatal tobacco exposure may not be causally associated with ADHD (D’Onofrio et al, 2008; Nigg & Breslau, 2007; Thapar et al, 2009), or may be predictive of comorbid externalizing spectrum psychopathology (i.e., ODD and CD), but not ADHD (Nigg & Breslau, 2007).…”

“…Further, parental age (both younger and older) has also been associated with increased risk for neurodevelopmental disorders, including ADHD (Gardener, Spiegelman, & Buka, 2009; Gustafsson & Kallen, 2011a). Parental age has also not been consistently covaried in studies investigating associations between LBW and ADHD (Anderson et al, 2011; Botting et al, 1997; Breslau et al, 1996; Elgen et al, 2002; Elgen et al, 2013; Hack et al, 2009; Hatch et al, 2014; Strang-Karlsson et al, 2008; Szatmari et al, 1990), and when parental age is used as a covariate, studies typically use maternal age, but not paternal age (Halmoy et al, 2012; Mick, Biederman, Prince, et al, 2002). …”

Pre- and Perinatal Risk for Attention-Deficit Hyperactivity Disorder: Does Neuropsychological Weakness Explain the Link?

“…Thus, pre- and perinatal health may indirectly influence risk for ADHD and other disruptive behavior disorders, such that early insults influence the development of cortico-striatal circuitry, resulting in neuropsychological dysfunction and subsequently increasing liability for ADHD and/or other disruptive behavior problems. Hatch, Healey, and Halperin (2014) recently demonstrated that primary neuropsychological functioning (defined as visuo-spatial perception and motor coordination) mediated associations between birth weight and ADHD symptoms. However, while innovative, this work did not consider potential differential effects of pre- and perinatal health risk on ADHD versus disruptive behavior disorders (Nigg & Breslau, 2007), other potentially relevant indicators of risk (e.g., teratogen exposure, complications during pregnancy and/or delivery, perinatal health), or familial confounds (i.e., potential impact of shared genetic and environmental factors).…”

Low birth weight and its association with attention deficit hyperactivity disorder (ADHD) in young children

“…Another study explains that birth weight has indirect effect on ADHD through primary neuropsychological functions. In fact, children with ADHD are more likely to have neuropsychological function problems, especially in children aged 3-4 years old (12).…”