Preterm postnatal complications and risk of attention‐deficit/hyperactivity disorder

Abstract

Aim To investigate the association between the risk of attention‐deficit/hyperactivity disorder (ADHD) and preterm birth and determine how postnatal complications in children born preterm is associated with the risk of ADHD. Method This population‐based cohort study used data from the Hong Kong electronic medical records. We followed 359 614 children (48% female; 6–17 years old, mean 11 years 7 months, SD 3 years 2 months) born in public hospitals in Hong Kong from 1st January 2004 to 31st December 2014 and collected medical records and demographic details for mothers and children until 11th November 2020. Results The risk of ADHD was 4.0% in children born at term and 5.1% in children born preterm. The odds ratio for ADHD was 2.08 (95% confidence interval [CI] 1.64–2.64) for children born extremely preterm, 1.64 (95% CI 1.46–1.85) for children born very preterm, and 1.15 (95% CI 1.08–1.23) for children born late preterm. Among preterm postnatal complications, only early respiratory disease, retinopathy of prematurity (ROP), and intraventricular haemorrhage were significant predictors of ADHD after controlling for preterm birth, other risk factors, and sociodemographic variables. The excess risk of ADHD among children born very preterm or late preterm could be partly explained by respiratory disease. ROP partially mediated the risk of ADHD in children born very preterm. Interpretation Children born preterm in all subcategories, from extremely preterm to late preterm, have increased risk of ADHD. Early respiratory infection partially mediates the risk of ADHD in children born preterm.

Early Dental Visit Affects Dental Treatment in Korean Preschool Children Born Preterm: A Nationwide Population-Based Study

“…higher hyperactivity, and the manifestation of externalizing and internalizing problems [19,21,22] in preterm children than in FT children. Owing to their diminished cooperation and di culties in behavioral regulation, dentists tend to aim to complete treatment on the same day [23,24].…”

Mediators of attention‐deficit/hyperactivity disorder risk in individuals born preterm

“…While therapeutic hypothermia improves outcome after moderate and severe neonatal hypoxic-ischaemic encephalopathy (HIE) in high-income countries, many cooled infants without cerebral palsy (CP) have cognitive impairment and memory deficits during childhood. 1 They are less school-ready than typically developing peers and often have behavioural difficulties and special educational needs. These children may easily slip through the net if careful, longterm follow-up assessments are not performed.…”

“…Yuta Shinya https://orcid.org/0000-0002-5229-1554 Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children born preterm, with the highest risk group being those born extremely preterm (birth before 28 weeks of gestation). 1 In a large cohort of individuals born extremely preterm, ADHD was the most common psychiatric outcome at 15 years of age with a prevalence of 18%. 2 As compared to individuals born at term, those born most extremely preterm (22-25 weeks of gestation) have a more than fourfold increase in odds of any ADHD diagnosis, with tenfold increase in odds of ADHD inattentive subtype.…”

“…Despite the potential value of such studies, very few research reports have described specific antecedents of ADHD among individuals born preterm. The study by Tso et al 1 begins to fill this knowledge gap by analyzing relationships between postnatal complications and ADHD in a large population‐based sample of children born in Hong Kong. In this sample, early respiratory diseases, retinopathy of prematurity (ROP), and intraventricular hemorrhage mediated the relationship between preterm birth and ADHD, with the proportion mediated varying considerably as a function of prevalence.…”

“…Attention‐deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children born preterm, with the highest risk group being those born extremely preterm (birth before 28 weeks of gestation) 1 . In a large cohort of individuals born extremely preterm, ADHD was the most common psychiatric outcome at 15 years of age with a prevalence of 18% 2 .…”