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Premature birth raises odds for ADHD

The risk that children will develop attention-deficit / hyperactivity disorder (ADHD) rises with every week they are born short of full term.

Premature birth raises odds for ADHD

The risk that children will develop attention-deficit / hyperactivity disorder (ADHD) rises with every week they are born short of full term.

Increasing numbers of infants born preterm are reaching adulthood as a consequence of advances in newborn care. Attention-de?cit / hyperactivity disorder (ADHD) is the most common neuro-developmental disorder in Western countries and studies have indicated that attention problems are more common in children born preterm.

To analyse the effect of different levels of preterm birth on ADHD, taking genetic, environmental and perinatal risk factors into consideration , researchers collected data on almost 1 180 616 Swedish children born between 1987 and 2000. These children were followed to see if they took medication for ADHD when they were between 6 to 19 years old.

It was found that the earlier the birth, the greater the risk the child would develop ADHD. The uptick in risk ranged from between 10 to 20 percent for children born at 37 to 38 weeks of gestation, to 40 percent for those born at 33 and 34 weeks, and 60 percent for those born at 29 to 32 weeks of gestation. Children born very preterm - 23 to 28 weeks - had double the odds of a full-term baby of developing ADHD.  This effect was largely independent of socioeconomic, perinatal, and genetic factors. However, social adversity, as de?ned by low maternal education, increased the effect of moderately preterm birth on the risk of ADHD.

The gradual risk increase for ADHD by increasing degree of immaturity seems to point to the role of brain development for explaining the main mechanisms linking preterm birth with ADHD.

These findings have important implications for planned caesarian births, which are often performed during these very weeks as pre-term birth could impact the neurological, developmental, cognitive and behavioural health of the children. To minimise the risk for ADHD, these births should be planned as close to the full term date - that is, week 40 - as possible. The researchers suggest that more attention is needed toward the advancement of care and follow-up for infants born even moderately preterm.
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