Perinatal, maternal, and fetal characteristics of children diagnosed with attention-deficit-hyperactivity disorder: results from a population-based study utilizing the Swedish Medical Birth Register

Dev Med Child Neurol. 2011 Mar;53(3):263-8. doi: 10.1111/j.1469-8749.2010.03820.x. Epub 2010 Oct 21.

Abstract

Aim: The aim of this study was to evaluate the impact of pre- and perinatal factors on the risk of developing attention-deficit-hyperactivity disorder (ADHD).

Method: We investigated the medical history of 237 children (206 male; 31 female) from Malmö, Sweden born between 1986 and 1996 and in whom a diagnosis of ADHD (Diagnostic and Statistical Manual of Mental Disorders-IIIR or IV) was subsequently made at the Department of Child and Adolescent Psychiatry, Lund University, and a reference group of 31,775 typically developing children from Malmö using data from the Swedish Medical Birth Register.

Results: The results of multiple logistic regression analysis revealed that ADHD was significantly associated with a young maternal age (odds ratio [OR] for 5 y increase 0.87; 95% confidence interval [CI] 0.76-0.99), maternal smoking (OR 1.35; 95% CI 1.14-1.60), maternal birthplace in Sweden (OR 2.04; 95% CI 1.45-2.94), and preterm birth <32 weeks (OR 3.05; 95% CI 1.39-6.71), and a male predominance (OR 6.38; 95% CI 4.37-9.32). Apgar scores at 5 minutes below 7 were significantly associated with ADHD in the univariable analysis (OR 2.60; 95% CI 1.15-5.90). The population-attributable fraction of ADHD caused by the perinatal factors studied was estimated to be 2.8%.

Interpretation: The results indicate that the studied factors constitute weak risk factors for developing ADHD.

MeSH terms

  • Adult
  • Apgar Score
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Attention Deficit Disorder with Hyperactivity / etiology*
  • Birth Weight
  • Delivery, Obstetric / methods
  • Family Characteristics
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Male
  • Maternal Age
  • Maternal Behavior*
  • Mothers / statistics & numerical data*
  • Registries*
  • Risk Factors
  • Smoking / adverse effects
  • Sweden / epidemiology