Antecedents of Screening Positive for Attention Deficit Hyperactivity Disorder in 10-Year Old Children Born Extremely Preterm.

Publication date: Available online 21 December 2017
Source:Pediatric Neurology
Author(s): Alan Leviton, Stephen R. Hooper, Scott J. Hunter, Megan N. Scott, Elizabeth N. Allred, Robert M. Joseph, T. Michael O'Shea, Karl Kuban
BackgroundAttention deficit hyperactivity disorder (ADHD) incidence is higher among children born very preterm than among children who are mature at birth.MethodsWe studied 583 ten-year old children born before 28 weeks of gestation whose IQ was above 84 and had a parent-completed Child Symptom Inventory-4 (CSI-4), which allowed classifying the child as having or not having symptoms of ADHD. For 422 we also had a teacher report, and for 583 we also had a parent report of whether or not a physician made an ADHD diagnosis.ResultsThe risk profile of screening positive for ADHD based on a parent's report (P) differed from the risk profile based on the teacher's (T) report, while the risk profile according to a physician (MD), and according to any 2 observers (2) closely resembled the parent-report profile. Among the statistically significant risk factors were young maternal age (P, MD, 2), maternal obesity (P, MD, 2), maternal smoking (P, MD, 2), magnesium given at delivery for seizure prophylaxis (P, 2), recovery of Mycoplasma sp from the placenta (T, 2), low gestational age (P, 2), low birth weight (T, MD), singleton (P, MD, 2), male (P,T, MD, 2), mechanical ventilation on postnatal day 7 (MD), receipt of a sedative (P, 2), retinopathy of prematurity (P), necrotizing enterocolitis (MD), antibiotic receipt (MD, 2), and ventriculomegaly on brain scan (P, 2).ConclusionThe multiplicity of risk factors identified can be subsumed as components of four broad themes, low socioeconomic state, immaturity/vulnerability, inflammation, and epigenetic phenomena.



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