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Preterm or early term birth and risk of attention-deficit/hyperactivity disorder : a national cohort and co-sibling study

Crump, Casey LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2023) In Annals of Epidemiology 86. p.4-125
Abstract

Purpose: To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. Methods: A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973–2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. Results: ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22–27 weeks), 7.0% for moderately preterm (28–33 weeks),... (More)

Purpose: To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. Methods: A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973–2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. Results: ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22–27 weeks), 7.0% for moderately preterm (28–33 weeks), 5.7% for late preterm (34–36 weeks), 6.1% for all preterm (<37 weeks), 5.2% for early term (37–38 weeks), and 4.5% for full-term (39–41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15–2.57), 1.28 (1.25–1.31), and 1.12 (1.10–1.13) among males, and 2.46 (2.17–2.78), 1.24 (1.20–1.28), and 1.08 (1.06–1.10) among females (P < .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18–1.24; and 1.39; 1.34–1.43, respectively). Conclusions: In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Attention deficit disorder, Attention deficit-hyperactivity disorder, Gestational age, Prematurity, Preterm birth
in
Annals of Epidemiology
volume
86
pages
4 - 125
publisher
Elsevier
external identifiers
  • pmid:37648179
  • scopus:85171359954
ISSN
1047-2797
DOI
10.1016/j.annepidem.2023.08.007
language
English
LU publication?
yes
id
a8562d8b-30e6-4098-8944-0bb1ea824092
date added to LUP
2023-12-07 11:04:57
date last changed
2024-04-20 05:23:20
@article{a8562d8b-30e6-4098-8944-0bb1ea824092,
  abstract     = {{<p>Purpose: To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. Methods: A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973–2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. Results: ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22–27 weeks), 7.0% for moderately preterm (28–33 weeks), 5.7% for late preterm (34–36 weeks), 6.1% for all preterm (&lt;37 weeks), 5.2% for early term (37–38 weeks), and 4.5% for full-term (39–41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15–2.57), 1.28 (1.25–1.31), and 1.12 (1.10–1.13) among males, and 2.46 (2.17–2.78), 1.24 (1.20–1.28), and 1.08 (1.06–1.10) among females (P &lt; .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18–1.24; and 1.39; 1.34–1.43, respectively). Conclusions: In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.</p>}},
  author       = {{Crump, Casey and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{1047-2797}},
  keywords     = {{Attention deficit disorder; Attention deficit-hyperactivity disorder; Gestational age; Prematurity; Preterm birth}},
  language     = {{eng}},
  pages        = {{4--125}},
  publisher    = {{Elsevier}},
  series       = {{Annals of Epidemiology}},
  title        = {{Preterm or early term birth and risk of attention-deficit/hyperactivity disorder : a national cohort and co-sibling study}},
  url          = {{http://dx.doi.org/10.1016/j.annepidem.2023.08.007}},
  doi          = {{10.1016/j.annepidem.2023.08.007}},
  volume       = {{86}},
  year         = {{2023}},
}