Early-term Births Associated with Higher ADHD Rates

Author: Rutgers University
Published: 2022/08/12 - Updated: 2023/01/04
Peer Reviewed Publication: Yes
Category Topic: ADHD and ADD - Academic Publications

Page Content: Synopsis - Introduction - Main

Synopsis: Research study is the first on gestational age at term and ADHD in school-age children to use teacher reports of ADHD symptoms. ADHD, which affects more than 10 percent of U.S. school-age children, according to the Centers for Disease Control and Prevention (CDC), manifests early in childhood with symptoms of hyperactivity, impulsivity, or inattention and has known links to preterm birth (less than 37 weeks gestation).

Defining Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by excessive inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate. ADHD is associated with other neurodevelopmental and mental disorders and some non-psychiatric disorders, which can cause additional impairment, especially in modern society. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems. Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy), and therapy for any mental health conditions that occur along with ADHD.

Introduction

Gestational Age at Term and Teacher-Reported ADHD Symptom Patterns

Among children born at term (37-41 weeks), those born before 39 weeks are more likely to experience symptoms associated with attention-deficit/hyperactivity disorder (ADHD), according to a study by Rutgers Robert Wood Johnson Medical School.

Main Content

ADHD, which affects more than 10 percent of U.S. school-age children, according to the Centers for Disease Control and Prevention (CDC), manifests early in childhood with symptoms of hyperactivity, impulsivity, or inattention and has known links to preterm birth (less than 37 weeks gestation).

The study, published in the Journal of Pediatrics, is one of only a few to investigate the associations between gestational age at term (37-41 weeks) and a diagnosis or symptoms of ADHD. It is the first to include reports from teachers.

"Teachers' reports, in conjunction with maternal reports and physician evaluations, provide valuable input for the diagnosis of ADHD," said Nancy Reichman, author of the study and a professor of pediatrics at Rutgers Robert Wood Johnson Medical School.

"Mother-reported symptoms generally reflect behaviors in the home or small family or social groups, while teacher-reported symptoms reflect behaviors in a structured educational setting by professionals who work with a large number of children and observe the range of behaviors that students exhibit. In classrooms."

Reichman and her team, which included Rutgers Robert Wood Johnson Medical School neonatology fellow Geethanjali Linguasubramanian, sought to estimate the associations between gestational age at term and 9-year-old children's symptoms of ADHD reported by their teachers.

They analyzed data on about 1,400 children in the Fragile Families and Child Wellbeing study.

This U.S. birth cohort study randomly sampled births in 75 hospitals in 20 large U.S. cities from 1998 to 2000 and re-interviewed mothers over nine years. During the nine-year follow-up, consent was obtained to contact the children's teachers, who were asked to evaluate their students using the Conners' Teacher Rating Scale-Revised Short Form, which includes symptoms of hyperactivity, ADHD, oppositional behavior, and cognitive problems or inattention.

Overall, the Rutgers researchers found that children born early-term (37-38 weeks) had significantly higher scores on the teacher rating scales than full-term children (39-41 weeks) for hyperactivity, ADHD, and cognitive problems or inattention. Still, that gestational age wasn't significantly associated with oppositional behavior.

Specifically, the researchers found that each week of gestational age at term was associated with 6 percent lower hyperactivity scores and 5 percent lower ADHD and cognitive problems or inattention scores, and that birth at 37 to 38 weeks was associated with 23 percent higher hyperactivity scores and 17 percent higher ADHD scores when compared with birth at 39 to 41 weeks.

"The findings add to the growing evidence supporting current recommendations for delaying elective deliveries to at least 39 weeks and suggest that regular screenings for ADHD symptoms are important for children born at 37 to 38 weeks," Reichman said.

Preterm infants are at increased risk for ADHD because of immature brain development.

"Significant growth and development in various kinds of brain cells are observed between 34 and 40 weeks of gestation," said Reichman. "Infants born at full-term likely benefit from the additional one to two weeks of brain growth in utero compared with those born early-term."

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Rutgers University and published on 2022/08/12, this content may have been edited for style, clarity, or brevity.