December 2, 2013
News Review From Harvard Medical School -- Pregnancy Problems May Have Role in ADHD
Some problems in pregnancy and birth increase a child's odds of having an attention disorder, a new study suggests. Researchers from Australia did the study. They used data on nearly 13,000 children. Records showed that they were taking medicine for attention-deficit hyperactivity disorder (ADHD). Researchers also looked at information from a pregnancy database. Then they randomly chose another 30,000 children from that database. This group was used for comparison. Mothers of children with ADHD were more likely to have smoked or had a urinary tract infection while they were pregnant. Some problems related to labor also occurred more often for children with ADHD. They were more likely to have been born after induced labor. Threats of going into early labor also were more common. Their mothers also were more likely to have had a problem called preeclampsia during pregnancy. The journal Pediatrics published the study December 2.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Now there's yet another reason to stay healthy during pregnancy: It might help prevent attention-deficit hyperactivity disorder (ADHD).
Researchers in Australia looked at the records of nearly 13,000 children and teenagers who were diagnosed with ADHD. They looked at the health records of their mothers, as well as pregnancy and birth information. For comparison, they also looked at the records of more than 30,000 randomly selected children born in Western Australia.
The study found that mothers of children with ADHD were more likely to:
- Be younger
- Be single
- Have smoked in pregnancy
- Have induced labor
- Have preterm labor, or early-term delivery
- Have preeclampsia
- Have a urinary tract infection during pregnancy
It's important that we learn everything we can about the causes of ADHD, because it's so common. A recent report from the U.S. Centers for Disease Control and Prevention (CDC) showed that 11% of children between the ages of 4 and 17 have been diagnosed with ADHD. This is up 41% since 2003, when 7.8% had this diagnosis.
Children with ADHD are more likely to struggle in school and struggle socially. They are more likely to get into trouble, and to have problems with substance abuse. One-third or more of youth with ADHD will continue to struggle with it as adults. Even if they don't still carry the diagnosis, adults who had ADHD as children are more likely to have substance abuse and other mental health problems. They are also more likely to try to commit suicide.
We don't do a great job of treating ADHD. That's because treating it is complicated. While medicine helps, it's no guarantee of success. People with ADHD need behavioral therapy to learn to manage their difficulties with attention. They do best when they get this therapy along with medicine. But sadly, many people with ADHD don't get the behavioral therapy they need. That's why preventing ADHD is so important.
What makes ADHD particularly hard to understand and prevent is that every child who has it is different. It doesn't just have one cause; there are many causes. It appears to run in families. Early exposure to television may play a role. So may other exposures and environmental factors. Ultimately, though, we just don't know what causes it.
For some time, researchers have believed that events during pregnancy contribute to ADHD. However, many studies haven't been big enough to say anything definitive. Because there were so many children in this study, the information is more useful.
What Changes Can I Make Now?
It's hardly news that pregnancy ideally should happen when a woman is in a supportive relationship, with the resources to take care of herself and her child. And it's hardly news that pregnant women should take care of themselves and get regular obstetrical care (starting early in the pregnancy). We have known this for a long time.
And yet, far too many women end up pregnant when they don't have the support they need. Far too many women don't get the care they need, or aren't able to take care of themselves. Far too often, it's the child who suffers.
If you are considering pregnancy, or are pregnant, please take it very seriously and do everything you can to ensure your health and the health of your child. It's not just ADHD you may prevent. Healthy pregnancies help prevent many problems, and give children their best start in life.
As a society, we need to value the health of our mothers-to-be, and put real resources into making sure we give every child the best start possible.
What Can I Expect Looking to the Future?
With ADHD numbers on the rise, it's very important that we work to understand the causes -- and how we can prevent it. This study helps us do that. I hope there will be many more like it.