703: Association between psychosocial disorder during pregnancy and childhood attention deficit hyperactivity disorder by gestational age and race/ethnicity

Abstract

pregnancy and childhood attention deficit hyperactivity disorder by gestational age and race/ethnicity Darios Getahun, Michael Fassett, Steven Jacobsen Kaiser Permanente Southern California, Research and Evaluation, Pasadena, CA, West Los Angeles Medical Center, Kaiser Permanente Southern California, Department of Obstetrics and Gynecology, Los Angeles, CA OBJECTIVE: Psychosocial distress disorder (PSD) during pregnancy is known to increase the risk of adverse perinatal outcomes. Because stressors during pregnancy may alter development of the fetal nervous system function and behavior later in life, we examined the association between PSD and childhood ADHD and whether the risk varies by gestational age and maternal race/ethnicity. STUDY DESIGN: A nested case-control study of singleton born children age 3-11 years delivered at 28 weeks of gestation (n 81,678) in Kaiser Permanente Southern California (KPSC) hospitals (1991-2006) was performed using the Perinatal Service System, Hospital Inpatient, Outpatient physician encounter, and Pharmacy records. ICD-9 codes from hospitalizations during pregnancy and infant birth certificates as well as pharmacy records on medication specific for PSD were used to ascertain the exposure and outcomes of interest. Adjusted odds ratio (OR) and 95% confidence interval (CI) were used to quantify the associations. RESULTS: Five percent of pregnancies were complicated by PSD. Compared with control children, case children were more likely to be male and of White or African-American race/ethnicity. Case children were more likely than control children to be exposed to PSD (OR 1.6, 95%CI 1.41.8). A stratified analysis by gestational age revealed that case children born at 34-36, and 37-42 weeks of gestation, were significantly more likely to be exposed to PSD (1.8-fold [95%CI 1.3, 2.5], and 1.6-fold [95%CI 1.4-1.8], respectively). PSD was associated with increased odds of ADHD across all racial/ethnic groups except Asian/Pacific Islanders. CONCLUSION: The results suggest that maternal PSD during pregnancy is associated with increased risk of childhood ADHD. Identification of at-risk children may provide the opportunity for early diagnosis and initiate treatment when it is more effective.