TY - JOUR
T1 - ADHD symptoms and diagnosis in adult preterms
T2 - systematic review, IPD meta-analysis, and register-linkage study
AU - Robinson, Rachel
AU - Girchenko, Polina
AU - Pulakka, Anna
AU - Heinonen, Kati
AU - Lähdepuro, Anna
AU - Lahti-Pulkkinen, Marius
AU - Hovi, Petteri
AU - Tikanmäki, Marjaana
AU - Bartmann, Peter
AU - Lano, Aulikki
AU - Doyle, Lex W.
AU - Anderson, Peter J.
AU - Cheong, Jeanie L.Y.
AU - Darlow, Brian A.
AU - Woodward, Lianne J.
AU - Horwood, L. John
AU - Indredavik, Marit S.
AU - Evensen, Kari Anne I.
AU - Marlow, Neil
AU - Johnson, Samantha
AU - de Mendonca, Marina Goulart
AU - Kajantie, Eero
AU - Wolke, Dieter
AU - Räikkönen, Katri
N1 - Funding Information:
This work was supported by funding from the European Union Horizon 2020 Grant # 733280 for RECAP, the European Commission NORFACE Dynamics of Inequality Across the Life course Grant #724363 (University of Warwick No. 462.16.100; University of Helsinki 462.16.101) for PremLife, Academy of Finland Grant #315690, 323910, 128459, 12848591, 1312670, 1324596, 330206, NHMRC (Australia) Grant #1153176; #1104300, #1176077, MRFF (Australia) #1141354, The Foundation for Pediatric Research (Finland), Sigrid Juselius Foundation; Signe and Ane Gyllenberg Foundation; Novo Nordisk Foundation. Open Access funding provided by University of Helsinki including Helsinki University Central Hospital.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022
Y1 - 2022
N2 - Background: This study examined differences in ADHD symptoms and diagnosis between preterm and term-born adults (≥18 years), and tested if ADHD is related to gestational age, birth weight, multiple births, or neonatal complications in preterm borns. Methods: (1) A systematic review compared ADHD symptom self-reports and diagnosis between preterm and term-born adults published in PubMed, Web of Science, and PROQUEST until April 2021; (2) a one-stage Individual Participant Data(IPD) meta-analysis (n = 1385 preterm, n = 1633 term; born 1978–1995) examined differences in self-reported ADHD symptoms[age 18–36 years]; and (3) a population-based register-linkage study of all live births in Finland (01/01/1987–31/12/1998; n = 37538 preterm, n = 691,616 term) examined ADHD diagnosis risk in adulthood (≥18 years) until 31/12/2016. Results: Systematic review results were conflicting. In the IPD meta-analysis, ADHD symptoms levels were similar across groups (mean z-score difference 0.00;95% confidence interval [95% CI] −0.07, 0.07). Whereas in the register-linkage study, adults born preterm had a higher relative risk (RR) for ADHD diagnosis compared to term controls (RR = 1.26, 95% CI 1.12, 1.41, p < 0.001). Among preterms, as gestation length (RR = 0.93, 95% CI 0.89, 0.97, p < 0.001) and SD birth weight z-score (RR = 0.88, 95% CI 0.80, 0.97, p < 0.001) increased, ADHD risk decreased. Conclusions: While preterm adults may not report higher levels of ADHD symptoms, their risk of ADHD diagnosis in adulthood is higher. Impact: Preterm-born adults do not self-report higher levels of ADHD symptoms, yet are more likely to receive an ADHD diagnosis in adulthood compared to term-borns.Previous evidence has consisted of limited sample sizes of adults and used different methods with inconsistent findings. This study assessed adult self-reported symptoms across 8 harmonized cohorts and contrasted the findings with diagnosed ADHD in a population-based register-linkage study.Preterm-born adults may not self-report increased ADHD symptoms. However, they have a higher risk of ADHD diagnosis, warranting preventive strategies and interventions to reduce the presentation of more severe ADHD symptomatology in adulthood.
AB - Background: This study examined differences in ADHD symptoms and diagnosis between preterm and term-born adults (≥18 years), and tested if ADHD is related to gestational age, birth weight, multiple births, or neonatal complications in preterm borns. Methods: (1) A systematic review compared ADHD symptom self-reports and diagnosis between preterm and term-born adults published in PubMed, Web of Science, and PROQUEST until April 2021; (2) a one-stage Individual Participant Data(IPD) meta-analysis (n = 1385 preterm, n = 1633 term; born 1978–1995) examined differences in self-reported ADHD symptoms[age 18–36 years]; and (3) a population-based register-linkage study of all live births in Finland (01/01/1987–31/12/1998; n = 37538 preterm, n = 691,616 term) examined ADHD diagnosis risk in adulthood (≥18 years) until 31/12/2016. Results: Systematic review results were conflicting. In the IPD meta-analysis, ADHD symptoms levels were similar across groups (mean z-score difference 0.00;95% confidence interval [95% CI] −0.07, 0.07). Whereas in the register-linkage study, adults born preterm had a higher relative risk (RR) for ADHD diagnosis compared to term controls (RR = 1.26, 95% CI 1.12, 1.41, p < 0.001). Among preterms, as gestation length (RR = 0.93, 95% CI 0.89, 0.97, p < 0.001) and SD birth weight z-score (RR = 0.88, 95% CI 0.80, 0.97, p < 0.001) increased, ADHD risk decreased. Conclusions: While preterm adults may not report higher levels of ADHD symptoms, their risk of ADHD diagnosis in adulthood is higher. Impact: Preterm-born adults do not self-report higher levels of ADHD symptoms, yet are more likely to receive an ADHD diagnosis in adulthood compared to term-borns.Previous evidence has consisted of limited sample sizes of adults and used different methods with inconsistent findings. This study assessed adult self-reported symptoms across 8 harmonized cohorts and contrasted the findings with diagnosed ADHD in a population-based register-linkage study.Preterm-born adults may not self-report increased ADHD symptoms. However, they have a higher risk of ADHD diagnosis, warranting preventive strategies and interventions to reduce the presentation of more severe ADHD symptomatology in adulthood.
UR - http://www.scopus.com/inward/record.url?scp=85122665722&partnerID=8YFLogxK
U2 - 10.1038/s41390-021-01929-1
DO - 10.1038/s41390-021-01929-1
M3 - Article
C2 - 34997222
AN - SCOPUS:85122665722
JO - Pediatric Research
JF - Pediatric Research
SN - 0031-3998
ER -