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ADHD symptoms and diagnosis in adult preterms : systematic review, IPD meta-analysis, and register-linkage study

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Robinson, Rachel, Girchenko, Polina, Pulakka, Anna, Heinonen, Kati, Lähdepuro, Anna, Lahti-Pulkkinen, Marius, Hovi, Petteri, Tikanmäki, Marjaana, Bartmann, Peter, Lano, Aulikki et al.
(2022) ADHD symptoms and diagnosis in adult preterms : systematic review, IPD meta-analysis, and register-linkage study. Pediatric Research . doi:10.1038/s41390-021-01929-1 (In Press)

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Official URL: http://dx.doi.org/10.1038/s41390-021-01929-1

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Abstract

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.

Item Type: Journal Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine
R Medicine > RJ Pediatrics
Divisions: Faculty of Science > Psychology
Library of Congress Subject Headings (LCSH): Attention-deficit hyperactivity disorder, Behavior disorders in children, People with mental disabilities , Developmental disabilities, Premature infants -- Development, Premature infants -- Growth , Premature infants -- Physiology , Premature infants -- Psychology
Journal or Publication Title: Pediatric Research
Publisher: Nature Publishing Group
ISSN: 0031-3998
Official Date: 7 January 2022
Dates:
DateEvent
7 January 2022Available
14 December 2021Accepted
DOI: 10.1038/s41390-021-01929-1
Status: Peer Reviewed
Publication Status: In Press
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
733280 (RECAP-Preterm)Horizon 2020 Framework Programmehttp://dx.doi.org/10.13039/100010661
724363 European Commissionhttp://dx.doi.org/10.13039/501100000780
462.16.100 University of Warwickhttp://dx.doi.org/10.13039/501100000741
462.16.101Helsingin Yliopistohttp://dx.doi.org/10.13039/100007797
315690Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
330206Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
128459Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
12848591Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
1312670Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
1324596Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
323910Academy of Finlandhttp://dx.doi.org/10.13039/501100002341
1153176National Health and Medical Research Councilhttp://dx.doi.org/10.13039/501100000925
1104300National Health and Medical Research Councilhttp://dx.doi.org/10.13039/501100000925
1176077National Health and Medical Research Councilhttp://dx.doi.org/10.13039/501100000925
1141354 (MRFF)Australia. Department of Healthhttp://viaf.org/viaf/134198971
UNSPECIFIEDLastentautien tutkimuskeskushttp://lastentautientutkimuskeskus.fi/en/
UNSPECIFIEDSigrid Juséliuksen Säätiöhttp://dx.doi.org/10.13039/501100006306
UNSPECIFIEDSigne ja Ane Gyllenbergin Säätiöhttp://dx.doi.org/10.13039/501100004325
UNSPECIFIEDNovo Nordiskhttp://dx.doi.org/10.13039/501100004191

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