ADHD symptoms and diagnosis in adult preterms: systematic review, IPD meta-analysis, and register-linkage study
Robinson, Rachel; Girchenko, Polina; Pulakka, Anna; Heinonen, Kati; Lähdepuro, Anna; Lahti-Pulkkinen, Marius; Hovi, Petteri; Tikanmäki, Marjaana; Bartmann, Peter; Lano, Aulikki; Doyle, Lex W.; Anderson, Peter J.; Cheong, Jeanie L. Y.; Darlow, Brian A.; Woodward, Lianne J.; Horwood, L. John; Indredavik, Marit S .; Evensen, Kari Anne I.; Marlow, Neil; Johnson, Samantha; de Mendonca, Marina Goulart; Kajantie, Eero; Wolke, Dieter; Räikkönen, Katri (2022-01-07)
Robinson, R., Girchenko, P., Pulakka, A. et al. ADHD symptoms and diagnosis in adult preterms: systematic review, IPD meta-analysis, and register-linkage study. Pediatr Res 93, 1399–1409 (2023). https://doi.org/10.1038/s41390-021-01929-1
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https://urn.fi/URN:NBN:fi-fe20231109143698
Tiivistelmä
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.
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