CORRELATION BETWEEN PREMATURE BIRTH WITH ADHD

By : Shabrina Herdiana Putri 030.08.222 Faculty of Medicine Trisakti University Jakarta, July 2011

ABSTRACT
Previous studies have demonstrated an increased risk for attention-deficit/ hyperactivity disorder (ADHD) in follow-up studies of preterm survivors from NICUs. This paper will explain the effect of moderate as well as extreme preterm birth on the risk for ADHD in school age, taking into account genetic, perinatal, and socioeconomic confounders.

CHAPTER I : INTRODUCTION

Increasing numbers of infants born preterm are reaching adulthood as a consequence of advances in perinatal care. A negative effect of preterm birth on the neurologic and psychological development of children and youth is well documented. Severe neurologic impairment has been reported in 10% to 12% of school-aged children born very preterm. Much higher rates have been reported for more subtle neurocognitive impairment with reports of lower IQ and poor academic achievement.

CHAPTER II : PREMATURE BIRTH

Birth that is at least 3 weeks before a baby's due date/preterm birth or less than 37 weeks Serious health risk for a baby leading cause of death among newborn babies

RISK FACTOR OF PREMATURE BIRTH

Carrying more than one baby (twins, triplets, quadruplets or more).

Having a previous preterm birth.

Problems with the uterus or cervix.

Chronic health problems in the mother, such as high blood pressure, diabetes, and clotting disorders.

Certain infection during pregnancy.

Cigarette smoking, alcohol use, or illicit drug use during pregnancy.

CHAPTER III : ADHD

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).

CHAPTER IV : FINDINGS
Several perinatal complications increased risk for short and long-term neurologic sequeale. Perinatal asphyxia hypoxic-ischemic encephalopathy in the neonate with widespread brain injuries as a consequence Poor intrauterine growth fetal hypoxia hypotension injure the striatal complex of the basal ganglia increase the number of dopamine receptors Undernutrition : during fetal brain development may also have long-term effects on attention, learning, and memory

At term birth

Gestational ages of 34-36 weeks : 70% increased risk of ADHD

 birth 90 % weights : increased 1500-2499 risk grams birth 50 % weights of increased 2500-2999 risk grams

family history of psychiatric disorders

comorbidity

socioeconomic status of the parents

risk of ADHD

maternal smoking during pregnancy

CHAPTER V : DISCUSSION

From those literature showed that preterm delivery near term and proxy measures of intrauterine growth in children born at or above term increase the risk of ADHD.

CONCLUSION
The association of preterm birth to ADHD is graded by degree of immaturity with significant increased risks also for children born moderately preterm. Children born preterm, also close to term, and children born at term with low birth weights (1500 2499 g) have an increased risk of clinically verified ADHD. These findings have important public health perspectives because the majority of preterm babies are born close to term.

REFERENCE

Lindstrm, K., Lindblad, F., Hjern, A. Preterm Birth and Attention-Deficit/ Hyperactivity Disorder in Schoolchildren. PEDIATRICS Vol. 127 No. 5 May 1, 2011. Delobel-Ayoub M, Arnaud C, White-Koning M, et al. Behavioral Problems and Cognitive Performance at 5 Years of Age After Very Preterm Birth: the EPIPAGE Study. Pediatrics. 2009;123(6):14851492. Levin, Aaron. Low Birth Weight, Prematurity Can Raise ADHD Risk. Psychiatric News by American Psychiatric Association Vol.41 No.15 p27. August 4, 2006. Linnet, K.M., Wisborg, K., Agerbo, E., Secher, N.J. Gestational age, birth weight, and the risk of hyperkinetic disorder. Arch Dis Child Vol. 91 Issue 8 p 655-660. 2006

REFERENCE (CONT)

Goodman, Brenda. Risk for Attention Deficit Hyperactivity Disorder in School Age Children Associated With Premature Birth. WebMD Health News. 2011. Taylor HG, Klein N, Minich NM, et al. Middle-school-age outcomes in children with very low birth weight. Child Dev 2000;71:1495511. Bhutta AT, Cleves MA, Casey PH, et al. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA 2002;288:72837. OKeeffe MJ, OCallaghan M, Williams GM, et al. Learning, cognitive, and attentional problems in adolescents born small for gestational age. Pediatrics 2003;112:3017.