Departments of Research & Evaluation and.
Psychiatry, Kaiser Permanente Southern California, Pasadena, CA.
J Dev Behav Pediatr. 2019 Jun;40(5):321-329. doi: 10.1097/DBP.0000000000000669.
To assess the interaction between maternal attention-deficit/hyperactivity disorder (ADHD) history and young parental age on child's ADHD risk.
The study included 321,272 singleton children born between 1995 and 2012 from hospitals within a single integrated health care organization. The children were prospectively followed up through electronic medical record systems from birth until the first date of the following: date of clinical diagnosis of ADHD, last date of continuous health plan membership, death due to any cause, or December 31, 2017. Risks of ADHD associated with a maternal history of ADHD before pregnancy and young parental age were assessed by using Cox regression adjusting for potential confounders.
The children were followed up for a median (interquartile range) of 8.9 (6.2, 13.6) years from birth. Among them, 5.1% had ADHD diagnosis, 1.8% had a maternal history of ADHD before the pregnancy, and 4.4% had mothers <20 years and 2.3% had fathers <20 years at date of birth. The hazard ratio (HR) of ADHD in children associated with parental age <20 years varied by maternal history of ADHD (p < 0.005 for both multiplicative and additive interactions). For children without a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.14 (95% confidence interval 1.04-1.24). However, for children with a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.92 (95% confidence interval 1.31-2.82).
High ADHD risk in offspring associated with young parenthood was predominantly observed among children with a maternal history of ADHD.
评估母体注意缺陷多动障碍（ADHD）病史和年轻父母年龄对儿童 ADHD 风险的交互作用。
本研究纳入了 1995 年至 2012 年期间在单一综合医疗保健组织内医院出生的 321272 名单胎儿童。通过电子病历系统从出生开始对儿童进行前瞻性随访，直到以下日期之一：ADHD 的临床诊断日期、连续健康计划成员资格的最后日期、任何原因导致的死亡或 2017 年 12 月 31 日。使用 Cox 回归调整潜在混杂因素，评估母体妊娠前 ADHD 病史和年轻父母年龄与 ADHD 风险之间的关联。
儿童从出生起中位（四分位距）随访 8.9（6.2，13.6）年。其中，5.1%的儿童被诊断为 ADHD，1.8%的母亲在妊娠前有 ADHD 病史，4.4%的母亲在出生日期时年龄<20 岁，2.3%的父亲年龄<20 岁。与父母年龄<20 岁相关的 ADHD 儿童的风险比（HR）因母体 ADHD 病史而异（两者的乘法和加法交互作用均<0.005）。对于没有母体 ADHD 病史的儿童，至少有 1 位父母年龄<20 岁的 HR 为 1.14（95%置信区间 1.04-1.24）。然而，对于有母体 ADHD 病史的儿童，至少有 1 位父母年龄<20 岁的 HR 为 1.92（95%置信区间 1.31-2.82）。
与年轻父母有关的 ADHD 高风险主要见于有母体 ADHD 病史的儿童。
