Endo Kaori, Stanyon Daniel, Yamasaki Syudo, Nakanishi Miharu, Niimura Junko, Kanata Sho, Fujikawa Shinya, Morimoto Yuko, Hosozawa Mariko, Baba Kaori, Oikawa Nao, Nakajima Naomi, Suzuki Kazuhiro, Miyashita Mitsuhiro, Ando Shuntaro, Hiraiwa-Hasegawa Mariko, Kasai Kiyoto, Nishida Atsushi
Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Front Psychiatry. 2022 Apr 28;13:806669. doi: 10.3389/fpsyt.2022.806669. eCollection 2022.
Attention-deficit/hyperactivity disorder (ADHD) develops in early childhood and carries lifelong impact, but early identification and intervention ensure optimal clinical outcomes. Prolonged or excessive parenting stress may be a response to infant behavioral differences antecedent to developmental disorders such as ADHD, and therefore represents a potentially valuable inclusion in routine early-life assessment. To investigate the feasibility of using routinely-collected self-reported maternal parenting stress as a risk marker for child ADHD, this study investigated the longitudinal association between maternal parenting stress from 1 to 36 months after childbirth and child ADHD in early adolescence.
The sample comprised 2,638 children (1,253 girls) from the Tokyo Teen Cohort population-based birth cohort study. Mothers recorded parenting stress five times from 1 to 36 months following childbirth in the Maternal and Child Health Handbook, a tool used for routine early-life assessment in Japan. Nine years later, mothers evaluated their child's ADHD symptoms at 12 y using the hyperactivity/inattention subscale from the Strength and Difficulties Questionnaire.
Approximately 7.5% of parents reported that they had parenting stress at 36 m after childbirth. 6.2% of children were evaluated as above the cut-off for ADHD symptoms at 12 y. Parenting stress at 1 and 3-4 m was not associated with child ADHD symptoms at 12 y. However, child ADHD symptoms at 12 y was significantly associated with parenting stress at 9-10 m (unadjusted OR = 1.42, =.047, 95% CI [1.00, 2/00]), 18 m (unadjusted OR = 1.57, =.007, 95% CI [1.13, 2.19]) and 36 m (unadjusted OR = 1.67, =.002, 95% CI [1.20, 2.31]). These associations remained after adjustment for child's sex, age in months and family income.
We identified associations between parenting stress at 9-10, 18 and 36 m after childbirth and child ADHD symptoms at 12 years old. Self-reported parenting stress data may have utility as an early indicator for ADHD risk. Participation in early-life health checks, assessment of parenting stress, and tailoring support to family needs should be promoted for early identification and intervention for ADHD.
注意力缺陷多动障碍（ADHD）在儿童早期发病并产生终身影响，但早期识别和干预可确保最佳临床结果。长期或过度的育儿压力可能是对ADHD等发育障碍之前婴儿行为差异的一种反应，因此在常规的早期生活评估中可能是一个潜在的有价值的因素。为了研究将常规收集的自我报告的母亲育儿压力作为儿童ADHD风险标志物的可行性，本研究调查了产后1至36个月母亲的育儿压力与青春期早期儿童ADHD之间的纵向关联。
样本包括来自东京青少年队列基于人群的出生队列研究的2638名儿童（1253名女孩）。母亲们在《母婴健康手册》中记录了产后1至36个月期间的育儿压力5次，《母婴健康手册》是日本用于常规早期生活评估的工具。9年后，母亲们使用《长处与困难问卷》中的多动/注意力不集中子量表评估了孩子12岁时的ADHD症状。
约7.5%的父母报告说他们在产后36个月时有育儿压力。6.2%的儿童在12岁时被评估为ADHD症状高于临界值。产后1个月和3至月时的育儿压力与12岁时儿童的ADHD症状无关。然而，12岁时儿童的ADHD症状与产后9至10个月（未调整OR = 1.42，P = 0.047，95%CI [1.00, 2.00]）、18个月（未调整OR = 1.57，P = 0.007，95%CI [1.13, 2.19]）和36个月（未调整OR = 1.67，P = 0.002，95%CI [1.20, 2.31]）时的育儿压力显著相关。在对孩子的性别、月龄和家庭收入进行调整后，这些关联仍然存在。
我们发现产后9至10个月、18个月和36个月时的育儿压力与12岁时儿童的ADHD症状之间存在关联。自我报告的育儿压力数据可能作为ADHD风险的早期指标有用。应促进参与早期健康检查、育儿压力评估以及根据家庭需求提供支持，以便对ADHD进行早期识别和干预。
