Getahun Darios, Fassett Michael J, Mensah Nana A, Khadka Nehaa, Yeh Meiyu, Chiu Vicki Y, Oyelese Yinka, Peltier Morgan R
Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, 2nd Floor, Pasadena, CA, 91101, USA.
Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
Reprod Sci. 2025 Apr 17. doi: 10.1007/s43032-025-01862-2.
Postpartum Depression (PPD) is a common adverse pregnancy outcome, but the extent to which PPD correlates with attention deficit hyperactivity disorder (ADHD) in the offspring is unclear. Therefore, we examined if children of mothers who experienced PPD are at risk for developing ADHD and how this association may be modified by the child's sex, race/ethnicity, and gestational age at delivery. A retrospective cohort study of singleton-born children aged 3-12 years and delivered in Kaiser Permanente Southern California hospitals between 01/01/2010-12/31/2019 (n = 229,860) was performed using electronic health records. ICD- 9-CM and ICD- 10-CM codes and pharmacy records were used to ascertain exposure and outcomes of interest. Incidence rates and adjusted hazard ratios (aHR) were estimated to quantify the association between PPD and childhood ADHD. Children of women with PPD were more likely to be diagnosed with ADHD than children of women without PPD (8.85 vs. 5.18/1000 person-years, aHR = 1.76, confidence interval (CI): 1.66-1.86). Among women who delivered at 29-32 and 33-36 weeks of gestation, PPD was associated with 1.61-fold (95% CI: 1.06-2.57) and 1.72-fold (95% CI: 1.44-2.06) increased risk of ADHD, respectively, compared to pregnancies without a history of PPD. PPD was associated with an increased ADHD risk for all racial/ethnic groups and both child sex categories. PPD may help identify at-risk children who could benefit from earlier surveillance and interventions. Additional studies are needed to determine if PPD has a causal relationship with ADHD or if these conditions have a common risk factor.
产后抑郁症(PPD)是一种常见的不良妊娠结局,但PPD与后代注意力缺陷多动障碍(ADHD)的关联程度尚不清楚。因此,我们研究了经历过PPD的母亲的孩子患ADHD的风险,以及这种关联如何因孩子的性别、种族/族裔和分娩时的孕周而改变。我们利用电子健康记录对2010年1月1日至2019年12月31日在南加州凯撒医疗机构医院出生的3至12岁单胎儿童进行了一项回顾性队列研究(n = 229,860)。使用国际疾病分类第九版临床修正本(ICD-9-CM)和国际疾病分类第十版临床修正本(ICD-10-CM)编码以及药房记录来确定感兴趣的暴露因素和结局。估计发病率和调整后的风险比(aHR)以量化PPD与儿童ADHD之间的关联。与未患PPD的女性的孩子相比,患PPD的女性的孩子更有可能被诊断为ADHD(每1000人年8.85例 vs. 5.18例,aHR = 1.76,置信区间(CI):1.66 - 1.86)。与无PPD病史的妊娠相比,在妊娠29 - 32周和33 - 36周分娩的女性中,PPD分别与ADHD风险增加1.61倍(95% CI:1.06 - 2.57)和1.72倍(95% CI:1.44 - 2.06)相关。PPD与所有种族/族裔群体以及两种儿童性别类别的ADHD风险增加均相关。PPD可能有助于识别那些可能从早期监测和干预中受益的高危儿童。需要进一步的研究来确定PPD与ADHD之间是否存在因果关系,或者这些情况是否有共同的风险因素。