Pre- and Postnatal Risk Factors for ADHD in a Nonclinical Pediatric Population

OBJECTIVE: The authors characterized pre- and postnatal risk factors for ADHD among a population-based sample of 8-year-old children followed since birth (N = 604). METHOD: Parents and teachers rated ADHD symptoms, including inattention and impulsivity/hyperactivity. The authors reviewed pediatric medical records for history of an ADHD diagnosis, and parents reported ADHD medication use. The authors analyzed risk factors in relationship to outcomes using multivariable regression models. RESULTS: Low paternal education, prenatal smoking, prenatal illicit drug use, maternal depression, and low Home Observation for Measurement of the Environment score were associated with greater risk for ADHD behaviors assessed via rating scale. Low income and being male were associated with ADHD diagnosis in medical records and ADHD medication use. CONCLUSION: The authors found associations between socioeconomic, psychosocial, and prenatal exposures and ADHD-related behavior. Selection bias due to access to care and recall bias from inaccurate report of past exposures is minimized in this large, nonclinical, prospective cohort study.