Children born at 37-38 weeks of gestation are at risk of developing symptoms of ADHD, suggests a study recently published in the Journal of Pediatrics.¹

Researchers from the United States carried out a secondary analysis of data of 1400 children in the Fragile Families and Child Wellbeing study. These children underwent evaluation at 9 years of age by their teachers for symptoms of hyperactivity, ADHD, cognitive problems or inattention and oppositional behavior with the aid of the Conners Teacher Rating Scale-Revised Short Form. These evaluation reports have been used by the researchers for the first time. In this study, the researchers sought to examine if gestational age and symptoms associated with ADHD at age 9 among children born at term (37-41 weeks) were correlated.

Overall, children born at 37-38 weeks scored high on the teacher-rating scales compared to those born at 39-41 weeks. The hyperactivity scores were 6% lower with every week of gestational age at term with an adjusted incidence rate ratio (IRR) of 0.94. Similarly, the ADHD and cognitive problems or inattention scores were 5% lower with adjusted IRR of 0.95.

Children born at 37-38 weeks of gestation had 23% higher hyperactivity scores (adjusted IRR 1.23). Their ADHD scores were also increased by 17% (adjusted IRR 1.17) compared to children born at 39-41 weeks. No such association was observed for gestational age and oppositional behavior scores.

In its Committee Opinion No. 765, the American College of Obstetricians and Gynecologists (ACOG) recommends “delaying elective (i.e., not medically indicated) deliveries until 39 weeks of gestation or beyond”.2 Full-term infants are usually not considered to be at risk for adverse outcomes later on and might be unattended to vis a vis preterm infants for ADHD. By demonstrating a risk of ADHD symptoms even in full-term infants during the 9-year follow-up period, the findings of the study affirm these recommendations and further advocate that children born at 37-38 weeks gestational age should undergo regular screening for symptoms of ADHD.

References

2. Lingasubramanian G, et al. Gestational age at term and teacher-reported ADHD symptom patterns. J Pediatr. 2022 Aug 5:S0022-3476(22)00698-9. doi: 10.1016/j.jpeds.2022.07.042.
3. ACOG Committee Opinion No. 765: Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities. Obstet Gynecol. 2019 Feb;133(2):e156-e163. doi: 10.1097/AOG.0000000000003076.