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Fast K, Wentz E, Roswall J, Strandberg M, Bergman S, Dahlgren J. Prevalence of attention-deficit/hyperactivity disorder and autism in 12-year-old children: A population-based cohort. Dev Med Child Neurol 2024; 66:493-500. [PMID: 37740541 DOI: 10.1111/dmcn.15757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 09/24/2023]
Abstract
AIM To investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in a population-based birth cohort and correlate the findings with prenatal and perinatal factors. We hypothesized that children born preterm, having experienced preeclampsia or maternal overweight, would have an increased risk of ADHD or ASD. METHOD A Swedish cohort of 2666 children (1350 males, 1316 females) has been followed from birth with parental and perinatal data. The National Board of Health and Welfare's registries were used to collect data regarding perinatal status and assigned diagnoses at the age of 12 years. RESULTS The prevalence of ADHD and ASD was 7.6% and 1.1% respectively. Maternal obesity early in pregnancy resulted in a three-fold increased risk of ADHD in the child. Similarly, paternal obesity resulted in a two-fold increased risk. The association was significant also when adjusted for sex, preterm birth, smoking, and lower educational level. The prevalence of ASD was too low for statistically relevant risk factor analyses. INTERPRETATION Our results corroborate earlier findings regarding prevalence and sex ratio for both ADHD and ASD. Maternal body mass index and preterm birth were correlated with an ADHD diagnosis at the age of 12 years.
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Affiliation(s)
- Karin Fast
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Psychology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefine Roswall
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Halland, Halland's Hospital Halmstad, Halmstad, Sweden
| | - Maxwell Strandberg
- Master of Science, Applied Statistics, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Stefan Bergman
- Spenshult Research and Development Centre, Halmstad, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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Kuhn L. Are links between maternal obesity early in pregnancy and child neurodevelopment causal? Dev Med Child Neurol 2024; 66:411-412. [PMID: 37818731 DOI: 10.1111/dmcn.15780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
This commentary is on the original article by Fast et al. on pages 493–500 of this issue.
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Affiliation(s)
- Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
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Portugal CC. Ascorbate and its transporter SVCT2: The dynamic duo's integrated roles in CNS neurobiology and pathophysiology. Free Radic Biol Med 2024; 212:448-462. [PMID: 38182073 DOI: 10.1016/j.freeradbiomed.2023.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
Ascorbate is a small antioxidant molecule essential for the proper development and function of the brain. Ascorbate is transported into the brain and between brain cells via the Sodium vitamin C co-transporter 2 (SVCT2). This review provides an in-depth analysis of ascorbate's physiology, including how ascorbate is absorbed from food into the CNS, emphasizing cellular mechanisms of ascorbate recycling and release in different CNS compartments. Additionally, the review delves into the various functions of ascorbate in the CNS, including its impact on epigenetic modulation, synaptic plasticity, and neurotransmission. It also emphasizes ascorbate's role on neuromodulation and its involvement in neurodevelopmental processes and disorders. Furthermore, it analyzes the relationship between the duo ascorbate/SVCT2 in neuroinflammation, particularly its effects on microglial activation, cytokine release, and oxidative stress responses, highlighting its association with neurodegenerative diseases, such as Alzheimer's disease (AD). Overall, this review emphasizes the crucial role of the dynamic duo ascorbate/SVCT2 in CNS physiology and pathology and the need for further research to fully comprehend its significance in a neurobiological context and its potential therapeutic applications.
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Affiliation(s)
- Camila C Portugal
- I3s - Instituto de Investigação e Inovação em Saúde da Universidade do Porto and IBMC - Instituto de Biologia Molecular e Celular, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
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Mitha A, Chen R, Razaz N, Johansson S, Stephansson O, Altman M, Bolk J. Neurological development in children born moderately or late preterm: national cohort study. BMJ 2024; 384:e075630. [PMID: 38267070 DOI: 10.1136/bmj-2023-075630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To assess long term neurodevelopmental outcomes of children born at different gestational ages, particularly 32-33 weeks (moderately preterm) and 34-36 weeks (late preterm), compared with 39-40 weeks (full term). DESIGN Nationwide cohort study. SETTING Sweden. PARTICIPANTS 1 281 690 liveborn singleton children without congenital malformations born at 32+0 to 41+6 weeks between 1998 and 2012. MAIN OUTCOME MEASURES The primary outcomes of interest were motor, cognitive, epileptic, hearing, and visual impairments and a composite of any neurodevelopmental impairment, diagnosed up to age 16 years. Hazard ratios and 95% confidence intervals were estimated using Cox regression adjusted for parental and infant characteristics in the study population and in the subset of full siblings. Risk differences were also estimated to assess the absolute risk of neurodevelopmental impairment. RESULTS During a median follow-up of 13.1 years (interquartile range 9.5-15.9 years), 75 311 (47.8 per 10 000 person years) liveborn singleton infants without congenital malformations had at least one diagnosis of any neurodevelopmental impairment: 5899 (3.6 per 10 000 person years) had motor impairment, 27 371 (17.0 per 10 000 person years) cognitive impairment, 11 870 (7.3 per 10 000 person years) epileptic impairment, 19 700 (12.2 per 10 000 person years) visual impairment, and 20 393 (12.6 per 10 000 person years) hearing impairment. Children born moderately or late preterm, compared with those born full term, showed higher risks for any impairment (hazard ratio 1.73 (95% confidence interval 1.60 to 1.87) and 1.30 (1.26 to 1.35); risk difference 4.75% (95% confidence interval 3.88% to 5.60%) and 2.03% (1.75% to 2.35%), respectively) as well as motor, cognitive, epileptic, visual, and hearing impairments. Risks for neurodevelopmental impairments appeared highest from 32 weeks (the earliest gestational age), gradually declined until 41 weeks, and were also higher at 37-38 weeks (early term) compared with 39-40 weeks. In the sibling comparison analysis (n=349 108), most associations remained stable except for gestational age and epileptic and hearing impairments, where no association was observed; for children born early term the risk was only higher for cognitive impairment compared with those born full term. CONCLUSIONS The findings of this study suggest that children born moderately or late preterm have higher risks of adverse neurodevelopmental outcomes. The risks should not be underestimated as these children comprise the largest proportion of children born preterm. The findings may help professionals and families achieve a better risk assessment and follow-up.
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Affiliation(s)
- Ayoub Mitha
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- CHU Lille, Pediatric and Neonatal Intensive Care Transport Unit, Department of Emergency Medicine, Lille, France
- Université Paris Cité, CRESS, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé) INSERM, INRAE, Paris, France
| | - Ruoqing Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518107, China
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Neda Razaz
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Johansson
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Olof Stephansson
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Maria Altman
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Rheumatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jenny Bolk
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Pettinger KJ, Copper C, Boyle E, Blower S, Hewitt C, Fraser L. Risk of Developmental Disorders in Children Born at 32 to 38 Weeks' Gestation: A Meta-Analysis. Pediatrics 2023; 152:e2023061878. [PMID: 37946609 PMCID: PMC10657778 DOI: 10.1542/peds.2023-061878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Very preterm birth (<32 weeks) is associated with increased risk of developmental disorders. Emerging evidence suggests children born 32 to 38 weeks might also be at risk. OBJECTIVES To determine the relative risk and prevalence of being diagnosed with, or screening positive for, developmental disorders in children born moderately preterm, late preterm, and early term compared with term (≥37 weeks) or full term (39-40/41 weeks). DATA SOURCES Medline, Embase, Psychinfo, Cumulative Index of Nursing, and Allied Health Literature. STUDY SELECTION Reported ≥1 developmental disorder, provided estimates for children born 32 to 38 weeks. DATA EXTRACTION A single reviewer extracted data; a 20% sample was second checked. Data were pooled using random-effects meta-analyses. RESULTS Seventy six studies were included. Compared with term born children, there was increased risk of most developmental disorders, particularly in the moderately preterm group, but also in late preterm and early term groups: the relative risk of cerebral palsy was, for 32 to 33 weeks: 14.1 (95% confidence intervals [CI]: 12.3-16.0), 34 to 36 weeks: 3.52 (95% CI: 3.16-3.92) and 37 to 38 weeks: 1.44 (95% CI: 1.32-1.58). LIMITATIONS Studies assessed children at different ages using varied criteria. The majority were from economically developed countries. All were published in English. Data were variably sparse; subgroup comparisons were sometimes based on single studies. CONCLUSIONS Children born moderately preterm are at increased risk of being diagnosed with or screening positive for developmental disorders compared with term born children. This association is also demonstrated in late preterm and early term groups but effect sizes are smaller.
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Affiliation(s)
| | | | - Elaine Boyle
- University of Leicester, Leicester, United Kingdom
| | | | | | - Lorna Fraser
- University of York, York, United Kingdom
- King’s College London, London, United Kingdom
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冯 叶. [Recent research on the long-term neurodevelopmental outcomes of very preterm infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1066-1071. [PMID: 37905765 PMCID: PMC10621061 DOI: 10.7499/j.issn.1008-8830.2305072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/16/2023] [Indexed: 11/02/2023]
Abstract
With the increase in the survival rate of very preterm infants, the long-term neurodevelopmental outcomes of such infants have attracted more and more attention. Very preterm infants tend to develop movement disorders and psychological and behavioral problems, including cerebral palsy, developmental coordination disorders, autism spectrum disorders, attention deficit hyperactivity disorders, specific learning disorders, and intellectual developmental disorders. It is of vital importance to improve the long-term prognosis of very preterm infants, and early comprehensive intervention measures can minimize disability and achieve optimal parenting outcomes. This article provides a review of the research progress on the long-term neurodevelopmental outcomes in extremely preterm infants.
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Crump C, Sundquist J, Sundquist K. Preterm or early term birth and risk of attention-deficit/hyperactivity disorder: a national cohort and co-sibling study. Ann Epidemiol 2023; 86:119-125.e4. [PMID: 37648179 PMCID: PMC10538375 DOI: 10.1016/j.annepidem.2023.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To examine risks of attention-deficit/hyperactivity disorder (ADHD) in preterm and early term birth survivors, and potential sex-specific differences. METHODS A national cohort study was conducted of all 4061,795 singletons born in Sweden in 1973-2013 who survived infancy, followed up for ADHD identified from nationwide diagnoses and medications through 2018. Poisson regression was used to compute prevalence ratios (PRs), adjusting for sociodemographic and perinatal factors. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic or environmental) factors. RESULTS ADHD prevalences by gestational age at birth were 12.1% for extremely preterm (22-27 weeks), 7.0% for moderately preterm (28-33 weeks), 5.7% for late preterm (34-36 weeks), 6.1% for all preterm (<37 weeks), 5.2% for early term (37-38 weeks), and 4.5% for full-term (39-41 weeks). Adjusted PRs comparing extremely preterm, all preterm, or early term versus full-term, respectively, were 2.35 (95% CI, 2.15-2.57), 1.28 (1.25-1.31), and 1.12 (1.10-1.13) among males, and 2.46 (2.17-2.78), 1.24 (1.20-1.28), and 1.08 (1.06-1.10) among females (P < .001 for each). These associations were virtually unchanged after controlling for shared familial factors. Both spontaneous and medically indicated preterm birth were associated with ADHD (adjusted PRs, 1.21; 95% CI, 1.18-1.24; and 1.39; 1.34-1.43, respectively). CONCLUSIONS In this large cohort, preterm and early term birth were associated with increased risks of ADHD in males and females, independently of covariates and shared familial factors.
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Affiliation(s)
- Casey Crump
- Departments of Family Medicine and Community Health and of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
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Fraiman YS, Guyol G, Acevedo-Garcia D, Beck AF, Burris H, Coker TR, Tiemeier H. A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1637. [PMID: 37892300 PMCID: PMC10605109 DOI: 10.3390/children10101637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the "ADHD Care Cascade". We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the "ADHD Care Cascade". By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course.
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Affiliation(s)
- Yarden S. Fraiman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Genevieve Guyol
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02218, USA
| | - Dolores Acevedo-Garcia
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Andrew F. Beck
- Cincinnati Children’s, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Heather Burris
- Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tumaini R. Coker
- Seattle Children’s, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Henning Tiemeier
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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LUDYGA SEBASTIAN, HANKE MANUEL, LEUENBERGER RAHEL, BRUGGISSER FABIENNE, PÜHSE UWE, GERBER MARKUS, LEMOLA SAKARI, CAPONE-MORI ANDREA, KEUTLER CLEMENS, BROTZMANN MARK, WEBER PETER. Martial Arts and Cognitive Control in Children with Attention-Deficit Hyperactivity Disorder and Children Born Very Preterm: A Combined Analysis of Two Randomized Controlled Trials. Med Sci Sports Exerc 2023; 55:777-786. [PMID: 36728805 PMCID: PMC10090288 DOI: 10.1249/mss.0000000000003110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Very preterm birth and attention-deficit hyperactivity disorder (ADHD) are associated with impairments in response inhibition that often persist beyond childhood. Athletes skilled in martial arts show a neurocognitive profile that is associated with an improved inhibition processing stream, suggesting that engagement in this kind of sport has the potential to reduce impairments in this cognitive function. We investigated the behavioral and neurocognitive effects of judo training on response inhibition in children born very preterm and children with ADHD by a combined analysis of two randomized controlled trials. METHODS In both the CHIPMANC ( n = 65) and JETPAC ( n = 63) studies, participants were randomly allocated to a waitlist or a 12-wk judo training program in a 1:1 ratio. At pretest and posttest, participants completed a Go/NoGo task, the Movement Assessment Battery for Children-2 and a physical work capacity test on a bicycle ergometer. During the cognitive task, event-related potentials (N2, P3a, P3b) were recorded via electroencephalography. RESULTS The effects of the judo training were moderated by the study group. In contrast to children with ADHD (JETPAC), judo training reduced the commission error rate on the Go/NoGo task and increased the P3a amplitude in children born very preterm (CHIPMANC). No treatment effects were found for N2, P3b and physical fitness outcomes. CONCLUSIONS The neurodevelopmental condition influences the cognitive benefits of judo training. Whereas judo may be ineffective in children with ADHD, children born very preterm can expect improved response inhibition due to a more effective engagement of focal attention to resolve the task-related response conflict.
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Affiliation(s)
- SEBASTIAN LUDYGA
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - MANUEL HANKE
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - RAHEL LEUENBERGER
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - FABIENNE BRUGGISSER
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - UWE PÜHSE
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - MARKUS GERBER
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | - SAKARI LEMOLA
- Department of Psychology, Bielefeld University, Bielefeld, GERMANY
- Department of Psychology, University of Warwick, Coventry, UNITED KINGDOM
| | - ANDREA CAPONE-MORI
- Division of Neuropediatrics, Kantonsspital Aarau, Clinic for Children and Teenagers, Aarau, SWITZERLAND
| | - CLEMENS KEUTLER
- St. Elisabethen Krankenhaus Lörrach, Clinic of Childhood and Adolescent Psychiatry and Psychotherapy, Lörrach, GERMANY
| | - MARK BROTZMANN
- Division of Neuropediatrics and Developmental Medicine, University of Basel, University Children’s Hospital, Basel, SWITZERLAND
| | - PETER WEBER
- Division of Neuropediatrics and Developmental Medicine, University of Basel, University Children’s Hospital, Basel, SWITZERLAND
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