Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden

Skoglund, Charlotte; Kallner, Helena Kopp; Skalkidou, Alkistis; Wikström, Anna‐Karin; Lundin, Cecilia; Hesselman, Susanne; Wikman, Anna; Poromaa, Inger Sundström

doi:10.1001/jamanetworkopen.2019.12463

Cited by 36 publications

(27 citation statements)

References 42 publications

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“…For example, young people with ADHD become sexually active earlier, have more sexual partners and are more frequently treated for sexually transmitted infections [99]. Rates of teenage, early or unplanned pregnancies are elevated in girls and women with ADHD [100][101][102]. Pregnant women with ADHD are more likely to smoke up to the third trimester, or be obese or underweight [102].…”

Section: Associated Features Functional Problems and Impairmentsmentioning

confidence: 99%

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Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women

et al. 2020

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Background There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. Methods The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. Results A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. Conclusions This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.

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Section: Associated Features Functional Problems and Impairmentsmentioning

confidence: 99%

“…Rates of teenage, early or unplanned pregnancies are elevated in girls and women with ADHD [100][101][102]. Pregnant women with ADHD are more likely to smoke up to the third trimester, or be obese or underweight [102].…”

Section: Associated Features Functional Problems and Impairmentsmentioning

confidence: 99%

Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women

et al. 2020

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“…[1][2][3][4][5][6] Women with ADHD are more often teenage mothers, smokers, obese and with a risk-taking sexual behaviour associated with higher rates of sexually transmitted infections. [7][8][9] Further, women with ADHD to a greater extent report behavioural and psychosocial problems such as substance abuse, low education and unemployment, 2,10,11 reflecting a social burden with potential serious consequences for the mother and the family.…”

Section: Introductionmentioning

confidence: 99%

Association of maternal attention deficit hyperactivity disorder and preterm birth: a cohort study

Hesselman

Wikman

Skoglund

et al. 2020

BJOG

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Objective Attention deficit hyperactivity disorder (ADHD) affects 3-7% of women of childbearing age. Whether ADHD is associated with an increased risk of preterm birth is unclear. Design National register-based cohort study. Setting Sweden. Population Nulliparous women giving birth to singleton infants 2007-2014 (n = 377 381). Methods Women were considered to have ADHD if they had been dispensed at least one prescription for ADHD medication, i.e. a central nervous system stimulant or non-stimulant drugs for ADHD, prior to, during or after pregnancy (2005-2014). Women with ADHD were compared with women without ADHD in regard to prevalence, severity and mode of onset of preterm birth. Logistic regression models were used, estimating adjusted odds ratios (aOR) with 95% confidence intervals (CI). Adjustments were made for maternal age and country of birth (model 1), and in addition for body mass index (BMI), education, alcohol or substance use disorders, and pre-gestational medical and psychiatric co-morbidity (model 2). Main outcome measures Preterm birth (<37 weeks). Results During the study period, 6327 (1.7%) women gave birth and had ADHD according to our definition. These women had a higher rate of preterm birth compared with women without ADHD (7.3 versus 5.8%, aOR model 2: 1.17; 95% CI 1.05-1.30). ADHD was particularly associated with very (<32 weeks) preterm births, and associations were seen with both spontaneous and medically indicated onsets. Conclusions Women with ADHD (i.e. who had been dispensed ADHD medication at any time in 2005-2014) had an increased risk of preterm birth.

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“…There is also some evidence that women with ADHD have a higher risk of developing substance abuse disorders than men with ADHD [18]. ADHD is also associated with early single parenthood [2] which is more common among women than men with ADHD [19,20].…”

Section: Discussionmentioning

confidence: 99%

Clustering of social disadvantage with attention-deficit/hyperactivity disorder in young adults: a register-based study in Sweden

Virtanen

Lallukka

Alexanderson

et al. 2021

Preprint

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Background Whether clustering of social disadvantage in young adulthood is associated with attention-deficit/hyperactivity disorder (ADHD) is poorly understood. We examined clustering of ADHD with low educational attainment and unemployment in young adulthood; whether such clustering is stronger when unemployment was prolonged; and whether further clustering of disability pensioning, low education and unemployment occurs among those with ADHD. Methods Data were obtained from Swedish health, demographic and social security registers from which 8990 individuals with recorded ADHD diagnoses at the age of 10 to 35 and their 44387 matched references without mental disorders. Social disadvantage was measured using data on educational attainment, unemployment and disability pension from the diagnosis year or age 19 if diagnosed at younger age. Clustering was examined by comparing observed and expected occurrence (O/E ratio) of all possible combinations of ADHD, low education and unemployment, and, among those with ADHD, additional combinations with new-onset disability pension. Results The likelihood of having neither ADHD, low education nor unemployment was increased (O/E ratio = 1.20, 95% confidence interval 1.19–1.20 at baseline; 1.18, 1.17–1.18 at follow-up), as well as having all three characteristics (O/E ratio = 3.99, 3.89–4.10 at baseline; 5.68, 5.47–5.89 at follow-up). This clustering was stronger among women than men and when unemployment was prolonged. Among individuals with ADHD, clustering of low education with disability pension and unemployment was observed. Conclusions Low education and unemployment appear to cluster remarkably with ADHD among young adults, more so among women and when unemployment is prolonged.

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Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden

Abstract: This cohort study examines the association of attention-deficit/hyperactivity disorder (ADHD) with teenage pregnancy among women and girls in Sweden.

Cited by 36 publications

References 42 publications

Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women

Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women

Association of maternal attention deficit hyperactivity disorder and preterm birth: a cohort study

Clustering of social disadvantage with attention-deficit/hyperactivity disorder in young adults: a register-based study in Sweden

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