In Utero Exposure to Ischemic-Hypoxic Conditions and Attention-Deficit/Hyperactivity Disorder

Abstract

These findings suggest that IHCs, especially birth asphyxia, respiratory distress syndrome, and preeclampsia, are independently associated with ADHD. This association was strongest in preterm births.

Spatial Working Memory Deficits in Male Rats Following Neonatal Hypoxic Ischemic Brain Injury Can Be Attenuated by Task Modifications

“…Both term and preterm HI populations show heightened incidence for an array of cognitive and behavioral deficits, including language impairments [32,33,35,36,37,109,110], attentional problems associated with ADHD [42,43,44,45,46,47,54,63,111] and memory impairments [33,38,39,40,56,57,64,112,113]. In the current series of studies, we focus specifically on working memory impairments associated with neonatal HI injury in a rat model.…”

Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

“…[38][39][40][41] The mechanism of how tobacco smoke affects the fetal brain remains unclear, 6,33 but it has been hypothesized that perinatal events resulting in hypoxia may affect brain development and lead to ADHD. 11,42,43 Such risk factors include threatened abortion, threatened preterm labor, preeclampsia, prematurity, intrauterine growth retardation, low Apgar scores, and fetal distress. 35,44,45 Our study contradicts some of these findings in that we found no association with acute events around delivery except for the rare event of cord prolapse in girls, also suggested in a recent study.…”

“…35,44,45 Our study contradicts some of these findings in that we found no association with acute events around delivery except for the rare event of cord prolapse in girls, also suggested in a recent study. 11 Maternal preeclampsia and genitourinary tract infections have been associated with other neurodevelopmental disorders, including ADHD, 12,46 where an inflammatory cascade affecting fetal brain development has been suggested. In our fully adjusted model, both preeclampsia and maternal genitourinary tract infections were associated with an elevated risk of ADHD irrespective of gender.…”

“…10 Others have suggested that the strong genetic risk for ADHD can be moderated or mediated by prenatal (eg, exposure to maternal stress, alcohol, nicotine, lead, preeclampsia, and maternal urinary tract infection [UTI]), perinatal (prematurity, low birth weight, anoxic-ischemic encephalopathy, meningitis, encephalitis), and postnatal (viral meningitis, encephalitis, cerebral trauma) factors. 6,8,9,11,12 However, population studies have shown varying results, from no elevated risk or low risk for ADHD due to perinatal factors 13,14 to an elevated risk associated with prematurity and postterm babies. 15,16 Recently there has been a focus on early term births (37-38 weeks' gestation), which may also increase the risk of ADHD.…”

Angiogenic, neurotrophic, and inflammatory system SNPs moderate the association between birth weight and ADHD symptom severity

“…Placental insufficiency and fetal growth restriction are associated with altered angiogenic [Conde-Agudelo et al, 2013], dopaminergic [Vucetic et al, 2010], neurotrophic [MalamitsiPuchner et al, 2007], and inflammatory responses [Amarilyo et al, 2011], and numerous poor neurodevelopmental outcomes [Baschat, 2011]. Prenatal ischemia-hypoxia is a common element to multiple early risk factors for ADHD including maternal smoking [Bush et al, 2000] and maternal alcohol use during pregnancy [Bosco and Diaz, 2012] as well as ischemia-hypoxia related obstetric complications [Pineda et al, 2007;Rennie et al, 2007;Getahun et al, 2013]. Consistent with the Developmental Origins of Health and Disease (DOHaD) framework [Gluckman et al, 2004;Mill et al, 2008;Swanson and Wadhwa, 2008;Swanson et al, 2009;Wadhwa et al, 2009], the association between lower birth weight and ADHD may arise from prenatal ischemia-hypoxia.…”