Very low birth weight and behavioral symptoms of attention deficit hyperactivity disorder in young adulthood: the Helsinki study of very-low-birth-weight adults.
OBJECTIVE
Children with very low birth weight (<1500 g) are at increased risk for attention deficit hyperactivity disorder (ADHD). Whether this increased risk continues into adulthood is unknown. The authors assessed behavioral symptoms of ADHD in a well-characterized cohort of very-low-birth-weight young adults who were either small for gestational age (less than two standard deviations below the Finnish mean) or appropriate for gestational age (within two standard deviations of the mean).


METHODS
A total of 162 very-low-birth-weight subjects (small for gestational age: N=52; appropriate for gestational age: N=110) and 172 term comparison subjects 18 to 27 years of age completed the Adult Problem Questionnaire, which yielded six exploratory factor analysis-derived subscales. Participants were also asked about substance use.


RESULTS
Very-low-birth-weight adults in the small for gestational age subgroup scored higher on the executive dysfunctioning and emotional instability subscales of the Adult Problem Questionnaire than did those in the appropriate for gestational age subgroup and the comparison group. The appropriate for gestational age and comparison groups had similar scores on these subscales. On the alcohol use subscale of the Adult Problem Questionnaire, both the appropriate and small for gestational age subgroups scored lower than comparison subjects and also reported fewer risk-taking behaviors (alcohol, smoking, and use of recreational drugs) than did comparison subjects.


CONCLUSIONS
Rather than very low birth weight per se, intrauterine growth retardation, as reflected by small for gestational age status in the very-low-birth-weight subjects, confers a risk for behavioral and emotional adversity related to ADHD in young adulthood.
Strang-Karlsson
Sonja
S
Hospital for Children and Adolescents, Biomedicum 2, Tukholmankatu 8C, Helsinki University Central Hospital, PO Box 705, FI-00029 Helsinki, Finland. sonja.strang@helsinki.fi
Räikkönen
Katri
K
Pesonen
Anu-Katriina
AK
Kajantie
Eero
E
Paavonen
E Juulia
EJ
Lahti
Jari
J
Hovi
Petteri
P
Heinonen
Kati
K
Järvenpää
Anna-Liisa
AL
Eriksson
Johan G
JG
Andersson
Sture
S
D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000523:psychology*; D005387:Finland; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D007236:Infant, Small for Gestational Age / Q000523:psychology*; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D012309:Risk-Taking