title: Mothers of children diagnosed with attention-deficit/hyperactivity disorder: health conditions and medical care utilization in periods before and after birth of the child.
abstract: BACKGROUND
  Analyzing health conditions and medical utilization of mothers of children with attention-deficit/hyperactivity disorder (ADHD) can shed light on biologic, environmental, and psychosocial factors relating to ADHD.
  
  
  OBJECTIVE
  To examine health conditions, health care utilization, and costs of mothers of children with ADHD in periods before the child was diagnosed.
  
  
  METHODS
  Using automated data from Northern California Kaiser Permanente we identified mothers of children with ADHD, mothers of children without ADHD, and mothers of children with asthma. Mothers' diagnostic clusters, health care utilization, and costs were compared. Mothers of children with ADHD were compared with mothers of children without ADHD and, separately, to mothers of children with asthma.
  
  
  RESULTS
  Compared with mothers of children without ADHD, mothers of children with ADHD were more likely to be diagnosed with numerous medical and mental health problems in the 2 years after birth of their child, including depression [odds ratio (OR): 1.88], anxiety neuroses (OR: 1.64), obesity (OR: 1.70), and musculoskeletal symptoms (OR: 1.51). Results were similar for the year before delivery. Mothers of children with ADHD also had higher total health care costs per person in the year before ($1,003) and the 2 years after ($953) the birth of their child. Mothers of children with ADHD also were diagnosed with more health conditions and had higher health care costs than mothers of children with asthma.
  
  
  CONCLUSIONS
  Our findings suggest that the likelihood of being diagnosed with ADHD is related to maternal conditions and use of health services that precede the child's diagnosis. Future studies are needed to clarify whether this is due to biologic, psychosocial, or environmental factors, or a combination.
authors.affiliation: Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, CA 94612, USA. tom.ray@kp.org
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Ray
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Croen
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Habel
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000191:economics*; D001289:Attention Deficit Disorder with Hyperactivity / Q000191:economics*; D002140:California / Q000453:epidemiology; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated / Q000191:economics; D019988:Children with Disabilities; D005260:Female; D017048:Health Care Costs; D006801:Humans; D016015:Logistic Models; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data*; D008429:Maternal Welfare / Q000191:economics* / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D009035:Mothers / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data*; D009939:Organizations, Nonprofit / Q000191:economics; D015995:Prevalence; D016387:Women's Health / Q000191:economics*; D055815:Young Adult