Are maternal genitourinary infection and pre-eclampsia associated with ADHD in school-aged children?
OBJECTIVE
To investigate the hypothesis that maternal genitourinary infection (GU) infection is associated with increased risk of ADHD.


METHODS
The authors obtained linked Medicaid billing data for pregnant women and their children in South Carolina, with births from 1996 through 2002 and follow-up data through 2008. Maternal GU infections and pre-eclampsia were identified on the basis of diagnoses made during pregnancy, and cases of ADHD were identified on the basis of diagnoses made in the child's Medicaid file.


RESULTS
There were 84,721 children in the data set used for analyses. Maternal genitourinary infection was associated with significantly increased odds of ADHD (OR = 1.29, 95% CI = 1.23-1.35). Pre-eclampsia was also associated with increased risk (OR = 1.19, 95% CI = 1.07-1.32). Children whose mothers had both GU infection and pre-eclampsia were 53% more likely to have ADHD, compared to those with neither exposure. When we examined specific infection diagnoses, chlamydia/nongonococcal urethritis, trichomoniasis, urinary tract infection, and candidiasis were associated with increased risk of ADHD, whereas gonorrhea was not.


CONCLUSIONS
Maternal GU infection appeared to be associated with increased risk of ADHD, and based on the findings it was concluded that further research is needed to describe the mechanism(s) underlying the association.
Mann
Joshua R
JR
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC 29203, USA. Joshua.mann@uscmed.sc.edu
McDermott
Suzanne
S
D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D002177:Candidiasis / Q000150:complications* / Q000523:psychology; D002648:Child; D002690:Chlamydia Infections / Q000150:complications* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011225:Pre-Eclampsia / Q000523:psychology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000523:psychology*; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D014552:Urinary Tract Infections / Q000150:complications* / Q000523:psychology