title: Medical augmentation of labor and the risk of ADHD in offspring: a population-based study.
abstract: OBJECTIVE
  Oxytocin for labor augmentation is widely used in obstetric care in Western countries. Two recent, smaller studies found opposing results regarding the association between prenatal exposure to oxytocin for labor augmentation and attention-deficit/hyperactivity disorder (ADHD). In Denmark, oxytocin is the medication used for nearly all medical augmentations of labor, and we examined the association between medical augmentation of labor and ADHD in a large cohort study based on national register data.
  
  
  METHODS
  All singletons born after spontaneous onset of labor in Denmark between 2000 and 2008 (N = 546 146) were included in the study. Data from the Danish Medical Birth Registry on medical augmentation of labor (yes/no) were used to identify exposed children. ADHD was defined based on the diagnostic codes of International Classification of Diseases, 10th Revision, for hyperkinetic disorder and information on dispensed ADHD medication. A multivariate proportional hazards regression model was used to test the association.
  
  
  RESULTS
  Among 546 146 deliveries, 26% included medical augmentation of labor, and 0.9% of the children were identified as having ADHD (n = 4617). We found no association between augmentation of labor and ADHD in the offspring (hazard ratio: 1.05 [95% confidence interval: 0.98-1.13]).
  
  
  CONCLUSIONS
  Our study does not support an association between medical augmentation of labor and ADHD in the child.
authors: Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Denmark; lonnyhenriksen@gmail.com.
authors: Lonny
authors: L
authors: Henriksen
authors: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark;
authors: Chun Sen
authors: CS
authors: Wu
authors: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark;
authors: Niels Jørgen
authors: NJ
authors: Secher
authors: Research Program for Mental Child Health, Institute for Handicap and Communication, Central Region, Denmark; and.
authors: Carsten
authors: C
authors: Obel
authors: Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Midwifery, Metropolitan University College, Copenhagen, Denmark.
authors: Mette
authors: M
authors: Juhl
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult
keywords: attention-deficit/hyperactivity disorder; labor augmentation; oxytocin