Health
Children who had in-utero exposure to ischemic-hypoxic conditions, situations during which the brain is deprived of oxygen, were significantly more likely to develop attention deficit hyperactivity disorder later in life as compared to unexposed children, according to a Kaiser Permanente study published in the journal Pediatrics.
The findings suggest that events in pregnancy may contribute to the occurrence of ADHD over and above well-known familial and genetic influences of the disorder.
The population-based study examines the association between IHC and ADHD. Researchers examined the electronic health records of nearly 82,000 children ages 5 years old and found that prenatal exposure to IHC – especially birth asphyxia, neonatal respiratory distress syndrome, and preeclampsia – was associated with a 16 percent greater risk of developing ADHD.
Specifically, exposure to birth asphyxia was associated with a 26 percent greater risk of developing ADHD, exposure to neonatal respiratory distress syndrome was associated with a 47 percent greater risk, and exposure to preeclampsia (high blood pressure during pregnancy) was associated with a 34 percent greater risk.
The study also found that the increased risk of ADHD remained the same across all race and ethnicity groups.
“Previous studies have found that hypoxic injury during fetal development leads to significant structural and functional brain injuries in the offspring,” said study lead author Darios Getahun, MD, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. “However, this study suggests that the adverse effect of hypoxia and ischemia on prenatal brain development may lead to functional problems, including ADHD.”
Researchers also found that the association between IHC and ADHD was strongest in preterm births and that deliveries that were breech, transverse (shoulder-first) or had cord complications were found to be associated with a 13 percent increased risk of ADHD.
These associations were found to be the case even after controlling for gestational age and other potential risk factors.
“Our findings could have important clinical implications. They could help physicians identify newborns at-risk that could benefit from surveillance and early diagnosis, when treatment is more effective,” said Getahun. “We suggest future research to focus on pre- and post-natal conditions and the associations with adverse outcomes, such as ADHD.”
During critical periods of fetal organ development, IHC may result in a lack of oxygen and nutrient transport from the mother’s blood to fetal circulation.
The result may be compromised oxygen delivery to tissues and cerebrovascular complications. However, this study suggests that the adverse effect of hypoxia on prenatal brain development may lead to functional problems, including ADHD.
In 2005, the Centers for Disease Control and Prevention estimated the annual cost of ADHD-related illness in children under 18 years of age to be between $36 billion and $52.4 billion, making the condition a public health priority.
In 2010, approximately 8.4 percent of children ages 3 to 17 had been diagnosed with ADHD. For about half the affected children, the disease persists into adulthood, according to CDC statistics. Symptoms of ADHD in children may include attention problems, acting without thinking, or an overly active temperament.
This study is part of Kaiser Permanente’s ongoing research to understand the relationship between prenatal conditions and adverse medical outcomes.
Earlier this year, Kaiser Permanente researchers found that in-utero exposure to relatively high magnetic field levels was associated with a 69 percent increased risk of being obese or overweight during childhood compared to lower in-utero magnetic field level exposure.
A Kaiser Permanente study conducted last year found exposure to selective serotonin reuptake inhibitors anti-depressants in early pregnancy may modestly increase the risk of autism spectrum disorders.
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Fit kids aren’t only first picked for kickball. New research from Michigan State University shows middle school students in the best physical shape outscore their classmates on standardized tests and take home better report cards.
Published in the Journal of Sports Medicine and Physical Fitness, it’s the first study linking children’s fitness to both improved scores on objective tests and better grades, which rely on subjective decisions by teachers.
The study also is among the first to examine how academic performance relates to all aspects of physical fitness – including body fat, muscular strength, flexibility and endurance – according to lead researcher Dawn Coe.
“We looked at the full range of what’s called health-related fitness,” said Coe, who conducted the research as a doctoral student in MSU’s kinesiology department and is now an assistant professor at the University of Tennessee, Knoxville. “Kids aren’t really fit if they’re doing well in just one of those categories.”
Coe and colleagues gathered their data from 312 students in sixth through eighth grade at a West Michigan school.
They gauged the kids’ fitness with an established program of push-ups, shuttle runs and other exercises.
Then they compared those scores to students’ letter grades throughout the school year in four core classes and their performance on a standardized test.
The results showed the fittest children got the highest test scores and the best grades, regardless of gender or whether they’d yet gone through puberty.
The findings suggest schools that cut physical education and recess to focus on core subjects may undermine students’ success on the standardized tests that affect school funding and prestige, said co-author James Pivarnik, who advised Coe on the project.
“Look, your fitter kids are the ones who will do better on tests, so that would argue against cutting physical activity from the school day,” said Pivarnik, an MSU professor of kinesiology. “That’s the exciting thing, is if we can get people to listen and have some impact on public policy.”
Making fitness a bigger part of children’s lives also sets them up for future success, Pivarnik added.
“Fit kids are more likely to be fit adults,” he said. “And now we see that fitness is tied to academic achievement. So hopefully the fitness and the success will both continue together.”
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