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Birth asphyxia measured by the pH value of the umbilical cord blood may predict an increased risk of attention deficit hyperactivity disorder
Author(s) -
Mikkelsen Susanne Hvolgaard,
Olsen Jørn,
Bech Bodil Hammer,
Wu Chunsen,
Liew Zeyan,
Gissler Mika,
Obel Carsten,
Arah Onyebuchi
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13807
Subject(s) - medicine , asphyxia , attention deficit hyperactivity disorder , apgar score , umbilical artery , gestational age , risk factor , umbilical cord , pediatrics , population , cohort , obstetrics , fetus , pregnancy , psychiatry , environmental health , anatomy , biology , genetics
Aim Although birth asphyxia is a major risk factor for neonatal and childhood morbidity and mortality, it has not been investigated much in relation to attention deficit hyperactivity disorder ( ADHD ). We examined whether birth asphyxia measured by the pH of the blood in the umbilical artery cord was associated with childhood ADHD . Method A population‐based cohort of 295 687 children born in Finland between 1991 and 2002 was followed until December 31, 2007. ADHD was identified by the International Classification of Diseases, 10th edition, as a diagnosis of hyperkinetic disorder. We examined the risk of ADHD with varying pH values using Cox regression, taking time trends into consideration. Results When compared to the reference group, a pH value below 7.10 was significantly associated with an increased risk of ADHD . The strongest risks were observed among children with a pH value <7.15 and a gestational age of <32 weeks. The pH value did not contribute much to the risk among children with an Apgar score of 0–3. Conclusion Birth asphyxia, defined by low pH value, may predict an increased risk of ADHD in childhood. The association between the pH value and ADHD was homogenous when stratified by gestational age and the Apgar score.