Maternal Stress as a Risk Factor for ADHD in School-Aged Children

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental disorders in the youth population, with a prevalence of 6-12% in North America. The disease negatively impacts academic and social functioning in childhood, as well as occupational achievements in adulthood. The etiology is highly multifactorial and embraces genetics, prenatal exposures to tobacco smoke and alcohol, and postnatal factors such as parenting style. Objective: To examine the association between maternal stress during pregnancy and the development of ADHD in school-aged children. Methodology: A systematic review was completed to investigate the relationship between maternal stress and ADHD symptomatology in offspring by using PubMed, Google Scholar, and Cochrane Library databases. Both quantitative and qualitative publications within the past twenty years were searched using keywords such as maternal stress, pregnancy, ADHD, behavioural disorder, and risk factor. The articles were screened for extraneous variables such as maternal age at conception to minimize biases. Results: Epidemiological studies have indicated an association between maternal stress and behavioural disturbances in offspring, persisting until the ages of four and six. The “excess glucocorticoid” theory suggests that severe maternal stress saturates the enzyme 11β-hydroxysteroid dehydrogenase type II responsible for deactivating cortisol in the placenta during pregnancy, allowing excess hormone to reach the fetus. Conclusion: Determining preventable risk factors early in life leads to new strategies and treatment options to reduce diagnostics of the disease, improve the quality of life of children at risk, and dramatically reduce health care costs. Further investigation is needed to establish causation.