Postpartum Depression Increases the Risk of Childhood Attention Deficit Hyperactivity Disorder Diagnosis

Postpartum Depression (PPD) is a common adverse pregnancy outcome, but the extent to which PPD correlates with attention deficit hyperactivity disorder (ADHD) in the offspring is unclear. Therefore, we examined if children of mothers who experienced PPD are at risk for developing ADHD and how this association may be modified by the child's sex, race/ethnicity, and gestational age at delivery. A retrospective cohort study of singleton-born children aged 3-12 years and delivered in Kaiser Permanente Southern California hospitals between 01/01/2010-12/31/2019 (n = 229,860) was performed using electronic health records. ICD- 9-CM and ICD- 10-CM codes and pharmacy records were used to ascertain exposure and outcomes of interest. Incidence rates and adjusted hazard ratios (aHR) were estimated to quantify the association between PPD and childhood ADHD. Children of women with PPD were more likely to be diagnosed with ADHD than children of women without PPD (8.85 vs. 5.18/1000 person-years, aHR = 1.76, confidence interval (CI): 1.66-1.86). Among women who delivered at 29-32 and 33-36 weeks of gestation, PPD was associated with 1.61-fold (95% CI: 1.06-2.57) and 1.72-fold (95% CI: 1.44-2.06) increased risk of ADHD, respectively, compared to pregnancies without a history of PPD. PPD was associated with an increased ADHD risk for all racial/ethnic groups and both child sex categories. PPD may help identify at-risk children who could benefit from earlier surveillance and interventions. Additional studies are needed to determine if PPD has a causal relationship with ADHD or if these conditions have a common risk factor.