Comparing Obstetrical Outcomes Between Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder: A Population-Based Studys

Objectives: Attention deficit hyperactivity disorder (ADHD) is among the most common neurodevelopmental disorders affecting women of reproductive age. Previous data on this condition did not study its different symptom clusters separately. Our aim was to compare perinatal outcomes between women with hyperactivity cluster (ADHD) and those with the inattentive cluster (attention deficit disorder (ADD)). Methods: A retrospective population-based study utilizing data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). All deliveries or maternal deaths from 2004 to 2014 were available for analysis, and perinatal outcomes were compared between participants with an ADD diagnosis and those with an ADHD diagnosis. A multivariate logistic regression was used to control for confounders. Results: During the study period, there were 9,096,788 deliveries. Of them, 7103 had an ADHD diagnosis, and 2928 had an ADD diagnosis. Women with ADHD, compared to those with ADD, were more likely to be younger than 25 years of age; to be Black; to be from a lower income quartile; to smoke tobacco during pregnancy; and to use illicit drugs (p < 0.001 for all). Using multivariate logistic regression, women with ADHD, compared to those with ADD, had a higher rate of hypertensive disorders of pregnancy (HDPs) (aOR 1.19, 95% CI 1.03-1.37, p = 0.02), preterm delivery (aOR 1.19, 95% CI 1.01-1.39, p = 0.038), maternal infection (aOR 1.39, 95% CI 1.04-1.85, p = 0.024), and small-for-gestational-age (SGA) neonates (aOR 1.33, 95% CI 1.04-1.69, p = 0.022). Conclusions: Women with an ADHD diagnosis, compared to those with ADD, had a higher incidence of various maternal and neonatal complications, including HDPs, preterm delivery, and SGA neonates.