Investigation of the relative frequency of attention deficit hyperactivity disorder (ADHD) in 6-year-old children with low birth weight in Yazd city

Dissertation:

To get a PhD

Abstract

Introduction: Attention-deficit hyperactivity disorder (ADHD:attention-deficit hyperactivity disorder) is a neurobehavioral syndrome characterized by lack of attention, irritability, A lot of activity, anxious and turbulent behavior is especially evident in boys. The etiology of ADHD has not yet been determined, but brain volume reduction, low birth weight, and brain injuries during delivery, especially in premature babies, are among the factors involved in the development of ADHD. The prevalence of ADHD is higher in children with low birth weight (weight less than 2500 grams). It is underweight and age at birth.

Materials and methods: An analytical study was conducted using the historical-cohort method on 120 6-year-old children, 60 children with a low birth weight (less than 2500 grams) were selected as the exposure group and 60 children with a birth weight above 3000 grams were selected as the non-exposure group. families were collected.

At the end of the study, the relative frequency of hyperactivity and attention deficit disorder in children with low birth weight was checked.

Findings: the relative frequency of mixed type ADHD in the exposure group was 26.7% and in the non-exposure group was 18.3% (with P-value: 0.274 not significant). The average of mixed type ADHD in the group exposure was 5.060 and in the non-exposure group 3.400 (significant with P-value: 0.033).

In this study, the relative frequency of mixed type ADHD according to gender, nutrition during infancy and age at birth was investigated, which was not significant according to the P-value, although their non-significance was probably due to the small sample size.

Conclusion: The relative frequency of mixed type ADHD in children with low birth weight was 26.7%, but this rate was not statistically significant, that is, mixed type ADHD is not related to low birth weight. However, from a medical point of view, this relative frequency is approximately 1.5 times the non-exposed group.

Key words: attention deficit hyperactivity disorder, low birth weight, age at birth, breastfeeding Prematurity

1-1- Neonatal period

Neonatal or neonatal period, although it is defined as the first 28 days of life, but fetal and neonatal life form a continuous period of time during which human development and growth is influenced by genetic factors, intrauterine and extrauterine environment. The infant period is a very vulnerable period for the child, during which many physiological adaptations necessary for life outside the womb are developed.

The infant period is a sensitive time for a child because many of the physical skills necessary for life outside the womb are completed during this time.

The high rate of mortality and morbidity in this period is the fragility of life in this period. shows that in all cases of death that occur in the first year of life, two-thirds of the cases are related to the neonatal period, and neonatal deaths are the highest in the first 24 hours and generally include 65% of all infant deaths.

Diseases associated with premature birth and low birth weight and fatal congenital abnormalities The main causes of infant mortality. Various medical, economic, and cultural factors affect perinatal and neonatal mortality. Preventive measures such as health education, perinatal care, nutrition, social support and recognition of risk factors and midwifery care effectively reduce perinatal and infant mortality rates. For the first time in 1919, ylppo called infants under 2500 grams as low birth weight (LBW). LBW and this definition as a high-risk standard for infants over 40 years old have been approved by the World Health Organization and are one of the main causes of infant and child mortality.LBW is defined as the high-risk standard for infants over 40 years old, which has been approved by the World Health Organization, and is one of the main causes of infant and newborn mortality, and along with congenital abnormalities (such as heart, central nervous system, and respiratory system) plays a significant role in childhood complications. If it is more, the infant mortality will be higher.

The most infant mortality occurs among babies whose birth weight is less than 1000 grams and their gestation period is less than 30 weeks. The lowest infant mortality is also among infants whose birth weight is 3000 to 4000 grams and whose gestation period is 38-40 weeks[1].

As the fetal weight approaches from 500 grams to 3000 grams, a logarithmic decrease in neonatal mortality is seen. Between 25 and 37 weeks of gestational age, the rate of neonatal mortality is almost halved for each week of gestational age increase. However, approximately 40% of all perinatal deaths occur in infants whose gestational age is after 37 weeks and weight equal to or more than 2500 grams.

Since most of the deaths in the newborn period happen in the first hours and days, the probability of survival increases as the baby ages. In fact, birth weight and gestational age are strong indicators of neonatal mortality. In fact, the survival rate at the age of 22 weeks is close to 22%, and this probability increases to 25% for 23 weeks, 56% for 24 weeks, and 79% for 25 weeks. Also, the mortality rate in babies with a birth weight of 4000 grams or more with a gestational age of 42 weeks or more suddenly increases [2].

Among the causes of low birth weight, premature birth or intrauterine growth restriction[1]1 or both are the main cause of low birth weight in the United States, premature birth is the main cause of intrauterine growth restriction, while in developing countries the main cause is intrauterine growth restriction.

The prevalence of LBW is more in black race and in girls than boys. Also, multiple births and high age of the mother also increase the risk of LBW.

Nowadays, the chance of survival of babies weighing 1501 to 2500 grams is 95% or more, but the mortality rate in those with lower weight is still high. Deaths are caused by infection, and therefore, at least in theory, many of them can be prevented. Congenital anatomical anomalies are present in 3 to 7% of LBW babies.

The growth and development of LBW babies born to mothers with poor socioeconomic status will be lower than babies who have a better environment during infancy. In 2000, 7.6% of live babies born in the United States weighed less than 2500 grams, among whom blacks were twice as likely as whites.

Prematurity and IUGR increase the morbidity and mortality of infants. Approximately 30% of LBW infants in the United States have intrauterine growth retardation (IUGR) and are born after 37 weeks of gestation. When the LBW rate exceeds 10%, the percentage of IUGR is higher. Prematurity will be less. In developing countries, approximately 70% of LBW babies suffer from IUGR, and IUGR babies have more mortality and complications compared to babies who have grown according to their gestational age. In Iran, according to surveys that have been done sporadically, the proportion of babies with intrauterine growth retardation is lower than in developing countries and more than in developed countries. It can be accurately said that the cause of low birth weight is 30 to 40%. The cases of IUGR and other cases are caused by the prematurity of the fetus and premature birth[2], the rate of LBW in the whole country is 29 per thousand live births[3].

1-2- Factors related to the birth of a premature baby and low birth weight

It is very difficult to separate the factors affecting prematurity from IUGR, there is a very strong connection between IUGR and prematurity from a On the other hand, there is the low socioeconomic level of the family