Perinatal, Socio-Demographic, and Familial Risk Factors Associated with ADHD: A Cross-Sectional Analysis

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Perinatal, socio-demographic, and familial factors are thought to influence ADHD risk, but limited data exist in Bangladeshi populations.

Objective: To examine perinatal, socio-demographic, and familial risk factors associated with ADHD among children and adolescents attending a tertiary psychiatry outpatient department.

Methods: This descriptive cross-sectional study enrolled 47 children and adolescents (aged 5–19 years) with ADHD from May 2018 to September 2020 at BSMMU. Participants were selected through purposive and consecutive sampling. Socio-demographic, perinatal, and familial data were collected via face-to-face interviews. Psychiatric comorbidities were assessed using the Development and Well-Being Assessment (DAWBA), and ADHD diagnoses were confirmed according to DSM-5 criteria.

Results: The mean age of participants was 12.8 ± 3.1 years; 25.5% were aged 5–9 years, and 40.4% were aged 10–14 years. Male-to-female ratio was 4.8:1. ADHD subtypes included combined type (68%), hyperactive/impulsive type (19.1%), and inattentive type (12.7%). A total of 57.4% had at least one psychiatric comorbidity; among them, 62.9% had a single comorbidity, while 37% had multiple. Common comorbidities were Oppositional Defiant Disorder (44.4%), Conduct Disorder (29.6%), obsessive-compulsive disorder (25.9%), Intellectual Disability (18.5%), and autism spectrum disorder (11.1%). Significant risk factors included male gender (64.1%), advanced maternal age (32.6 ± 11.2 years), low family income (57.4%), irregular antenatal care, multiparity (56%), history of maternal mental illness, birth complications such as asphyxia (25.5%) and injury (17%).

Conclusion: ADHD in this cohort was associated with male gender, perinatal complications, familial psychiatric history, and socio-demographic disadvantages. Early identification and management of these risk factors may aid in timely intervention.

Keywords: ADHD, Perinatal Factors, Socio-Demographic Factors, Familial Risk, Comorbidity.