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zoom RSS アプガースコア低下がADHD発症リスクと関連

<<   作成日時 : 2011/02/22 20:58   >>

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 新たな研究によれば、生後数分の新生児の健康状態が後で注意欠陥多動性障害(ADHD)の発症リスクに関連する可能性があるという。
 新生児のアプガースコアは呼吸、心拍、および筋緊張を含むいくつかの身体的徴候に基づく。7以上が正常で、9-10が新生児が最も良い状態にあることを示す。98万人以上のデンマーク子供について調査したところ、アプガースコアの低下がADHD発症のリスク増大と関連していた。スコア9-10の子どもに比べて、5-6の子どもはADHDリスクが63%高く、1-4では75%大きかった。
 1988年と2001年の間で誕生したデンマーク全国の980,902人の子供のうち8,234人がADHDと診断されほとんどは男だった。
 しかし、ほとんどの子どもはアプガースコアに関わらずADHDではなかった。結局アプガースコアがADHDに対して実際どういう意味を持つかはわかっていない。

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Health at birth tied to ADHD risk
http://www.reuters.com/article/2011/02/11/us-adhd-risk-idUSTRE71A7KO20110211

By Amy Norton

NEW YORK | Fri Feb 11, 2011 5:35pm EST

NEW YORK (Reuters Health) - A baby's health in the first minutes after birth may be linked to his or her risk of developing attention-deficit hyperactivity disorder (ADHD) later on, a new study suggests.

The findings, reported in the Journal of Pediatrics, suggest that the so-called Apgar score assigned to all newborns in the first five minutes of life may give some hint of a child's future risk of ADHD, a condition that involves attention problems and impulsive behavior.

A newborn's Apgar score is based on several physical signs, including breathing, heart rate and muscle tone. A score of 7 or higher is considered normal, with a 9 or 10 indicating that the baby is in the "best possible condition."

In the new study, researchers found that among more than 980,000 Danish children, the risk of developing ADHD climbed as Apgar scores dropped.

Compared with children whose scores had been a 9 or 10, those with a 5 or 6 had a 63 percent higher risk of ADHD. And those with an Apgar of 1 to 4 had a 75 percent greater risk.

In the U.S., surveys have found that nearly one in 10 school-aged kids have been diagnosed with the condition, according to the Centers for Disease Control and Prevention.

Exactly what the new findings mean is unclear. An abnormal Apgar score could reflect some sort of stress during pregnancy or birth -- like decreased oxygen supply -- that might contribute to ADHD development down the road, the researchers speculate.

"There may be a sharing of causes of low Apgar score and ADHD, but our analyses do not point (to) any specific factor here," Dr. Carsten Obel, one of the researchers on the work, told Reuters Health in an email.

A number of studies have linked preterm birth to an increased risk of ADHD, although the reasons aren't clear, noted Obel, of Aarhus University in Denmark.

Both preterm birth and a low Apgar score may be markers of less-than-optimal fetal development, he explained.

The findings are based on Danish national registry data for 980,902 children born between 1988 and 2001. Of those children, 8,234 were diagnosed with ADHD -- most of them boys.

Even after the researchers accounted for factors like preterm birth, family income and mothers' smoking and education levels, the risk of ADHD was higher among kids with Apgar scores below 7.

Still, the vast majority of children in the study were not diagnosed with ADHD, regardless of Apgar score. And it's not clear whether the Apgar-ADHD link might eventually have any practical implications.

In this study group, Obel said, the ability of a child's score to predict ADHD was not that strong.

"We do not find that the predictive value is so good that we routinely should inform parents who (have) a child with a low Apgar score about the higher risk of ADHD," Obel said.

Future studies, he said, could try to undercover the reasons for the link between Apgar score and ADHD. Large population studies might also be able to look at how combinations of factors -- like low Apgar score plus a family history of ADHD -- come into play.

SOURCE: bit.ly/el6Hjs Journal of Pediatrics, online January 18, 2011.


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