A Family-Based Study of the Association Between Labor Induction and Offspring Attention-Deficit Hyperactivity Disorder and Low Academic Achievement
The current study examined associations between labor induction and both (1) offspring attention-deficit hyperactivity disorder (ADHD) diagnosis in a Swedish birth cohort born 1992–2005 (n = 1,085,008) and (2) indices of offspring low academic achievement in a sub-cohort born 1992–1997 (n = 489,196). Associations were examined in the entire sample (i.e., related and unrelated individuals) with adjustment for measured covariates and, in order to account for unmeasured confounders shared within families, within differentially exposed cousins and siblings. We observed an association between labor induction and offspring ADHD diagnosis and low academic achievement in the population. However, these associations were fully attenuated after adjusting for measured covariates and unmeasured factors that cousins and siblings share. The results suggest that observed associations between labor induction and ADHD and low academic achievement may be due to genetic and/or shared environmental factors that influence both mothers’ risk of labor induction and offspring neurodevelopment.
KeywordsLabor induction Attention-deficit hyperactivity disorder Academic achievement Family studies Sibling comparison Cousin comparison
This study was supported by grants from the Indiana Clinical and Translational Sciences Institute: Pediatric Project Development Team; the Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) framework Grant No 340-2013-5867; the National Institute of Health, T32 Grant No HD 07475. This study was approved by the Institutional Review Board at the Karolinska Institutet.
Compliance with Ethical Standards
Conflict of interest
H Larsson has served as a speaker for Eli-Lilly and Shire and has received research grants from Shire; all outside the submitted work. Paul Lichtenstein has served as a speaker for Medice. All other authors report no conflicts of interest.
Research Involving with Human and Animal Rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and/or with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent was not required. This article does not contain any studies with animals performed by any of the authors.
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