ADHD and Teenage Pregnancies

This week’s blog is a summary of a study from our Swedish research group at Uppsala University and Karolinska Institutet. The study called Association of Attention-Deficit/Hyperactivity Disorder with Teenage Birth Among Women and Girls in Sweden was published in JAMA Netw Open in 2019 and explore if women with ADHD have a higher risk of teenage births than their unaffected peers.

ADHD is associated with increased risk taking and negative health related outcomes for both males and females and we know that girls and young women with ADHD have an earlier initiation of sexual activity than non-ADHD females. Also, they seem to have and more (casual) sexual partners and risky sexual behaviors, and perhaps not surprisingly also a higher risk for sexually transmitted diseases, victimization, and unplanned pregnancies. Swedish youth clinics have, since the 1970-ies carefully and successfully targeted these risks and given the easy access, free of charge counseling and contraception in Sweden all women should be able to plan their family life and future childbirths. Still, this is not the case for girls and women with ADHD. We therefore wanted to perform a study to find out why we fail to reach and support young women with ADHD. Our primary objective was to explore if teenage motherhood was more common in adolescent women with ADHD compared to same aged women without ADHD. And because eating disorders, overweight, smoking, and risky alcohol use is more common in both males and females with ADHD, we also wanted to find out if these young teenage women had particularly risky pregnancies.

We collected over 380,000 Swedish women that gave birth between 2007 and 2014 and when we compared women with ADHD to those without a diagnosis, we saw that that teenage girls and women with ADHD were six times more likely to become mothers when they were practically only children themselves (15.2% vs. 2.8%). ADHD-women also had more risky pregnancies, were more often smoking, or under- and overweight, during their pregnancy.

So, why is this important to know and what can, and should we do about it? Becoming a mother at very early age has long-term consequences for both the young mother and her small child. Research shows that young parents struggle to get an education, more often are single parents and depend on welfare. The negative consequences are transmitted to their children via risks during the pregnancy and negative outcomes such as low socioeconomic status and low quality of life later in life. This study could not answer the question of why this is. Hypothetically, women with ADHD may need other forms of contraceptive counseling? Or maybe they have more side effects from hormonal contraceptives and stop taking them? This is a hypothesis that we explored in our most recent study Hormonal Contraceptive Use and Risk of Depression Among Young Women with Attention-Deficit/Hyperactivity Disorder. You can read more about this study and what we found in that in a previous blog here. Regardless of why, we know that delaying childbirth until after age 25 is positive for both mother and child pointing to the importance of improving standard of care for women with ADHD. We predict that trans-disciplinary collaboration between psychiatry, gynecology, and youth clinics, such our research group GODDESS ADHD (Gender-informed research to Overcome Diagnostic Delay and Emotional dysregulation through Self-awareness and Self-efficacy in female ADHD) should have a fair chance to at least get closer to the needs and preferences of this vulnerable and previously underserved group of girls and young women. So, stay tuned for updates about everything from female specific ADHD and ADD symptoms, the adult female ADHD life and specific signs of ADHD in girls and women here!

Reference:

Skoglund C, Kopp Kallner H, Skalkidou A, Wikström AK, Lundin C, Hesselman S, Wikman A, Sundström Poromaa I. Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden. JAMA Netw Open. 2019 Oct 2;2(10):e1912463. doi: 10.1001/jamanetworkopen.2019.12463. PMID: 31577361; PMCID: PMC6777395.