Socio-maternal risk factors of ADHD among Iraqi children: A case-control study

Background: Attention-deficit hyperactivity disorder (ADHD) is a chronic disorder that appears first in childhood at preschool age (4 - 5) years, and is manifested by a symptomatic pattern of difficulties with attention, motor activity and impulsivity. Maternal factors like stress, socio-demographic and maternal life style factors are potential risk factors for ADHD. Methodology: A retrospective case-control study was conducted in Baghdad-Iraq. Cases have been taken from 5 private paediatric clinics. Controls were chosen from kindergartens within the same residential area of the paediatric private clinics. Mothers of cases and controls were investigated for the risk factors of ADHD using a self-administered questionnaire. The total sample size was 260. Number of cases was 130 and number of controls was 130. Results: Five variables were significantly associated with development of ADHD after using a multivariate logistic regression model, maternal war stress (Adjusted OR 9.08, 95% CI 4.70 - 17.52 and P value < 0.001), maternal smoking (Adjusted OR 3.27 95% CI 1.40 - 7.63, P < 0.001), father lost job (Adjusted OR 2.81, 95% CI 1.51 - 5.24, P value < 0.001), and house damaged (Adjusted OR 2.55, 95% CI 1.04 - 6.24, P < 0.05). Family income was also associated with risk of ADHD (OR 1.02 95% CI 1.00 - 3.12, P value < 0.05). Conclusion and suggestion: Maternal exposure to war stress has 9 times higher risk of developing ADHD among offspring. This study aimed to offer to the policy makers a good benchmark to plan more programmes related to women and child health with respect to the fourth and fifth Millennium Development Goals (MDGs) in reduction of child mortality and morbidity and improvement of maternal health. There is a real necessity to address the need of vulnerable pregnant mothers at war and disaster’s time for programmes which will be able to control the stress that those pregnant mothers would encounter during those hard times.