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
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.
Cite this paper
Saadi, H. , Shamsuddin, K. , Sutan, R. and Alshaham, S. (2013) Socio-maternal risk factors of ADHD among Iraqi children: A case-control study. Open Journal of Preventive Medicine, 3, 251-257. doi: 10.4236/ojpm.2013.32034.
 Faraone, S.V., Sergeant, J.A., Gillberg, C. and Biederman, J. (2003) The worldwide Prevalence of ADHD: Is it an American condition? World Psychiatry, 2, 104-113.
 Rohade, L.A., Beiderman, J., Busnello, E.A., et al. (1999) ADHD in a school sample of Brazilian Adolescents: A study of prevalence, comorbid conditions, and impairments. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 716-722.
 Behrman, E. and Kleigman, M.J. (2004) Attention deficit hyperactivity disorder: Psychologic disorders. Nelson Textbook of Pediatrics, 3, 70-73.
 Biederman, J. and Faraone, S.V. (2005) Attention deficit hyperactivity disorder. Lancet, 48, 327-366.
 AlObaidi, A. and Ali, N.S. (2009) Attention deficit/hyperactivity disorder among schoolchildren in Baghdad. Journal of the American Academy of Child and Adolescent Psychiatry, 18, 4-5.
 Barkley, R.A., DuPaul, G.J. and McMurray, M.B. (1990) A comprehensive evaluation of atten-tion deficit disorder with and without hyperactivity. Journal of Consulting and Clinical Psychology, 58, 775-789.
 Teixeira, J.A.M., Fisk, N.M. and Glover, V. (1999) Association between maternal anxiety in pregnancy and increased uterine artery resistance index: Cohort based study. British Medical Journal, 318, 153-157.
 Modell, M., Mughal, Z. and Boyd, R. (1998) Brain development of the fetus: Neurological development of attention. Brain Development in Pediatrics, 6, 92-96.
 Rangon, C.M., Fortes, S., Lelièvre, V., Leroux, P., Plaisant, F., Joubert, C., Lanfumey, L., Cohen-Salmon, C. and Gressens, P. (2007) Chronic mild stress during gestation worsens neonatal brain lesions in mice. Journal of Neuroscience, 27, 7532-7540.
 Barrot, M., Marinelli, M., Abrous, D., Pont, F., Moal, M. and Piazza, P. (2001) The dopaminergic hyper-responsiveness of the shell of the nucleus accumbens is hormonedependent. European Journal of Neuroscience, 12, 973979. doi:10.1046/j.1460-9568.2000.00996.x
 Van den Berg, M.P. (2005) Prenatal psychopathology and the early developing child: The generation R study. European Journal of Neuroscience, 17, 55-58.
 Xu, X., Harville, E.W., Mattison, D.R., Elkind-Hirsch, K., Pridjian, G. and Buekens, P. (2011) Exposure to Hurricane Katrina, post-traumatic stress disorder and birth outcome: Errature. American Journal of Medical Sciences, 341, 85.
 Catani, C., Jacob, N., Schauer, E., et al. (2008) Family violence, war, and natural disasters: A study of the effect of extreme stress on children’s mental health in Sri Lanka. BMC Psychiatry, 8, 33. doi:10.1186/1471-244X-8-33
 Tol, W.A., Komproe, I.H., Susanty, D., et al. (2008) School-based mental health intervention for children affected by political violence in Indonesia: A cluster randomized trial. Journal of the American Medical Association, 300, 655-662. doi:10.1001/jama.300.6.655
 Wadhawa, P. (1998) Prenatal stress and life-span development. In: Friedman, H.S., Ed., Encyclopedia of Mental Health, Academic Press, San Diego, 265-280.
 Huttunen, M.O. and Niskanen, P. (1987) Prenatal loss of father and psychiatric disorders. Archives of General Psychiatry, 35, 429-431.
 Mash, E.J. and Johnston, C. (1990) Determinants of parenting stress: Illustrations from families of hyperactive children and families of physically abused children. Journal of Clinical Child Psychology, 19, 313-328.
 Knopik, V.S., Sparrow, E.P., Madden, P.A., et al. (2005) Contributions of paternal alcoholism, prenatal substance exposure, and genetic transmission to child ADHD risk: A female twin study. Psychological Medicine, 35, 625-635.
 Linnet, K.M., Wisborg, K., Obel, C., et al. (2005) Smoking during pregnancy and risk of hyperkinetic disorder in offspring. Pediatrics, 116, 462-467.
 Langley, K., Rice, F., Van den Bree, M.B. and Thapar, A. (2005) Maternal smoking during pregnancy as an environmental risk factor for attention deficit hyperactivity disorder behavior: A review. Minerva Pediatrica, 57, 359371.
 Sexton, M., Fox, N.L. and Hebel, J.R. (1990) Parental exposure to tobacco. Effects on cognitive functioning at age three. International Journal of Epidemiology, 19, 7277. doi:10.1093/ije/19.1.72