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The Limited Effects of Obstetrical and Neonatal Complications on Conduct and Attention-Deficit Hyperactivity Disorder Symptoms in Middle Childhood

Wagner, Anna I. BA*; Schmidt, Nicole L. MS*; Lemery-Chalfant, Kathryn PhD; Leavitt, Lewis A. MD; Goldsmith, H Hill PhD*

Journal of Developmental & Behavioral Pediatrics: June 2009 - Volume 30 - Issue 3 - p 217-225
doi: 10.1097/DBP.0b013e3181a7ee98
Original Article

Objective: The purpose of this study was to examine the effects of a wide range of obstetrical and neonatal complications as well as socioeconomic variables on the behaviors characterized by attention-deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder.

Method: Data were collected on 7- to 8-year old twins, using multiple instruments assessing many areas of individual and family functioning. The influence of several aspects of prenatal care, labor and delivery, and early life were considered as well as indicators of socioeconomic status, such as family income and maternal education.

Results: The observed associations were stronger for attention-deficit hyperactivity disorder than conduct disorder symptoms and stronger for females than males. Family income and gender significantly predicted both behavioral outcomes, whereas birth weight predicted attention-deficit hyperactivity disorder symptoms only. However, the presence of attention-deficit hyperactivity disorder and conduct symptom behaviors were not associated with an occurrence of more obstetrical or neonatal complications as indicated by hierarchical linear modeling analyses.

Conclusions: By school age, behavioral problems related to inattention, impulsivity, hyperactivity, defiance, and conduct are relatively unaffected by general adversity in the neonatal and perinatal periods.

From the *Waisman Center and Department of Psychology, University of Wisconsin—Madison, Madison, WI; †Department of Psychology, Arizona State University, Tempe, AZ; ‡Waisman Center and Department of Pediatrics, University of Wisconsin—Madison, Madison, WI.

Received April 2008; accepted March 2009.

The research was supported by NIMH (R01 MH59785 and R37 MH50560 to H.H.G. and LL-C; P50-MH069315, Project 4 (H.H.G.). The Waisman Center provided core support (P30-HD03352).

Address for reprints: H. Hill Goldsmith, PhD, Department of Psychology, University of Wisconsin, 1202 West Johnson Street, Madison, WI 53706; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.