A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course

Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the ADHD Care Cascade. We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the ADHD Care Cascade. By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course.

Automated summary

Preterm birth is associated with an increased risk of ADHD, and both prematurity and ADHD have impacts on various aspects of pediatric life-course. The ADHD Care Cascade provides a framework for individuals to access appropriate services and treatments for ADHD. Racial and ethnic inequities affect the risk of preterm birth and steps along the ADHD Care Cascade. Inequalities accumulate over time to magnify the neurodevelopmental impact of preterm birth on vulnerable children throughout their life-course.