Recently, Anhui Province issued China’s first list of cesarean section management! On August 24, Anhui Health Planning Commission adopted 15 indications for the implementation of cesarean section. One of them is worthy of attention: if the mother strongly requests it, even without clear indications, a cesarean delivery is feasible with the signature of the pregnant woman and the attending physician in order to avoid medical disputes. If a mother chooses to terminate her pregnancy at random, it may result in premature birth, poor growth and increased risk of ADHD, you know? Infants born prematurely or with poor fetal growth and development are at increased risk for ADHD (attention deficit hyperactivity disorder in children), and the risk persists even in early infancy, according to the latest population-based study, published online Aug. 24 in the medical journal Pediatrics. “We have confirmed the idea that the risk of ADHD in infants increases with decreasing gestational weeks, which emphasizes the importance of each gestational week for late neurodevelopment.” Professor Minna Sucksdorff from the Department of Medicine, University of Turku, Finland, and colleagues reported, “However, we found that poor growth and development during fetal life also increases the risk of ADHD.” The researchers evaluated data from 10,321 patients with ADHD and 38,355 age- and sex-matched controls to clarify the association between gestational age and weight and the risk of developing ADHD, and stratified the potential association by weekly measures of fetal maturity. Data from the Finnish National Registry and the Finnish Medical Birth Registry have been used to identify singleton infants born between 1991.1.1 and 2005.12.31 and diagnosed with ADHD before 2011.12.31. Children diagnosed with ADHD before 2 years of age and with severe mental retardation or lack of information on gestational age and birth weight have been excluded. The mean age at diagnosis was 7.6 years, and 84% of the children were boys. After adjusting for confounding factors such as smoking during pregnancy, parental age, socioeconomic status and parental psychiatric history, the researchers found that “the risk of ADHD increased as the number of weeks of gestation decreased.” The adjusted ORs and 95% confidence interval CIs at 25, 30, 35, 37 and 38 weeks of gestation can be seen in the table below: In addition, while finding that the increased risk of ADHD depended on small for gestational age, the researchers noted that the risk of ADHD increased almost exponentially for infants with birth weights two standard deviations below the mean weight after adjusting for confounding factors, and The researchers noted that even though the association between ADHD and preterm birth has been statistically assessed, the difference between births at 34 to 36 weeks and births at 37 to 38 weeks was small, which could be explained by the “large number of ADHD cases based on population level”. In fact, many factors can contribute to ADHD in infants, including cortical hypoplasia and myelin formation defects, as well as factors that can influence premature delivery, such as infection, immune-mediated lesions and stress. Ultimately, the researchers concluded by highlighting “the importance of taking into account both preterm birth and fetal growth disorders when planning follow-up and support policies.” Pregnant moms, don’t be so capricious, a day that is naturally ripe is a truly auspicious day!