From Early to Fewer Births: ADHD and Family Formation

Sanna Kailaheimo-Björkqvist , University of Helsinki
Niina Metsä-Simola, University of Helsinki
Mikko Myrskylä, Max Planck Institute for Demographic Research

BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is common, yet its implications for fertility remain unclear. Because ADHD is linked to difficulties in relationships, it may influence both the likelihood and timing of entry into parenthood. METHODS We used Finnish population register data on 759,430 individuals born in 1982–1993. ADHD was identified based on diagnoses and prescription records. The outcome was the first birth by age, analysed using discrete-time event history models estimated separately for women and men. Interaction analyses assessed whether having a partner with ADHD influenced fertility outcomes. RESULTS ADHD was negatively associated with the likelihood of having a first child in models adjusted for age and birth year, with similar effects for men and women. In the fully adjusted model, which also accounted for partnership variables, the association reversed: individuals with ADHD had almost 10% higher odds of having a first child compared to those without ADHD. Having a partner with ADHD was negatively associated with the likelihood of a first birth, while childbearing was lowest among individuals without a co-residential partner. Predicted cumulative probabilities showed that individuals with ADHD entered parenthood earlier, but their overall likelihood of having a first child was lower. CONCLUSION ADHD is linked to earlier but ultimately less frequent entry into parenthood. Much of this disadvantage is explained by educational and partnership differences. Once partnership status is taken into account, individuals with ADHD are slightly more likely to become parents, underscoring the central role of relationship formation in shaping fertility patterns among people with ADHD.

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 Presented in Session 1. Flash Session Fertility and Health