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From early to fewer first births: ADHD and family formation among young adults.

Created on 24 Jun 2026

Authors

Sanna Kailaheimo-Björkqvist, Niina Metsä-Simola, Mikko Myrskylä

Published in

Journal of epidemiology and community health. Jun 23, 2026. Epub Jun 23, 2026.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is common and associated with relationship difficulties, which may influence entry into parenthood.
We used Finnish population register data to follow 759,430 individuals born in 1982-1993 and examined how ADHD is associated with the likelihood and timing of a first birth. ADHD was identified using healthcare diagnoses and prescription records. We estimated discrete-time event history models and sibling fixed-effects models to account for shared family background. All analyses were conducted separately for women and men.
In models adjusted for age and birth cohort, ADHD was associated with a lower likelihood of a first birth (ages 18-38) (men OR 0.92; women OR 0.90). After adjusting for partnership characteristics, the association reversed (men OR 1.07; women OR 1.09). All age-stratified analyses showed that ADHD was associated with a higher likelihood of first birth at ages 18-23, but with a lower likelihood at ages 24-30 and 31-38, indicating earlier entry into parenthood among individuals with ADHD. Results from sibling fixed-effects models were broadly similar to the population-level estimates, suggesting limited confounding by shared family background.
ADHD is associated not only with earlier entry into parenthood but also with a reduced overall probability of having a first child. Accounting for partnership status is important, as it largely explains the negative association observed in age-adjusted models. These findings highlight partnerships as a key pathway linking ADHD to fertility outcomes.

PMID:
42336634
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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