Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease

Clin Pediatr (Phila). 2015 Oct;54(11):1087-93. doi: 10.1177/0009922815594356. Epub 2015 Jul 6.

Abstract

Background: Children with sickle cell disease have an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder, intellectual disability, and specific learning disabilities. Little research has been done to characterize the sickle cell disease-related characteristics associated with neurodevelopmental disorders in the sickle cell disease population.

Methods: This study was a retrospective chart review involving the outpatient records of 2 medical centers, Kennedy Krieger Institute and Johns Hopkins Hospital. Participants in the study included 59 children with sickle cell disease with a documented neurodevelopmental diagnosis, specifically attention deficit hyperactivity disorder, attention issues, behavioral issues, executive dysfunction, specific learning disabilities in math, reading, and reading comprehension, intellectual disabilities, developmental delay, fine motor disorders, language disorders, or autism spectrum disorders.

Results: Children with sickle cell disease type hemoglobin S-β thalassemia plus had significantly higher odds of attention issues than children with sickle cell disease type hemoglobin SS (OR = 17.0, 95% CI = 1.99-145.00, P < .02). Children with sickle cell disease and a reported history of asthma had significantly higher odds of behavioral issues than children with sickle cell disease without a history of asthma, after adjustment for gender and sickle cell disease type (exact OR = 19.53, 95% CI = 1.16-1369.72, P < .04).

Conclusion: Children with sickle cell disease may have increased risk for certain neurodevelopmental diagnoses based on their disease characteristics and associated comorbidities. These preliminary study results should be explored in a larger database.

Keywords: ADHD; neurodevelopmental disorders; sickle cell disease.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / epidemiology*
  • Asthma / epidemiology*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Baltimore / epidemiology
  • Child Behavior Disorders / epidemiology
  • Comorbidity
  • Developmental Disabilities / epidemiology
  • Female
  • Humans
  • Learning Disabilities / epidemiology
  • Male
  • Neurodevelopmental Disorders / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Urban Population