From Early to Fewer First Births: ADHD and Family Formation among Young Adults

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is common and linked to relationship difficulties. It may affect the likelihood and timing of parenthood, yet its implications for fertility remain unclear.MethodsUsing Finnish population registers, we followed 759,430 individuals born in 1982–1993 to examine how ADHD is associated with the likelihood and timing of a first birth among young adults. ADHD diagnoses were identified from healthcare and prescription records. Discrete-time event-history models were estimated separately for women and men. Interaction analyses assessed whether a partner’s ADHD modified associations.ResultsIn age- and cohort-adjusted models, ADHD was linked to lower odds of a first birth (men OR 0.92; women OR 0.90), but after adjusting for partnerships the association was reversed (men OR 1.07; women OR 1.09). At ages 18–23, ADHD was associated with a higher likelihood of having a first birth, whereas an opposite association was observed at ages at 24–30 and 31–38. Thus, ADHD was related to a higher likelihood of first birth at young ages and lower likelihood at older ages. Both partners having ADHD does not seem to intensify the association.ConclusionsADHD is associated with earlier entry into parenthood but a lower risk of first birth at later ages. The results highlight the importance of accounting for partnerships: before this adjustment, ADHD was negatively related to the likelihood of becoming a parent, whereas after adjusting for partnerships the association reversed. This underscores partnership formation as a key pathway and suggests that supporting stable unions may help mitigate ADHD-related disparities in first births.Keywords: first birth, child, family formation, ADHD, partnerships