Risks of Neurodevelopmental Disorders in Offspring of Parents with Bipolar Disorder: A Birth Cohort Study

Abstract Objectives: In this study, we intended to assess the risks of neurodevelopmental disorders (NDDs) in children of parents with bipolar disorder (BD) with a nationwide birth cohort, and to compare them with matched controls from the general community. Methods: With the population-based cohort from Taiwan’s National Health Insurance Research Database, we included 2,169 offspring of parents diagnosed with BD (1996 – 2010), matched 1:10 with 21,690 offspring without BD in controls. NDDs included autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), tic disorder, developmental delays, speech/language disorder, coordination disorder, and intellectual disability (ID), based on the codes of the International Classification of Diseases 9th Revision, Clinical Modification . Results: Offspring of parents with BD had significantly elevated risks for ADHD (hazard ratio [95% confident interval] = 2.27 [1.91–2.70] , p < 0.05), developmental delays (1.58 [1.34–1.87], p < 0.05), speech/language disorder (1.34 [1.08–1.67], p < 0.05), coordination disorder (1.77 [1.20–2.60], p < 0.05), and ID (1.92 [1.38–2.67], p < 0.05), compared with those in controls. Elevated but nonsignificant risks were found for ASD and tic disorder. Children of BD parents also had more significantly more preterm or low birth weight ( p < 0. 05), neonatal jaundice ( p < 0.05), and higher annual clinical visit rates ( p < 0.01). Conclusion: Parental BD is associated with increased risks of multiple NDDs in offspring, particularly ADHD and ID. These findings underscore the need for early surveillance and intervention strategies targeting at children of BD-affected parents to mitigate long-term developmental impairments.