Association Between Perinatal Hypoxic-Ischemic Conditions and Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis.

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder worldwide, but its etiology is still not fully understood. Previous studies have reported that perinatal hypoxic-ischemic conditions may be a potential cause of ADHD.

METHODS

An online search of potential English studies published before September 2015 was conducted using the PsycINFO, EMBASE, Web of Science, and PubMed databases. The combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with random-effects models.

RESULTS

Ten studies were included, with 45 821 cases and 9 207 363 controls. The metaresults found that the following were associated with ADHD: preeclampsia (OR 1.31; 95% CI 1.26-1.37), an Apgar score <7 at 5 minutes (OR 1.31; 95% CI 1.12-1.54), breech/transverse presentations (OR 1.14; 95% CI 1.06-1.23), and a prolapsed/nuchal cord (OR 1.10; 95% CI 1.06-1.15).

CONCLUSION

Our results support that perinatal hypoxia-ischemia may contribute to ADHD. However, more clinical studies are warranted.