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

Tingting Zhu; Jing Gan; Jichong Huang; Yafei Li; Yi Qu; Dezhi Mu

doi:10.1177/0883073816650039

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

J Child Neurol. 2016 Sep;31(10):1235-44. doi: 10.1177/0883073816650039. Epub 2016 May 26.

Authors

Tingting Zhu¹, Jing Gan¹, Jichong Huang¹, Yafei Li¹, Yi Qu¹, Dezhi Mu²

Affiliations

¹ Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
² Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China Department of Pediatrics and Neurology, University of California, San Francisco, San Francisco, CA, USA mudz@scu.edu.cn.

PMID: 27229008
DOI: 10.1177/0883073816650039

Abstract

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.

Keywords: ADHD; hypoxia; ischemia; meta-analysis; risk factor.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Asphyxia Neonatorum / complications
Asphyxia Neonatorum / epidemiology*
Attention Deficit Disorder with Hyperactivity / epidemiology*
Attention Deficit Disorder with Hyperactivity / etiology*
Case-Control Studies
Fetal Hypoxia / complications
Fetal Hypoxia / epidemiology*
Humans
Risk Factors