Yin-Kai Zhao, Meng Li, Ting-Ting Shi, Miao-Miao Feng, Lu-Lu Hu
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Data synthesis was performed using random-effect models, and the quality of studies was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>This study included twelve studies, which revealed a significant association between premature delivery and an increased risk of ADHD in children [odds ratio (OR) = 2.76, 95% confidence interval (CI): 2.52-3.04, <i>P</i> < 0.001, <i>I²</i> = 1.9%). Conversely, higher maternal education levels were significantly associated with a reduced risk of ADHD in children (OR = 0.59, 95%CI: 0.48-0.73, <i>P</i> < 0.001, <i>I²</i> = 47.1%). Subgroup analysis further indicated that maternal education levels significantly influenced ADHD risk, particularly in studies conducted in China (OR = 0.59, 95%CI: 0.46-0.75, <i>P</i> < 0.001, <i>I²</i> = 81.2%), while no significant association was observed in studies from other regions (OR = 1.25, 95%CI: 0.66-2.40, <i>P</i> = 0.495, <i>I²</i> = 92.3%). The sensitivity analysis confirmed the robustness of our findings, showing no significant publication bias.</p><p><strong>Conclusion: </strong>This study found that preterm birth significantly increases the risk of ADHD in children, while a higher maternal education level serves as a protective factor against ADHD. 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Data synthesis was performed using random-effect models, and the quality of studies was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>This study included twelve studies, which revealed a significant association between premature delivery and an increased risk of ADHD in children [odds ratio (OR) = 2.76, 95% confidence interval (CI): 2.52-3.04, <i>P</i> < 0.001, <i>I²</i> = 1.9%). Conversely, higher maternal education levels were significantly associated with a reduced risk of ADHD in children (OR = 0.59, 95%CI: 0.48-0.73, <i>P</i> < 0.001, <i>I²</i> = 47.1%). Subgroup analysis further indicated that maternal education levels significantly influenced ADHD risk, particularly in studies conducted in China (OR = 0.59, 95%CI: 0.46-0.75, <i>P</i> < 0.001, <i>I²</i> = 81.2%), while no significant association was observed in studies from other regions (OR = 1.25, 95%CI: 0.66-2.40, <i>P</i> = 0.495, <i>I²</i> = 92.3%). 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引用次数: 0
摘要
背景:注意缺陷多动障碍(ADHD)是儿童时期常见的神经发育障碍。越来越多的证据表明,早产和母亲的教育水平对儿童患多动症的可能性都有很大的影响。然而,关于这些关联的系统综述和荟萃分析有限。目的:对早产儿和母亲受教育程度与儿童ADHD风险的关系进行系统回顾和meta分析。方法:我们在MEDLINE (PubMed)、Web of Science、Embase和Cochrane图书馆进行了全面的文献检索,包括截至2024年6月17日发表的研究。使用随机效应模型进行数据综合,并使用纽卡斯尔-渥太华量表评估研究质量。结果:本研究纳入12项研究,结果显示早产与儿童ADHD风险增加之间存在显著关联[优势比(OR) = 2.76, 95%可信区间(CI): 2.52-3.04, P < 0.001, I²= 1.9%]。相反,较高的母亲教育水平与儿童ADHD风险降低显著相关(OR = 0.59, 95%CI: 0.48-0.73, P < 0.001, I²= 47.1%)。亚组分析进一步表明,母亲受教育程度显著影响ADHD风险,特别是在中国进行的研究中(OR = 0.59, 95%CI: 0.46-0.75, P < 0.001, I²= 81.2%),而在其他地区的研究中未观察到显著关联(OR = 1.25, 95%CI: 0.66-2.40, P = 0.495, I²= 92.3%)。敏感性分析证实了我们研究结果的稳健性,没有明显的发表偏倚。结论:本研究发现,早产显著增加了儿童患ADHD的风险,而较高的母亲教育水平是预防ADHD的保护因素。为了降低儿童ADHD的发病率,公共卫生政策应注重对早产儿的早期干预和提高母亲的教育水平。
Association of premature birth and maternal education level on attention deficit hyperactivity disorder in children: A meta-analysis.
Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in childhood. There is growing evidence that both preterm birth and maternal education levels substantially affect the likelihood of ADHD in children. However, there are limited systematic reviews and meta-analyses examining these associations.
Aim: To systematically review and conduct a meta-analysis on the association of preterm birth and maternal education level on the risk of ADHD in children.
Methods: We conducted a comprehensive literature search across MEDLINE (PubMed), Web of Science, Embase, and the Cochrane Library, including studies published up to June 17, 2024. Data synthesis was performed using random-effect models, and the quality of studies was assessed using the Newcastle-Ottawa Scale.
Results: This study included twelve studies, which revealed a significant association between premature delivery and an increased risk of ADHD in children [odds ratio (OR) = 2.76, 95% confidence interval (CI): 2.52-3.04, P < 0.001, I² = 1.9%). Conversely, higher maternal education levels were significantly associated with a reduced risk of ADHD in children (OR = 0.59, 95%CI: 0.48-0.73, P < 0.001, I² = 47.1%). Subgroup analysis further indicated that maternal education levels significantly influenced ADHD risk, particularly in studies conducted in China (OR = 0.59, 95%CI: 0.46-0.75, P < 0.001, I² = 81.2%), while no significant association was observed in studies from other regions (OR = 1.25, 95%CI: 0.66-2.40, P = 0.495, I² = 92.3%). The sensitivity analysis confirmed the robustness of our findings, showing no significant publication bias.
Conclusion: This study found that preterm birth significantly increases the risk of ADHD in children, while a higher maternal education level serves as a protective factor against ADHD. To reduce the incidence of ADHD in children, public health policies should focus on early intervention for preterm infants and improving maternal education levels.
期刊介绍:
The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.