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.
LinnetKMDalsgaardSObelC. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry. 2003;160:1028–1040.
2.
RowlandASLesesneCAAbramowitzAJ. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev. 2002;8:162–170.
3.
AnselmiLFleitlich-BilykBMenezesAM. Prevalence of psychiatric disorders in a Brazilian birth cohort of 11-year-olds. Soc Psychiatry Psychiatr Epidemiol. 2010;45:135–142.
4.
BianchiniRPostorinoVGrassoR. Prevalence of ADHD in a sample of Italian students: a population-based study. Res Dev Disabil. 2013;34:2543–2550.
5.
HoldenSEJenkins-JonesSPooleCD. The prevalence and incidence, resource use and financial costs of treating people with attention deficit/hyperactivity disorder (ADHD) in the United Kingdom (1998 to 2010). Child Adolesc Psychiatry Ment Health. 2013;7:34.
6.
AngoldAErkanliAEggerHLCostelloEJ. Stimulant treatment for children: A community perspective. J Am Acad Child Adolesc Psychiatry. 2000;39:975–984.
7.
SecnikKSwensenALageMJ. Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder. Pharmacoeconomics. 2005;23:93–102.
8.
MaoARFindlingRL. Comorbidities in adult attention-deficit/hyperactivity disorder: a practical guide to diagnosis in primary care. Postgrad Med. 2014;126:42–51.
9.
HinojosaMSHinojosaRFernandez-BacaD. Parental strain, parental health, and community characteristics among children with attention deficit-hyperactivity disorder. Acad Pediatr. 2012;12:502–508.
10.
CussenASciberrasEUkoumunneOC. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr. 2012;171:271–280.
11.
KetzerCRGalloisCMartinezAL. Is there an association between perinatal complications and attention-deficit/hyperactivity disorder-inattentive type in children and adolescents?Rev Bras Psiquiatr. 2012;34:321–328.
12.
AmiriSMalekASadegfardM. Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study. ISRN Pediatr. 2012;2012:458064.
13.
MannJRMcDermottS. Are maternal genitourinary infection and pre-eclampsia associated with ADHD in school-aged children?J Atten Disord. 2011;15:667–673.
14.
Froehlich-SantinoWLondono TobonAClevelandS. Prenatal and perinatal risk factors in a twin study of autism spectrum disorders. J Psychiatr Res. 2014;54:100–108.
15.
van HandelMSwaabHde VriesLS. Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review. Eur J Pediatr. 2007;166:645–654.
16.
NatarajanGShankaranSLaptookAR. Apgar scores at 10 min and outcomes at 6-7 years following hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2013;98: F473–F479.
GetahunDRhoadsGGDemissieK. In utero exposure to ischemic-hypoxic conditions and attention-deficit/hyperactivity disorder. Pediatrics. 2013;131:e53–e61.
19.
WellsGA. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. Ottawa, Canada: Ottawa Hospital Research Institute. Available at:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed April 2, 2012.
20.
HigginsJPThompsonSGDeeksJJ. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560.
21.
SilvaDColvinLHagemannEBowerC. Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics. 2014;133:e14–e22.
22.
GolmirzaeiJNamaziSAmiriS. Evaluation of attention-deficit hyperactivity disorder risk factors. Int J Pediatr. 2013;2013:953103.
23.
HalmøyAKlungsøyrKSkjærvenR. Pre- and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2012;71:474–481.
24.
LiJOlsenJVestergaardMObelC. Low Apgar scores and risk of childhood attention deficit hyperactivity disorder. J Pediatr. 2011;158(5):775–779.
25.
GustafssonPKällénK. Perinatal, maternal, and fetal characteristics of children diagnosed with attention-deficit-hyperactivity disorder: results from a population-based study utilizing the Swedish Medical Birth Register. Dev Med Child Neurol. 2011;53:263–268.
26.
ChandolaCARoblingMRPetersTJ. Pre- and perinatal factors and the risk of subsequent referral for hyperactivity. J Child Psychol Psychiatry. 1992;33:1077–1090.
27.
Sánchez-ArangurenLCPradaCERiaño-MedinaCE. Endothelial dysfunction and preeclampsia: role of oxidative stress. Front Physiol. 2014;5:372.
28.
Charnock-JonesDS. Placental hypoxia, endoplasmic reticulum stress and maternal endothelial sensitisation by sFLT1 in pre-eclampsia. J Reprod Immunol. 2015;114:81–85. doi:10.1016/j.jri.2015.07.004.
29.
CaseyBMMcIntireDDLevenoKJ. The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med. 2001;344:467–471.
30.
KecskesZDunsterKRColditzPB. NSE and S100 after hypoxia in the newborn pig. Pediatr Res. 2005;58:953–957.
31.
VasiljevicBMaglajlic-DjukicSGojnicM. New insights into the pathogenesis of perinatal hypoxic-ischemic brain injury. Pediatr Int. 2011;53:454–462.
32.
ZhaoYDOuSChengSY. Dendritic development of hippocampal CA1 pyramidal cells in a neonatal hypoxia-ischemia injury model. J Neurosci Res. 2013;91:1165–1173.
33.
JantzieLLGetsyPMDensonJL. Prenatal hypoxia-ischemia induces abnormalities in ca3 microstructure, potassium chloride co-transporter 2 expression and inhibitory tone. Front Cell Neurosci. 2015;9:347.
34.
JantzieLLCorbettCJFirlDJ. Postnatal erythropoietin mitigates impaired cerebral cortical development following subplate loss from prenatal hypoxia-ischemia. Cereb Cortex. 2015;25:2683–2695.
35.
SimonishviliSJainMRLiH. Identification of Bax-interacting proteins in oligodendrocyte progenitors during glutamate excitotoxicity and perinatal hypoxia-ischemia. ASN Neuro. 2013;5:e00131.
36.
van de LooijYChatagnerAQuairiauxC. Multi-modal assessment of long-term erythropoietin treatment after neonatal hypoxic-ischemic injury in rat brain. PLOS ONE. 2014;9:e95643.
37.
MontaldoPChabanBLallyPJ. Quantification of ante-mortem hypoxic ischemic brain injury by post-mortem cerebral magnetic resonance imaging in neonatal encephalopathy. Eur J Paediatr Neurol. 2015;19:665–671. doi:10.1016/j.ejpn.2015.07.006.
38.
GhoshNSunYBhanuB. Automated detection of brain abnormalities in neonatal hypoxia ischemic injury from MR images. Med Image Anal. 2014;18:1059–1069.
39.
Martinez-BiargeMBregantTWusthoffCJ. White matter and cortical injury in hypoxic-ischemic encephalopathy: antecedent factors and 2-year outcome. J Pediatr. 2012;161:799–807.
40.
WhitelyM. Attention deficit hyperactive disorder diagnosis continues to fail the reliability and validity tests. Aust N Z J Psychiatry. 2015;49:497–498.
41.
PolanczykGde LimaMSHortaBL. The worldwide prevalence of ADHD: a systematic review and meta regression analysis. Am J Psychiatry. 2007;164:942–948.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
