Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is being encountered more frequently. PURPOSE: In this study, by compiling the evidence from available meta-analyses, an umbrella systematic review was performed of the neonatal risk factors associated with ADHD. METHODS: The PubMed, Scopus, and Web of Science databases were searched for eligible studies. Only systematic reviews were included. Using a random-effects model, 95% prediction intervals were reported for each risk factor. Three studies were ultimately included in the review. RESULTS: Congenital heart disease, short-duration or incomplete breastfeeding, low birth weight, and 5-minute Apgar scores <7 were significant risk factors for ADHD. However, the quality of the included systematic reviews was low to moderate and the evidence credibility level was suggestive to weak. CONCLUSION: The results of this umbrella review proposed that congenital anomalies, short-duration or incomplete breastfeeding, low birth weight, and low Apgar scores were important factors for the manifestation of ADHD symptoms. However, the inclusion of more high-quality studies is needed to validate our results.