Association of assisted reproductive technology with attention deficit hyperactivity disorder in children:A Meta-analysis
Objective To determine the association of assisted reproductive technology(ART)with attention deficit hyperactivity disorder(ADHD)in children via systematic evaluation.Methods Four databases,PubMed,Web of Science,Embase and Cochrane were searched,and references were reviewed.The literature was screened and effect sizes were ex-tracted in duplicate to quantitatively synthesize the relevance of ART to ADHD.Results This study includes 10 cohorts from 9 cohort studies,comprising 204480 children born from ART.The results showed that children conceived by ART had a statisti-cally significant increased hazard ratio(HR)for ADHD(HR=1.06,95％CI 1.03-1.10,P＜0.001)and a suggestive but not sta-tistically significant increased relative risk(RR)(RR=1.15,95％CI 0.79-1.69,P=0.460)compared with children not conceived by ART.The study found a significant positive association between ART and ADHD in children who were singletons(HR=1.08,95％CI 1.03-1.14,P=0.001).However,no significant association was found between ART and ADHD in children who were multiples(HR=1.01,95％CI 0.88-1.16,P=0.879).Subgroup(The HR group included six studies with an effect size of HR,and the RR group included three studies with an effect size of RR)analyses showed that ART was more strongly asso-ciated with childhood ADHD in studies conducted in North America in the HR group,and also more strongly associated with childhood ADHD in studies conducted in the HR group when controlling for sex;none of studies conducted by the RR group found a significant association between ART and childhood ADHD when categorized by different subgroups.Conclusion The evidence quality was higher in the HR group compared to the RR group due to the inclusion of large population studies with more comprehensive control for confounders.Consequently,there appears to be a weak positive association between ART and ADHD in children.
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