Schwartz Ashlyn N, Reyes Lucia M, Meschke Laurie L, Kintziger Kristina W
The Department of Public Health, The University of Tennessee, Knoxville, TN 37996, USA.
The Department of Child and Family Studies, The University of Tennessee, Knoxville, TN 37996, USA.
Children (Basel). 2021 Feb 4;8(2):106. doi: 10.3390/children8020106.
To systematically investigate the association between prenatal opioid exposure (POE) and attention-deficit hyperactivity disorder (ADHD) symptoms in children 2-18 years old, studies were searched using PubMed, CINAHL, PsycINFO, and Web of Science from January of 1950 to October of 2019. Inclusion criteria were observational studies reporting ADHD symptoms of children with POE compared with non-exposed children or normative data. The study protocol was registered with PROSPERO: CRD42018115967. Two independent reviewers extracted data on hyperactivity/impulsivity, inattention symptoms, ADHD combined subscale symptoms, and sample characteristics. Of 223 articles screened, seven met the inclusion criteria. Data represent 319 children with POE and 1308 non-exposed children from 4.3 to 11.2 mean years from five countries. POE was positively associated with childhood hyperactivity/impulsivity (d = 1.40; 95% CI, 0.49-2.31; = 0.003), inattention (d = 1.35; 95% CI, 0.69-2.01; < 0.0001), and combined ADHD symptoms scores (d = 1.27; 95% CI = 0.79-1.75; < 0.0001). POE was positively associated with ADHD combined symptom scores at preschool (d = 0.83, 95% CI, 0.57, 1.09; < 0.0001) and school age (d = 1.45, 95% CI, 0.85 to 2.04; < 0.0001). Results suggest increased risk of ADHD symptoms during school age. Future research is needed to clarify the relationship between biological, social, and environmental risk and ADHD symptoms for children who experienced POE.
为了系统地研究产前阿片类药物暴露（POE）与2至18岁儿童注意力缺陷多动障碍（ADHD）症状之间的关联，我们使用PubMed、CINAHL、PsycINFO和Web of Science数据库检索了1950年1月至2019年10月期间的研究。纳入标准为报告POE儿童与未暴露儿童的ADHD症状对比或规范数据的观察性研究。该研究方案已在国际前瞻性系统评价注册库（PROSPERO）注册：CRD42018115967。两名独立评审员提取了关于多动/冲动、注意力不集中症状、ADHD综合子量表症状和样本特征的数据。在筛选的223篇文章中，有7篇符合纳入标准。数据代表来自五个国家的319名有POE的儿童和1308名未暴露儿童，平均年龄在4.3至11.2岁之间。POE与儿童期多动/冲动（d = 1.40；95%置信区间，0.49 - 2.31；P = 0.003）、注意力不集中（d = 1.35；95%置信区间，0.69 - 2.01；P < 0.0001）以及ADHD综合症状评分（d = 1.27；95%置信区间 = 0.79 - 1.75；P < 0.0001）呈正相关。POE与学龄前（d = 0.83，95%置信区间，0.57，1.09；P < 0.0001）和学龄期（d = 1.45，95%置信区间，0.85至2.04；P < 0.0001）的ADHD综合症状评分呈正相关。结果表明学龄期ADHD症状风险增加。未来需要开展研究以阐明经历过POE的儿童的生物学、社会和环境风险与ADHD症状之间的关系。
