Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Prev Sci. 2024 May;25(Suppl 2):316-336. doi: 10.1007/s11121-022-01398-w. Epub 2022 Aug 10.
Although neurobiologic and genetic factors figure prominently in the development of attention deficit/hyperactivity disorder (ADHD), adverse physical health experiences and conditions encountered during childhood may also play a role. Poor health is known to impact the developing brain with potential lifelong implications for behavioral issues. In attempt to better understand the relationship between childhood physical health and the onset and presence of ADHD symptoms, we summarized international peer-reviewed articles documenting relationships between a select group of childhood diseases or health events (e.g., illnesses, injuries, syndromes) and subsequent ADHD outcomes among children ages 0-17 years. Drawing on a larger two-phase systematic review, 57 longitudinal or retrospective observational studies (1978-2021) of childhood allergies, asthma, eczema, head injury, infection, or sleep problems and later ADHD diagnosis or symptomatology were identified and subjected to meta-analysis. Significant associations were documented between childhood head injuries, infections, and sleep problems with both dichotomous and continuous measures of ADHD, and between allergies with dichotomous measures of ADHD. We did not observe significant associations between asthma or eczema with ADHD outcomes. Heterogeneity detected for multiple associations, primarily among continuously measured outcomes, underscores the potential value of future subgroup analyses and individual studies. Collectively, these findings shed light on the importance of physical health in understanding childhood ADHD. Possible etiologic links between physical health factors and ADHD are discussed, as are implications for prevention efforts by providers, systems, and communities.
虽然神经生物学和遗传学因素在注意缺陷多动障碍（ADHD）的发展中起着重要作用，但儿童时期经历的不良身体健康体验和状况也可能起作用。众所周知，身体健康状况不佳会影响大脑发育，对行为问题产生潜在的终身影响。为了更好地理解儿童身体健康与 ADHD 症状的发生和存在之间的关系，我们总结了国际同行评议的文献，记录了一组特定的儿童疾病或健康事件（例如，疾病、伤害、综合征）与 0-17 岁儿童随后出现 ADHD 结果之间的关系。基于一项更大的两阶段系统评价，我们确定了 57 项关于儿童过敏、哮喘、湿疹、头部损伤、感染或睡眠问题与随后的 ADHD 诊断或症状的纵向或回顾性观察研究（1978-2021 年），并对这些研究进行了荟萃分析。研究记录了儿童头部损伤、感染和睡眠问题与 ADHD 的二分类和连续测量指标之间存在显著关联，以及过敏与 ADHD 的二分类测量指标之间存在显著关联。我们没有观察到哮喘或湿疹与 ADHD 结果之间存在显著关联。对于多项关联存在明显的异质性，主要是在连续测量的结果中，这突出了未来亚组分析和个别研究的潜在价值。总的来说，这些发现强调了身体健康在理解儿童 ADHD 中的重要性。讨论了身体健康因素与 ADHD 之间可能存在的病因联系，以及提供者、系统和社区在预防工作方面的影响。
