RECENT RESEARCH
However, significant improvements were observed in material organization( P =. 03), working memory( P =. 04), and inhibition( P =. 05), particularly among patients more engaged with the MOON treatment.
Conclusions: Serious video games, when integrated into a multimodal treatment plan, can enhance outcomes for symptoms associated with ADHD.
Risk factors
Mohammadian M, Khachatryan LG, Vadiyan FV, Maleki M, Fatahian F, Mohammadian- Hafshejani A. The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit / hyperactivity disorder( ADHD) in offspring: A systematic review and meta-analysis. PLoS One. 2025 Feb 7; 20( 2): e0317112. doi: 10.1371 / journal. pone. 0317112. PMID: 39919144; PMCID: PMC11805386.
Introduction: Maternal tobacco smoking during pregnancy is a significant public health concern with potential long-lasting effects on child development. ADHD, a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, may be influenced by prenatal nicotine exposure. This systematic review and meta-analysis examine the association between maternal tobacco smoking during pregnancy and the risk of ADHD in offspring.
Methods: Following PRISMA guidelines, we searched databases including PubMed, Web of Science, Cochrane Central, Embase, Scopus, CINAHL, LILACS, SciELO, Allied and Complementary Medicine Database( AMED), ERIC, CNKI, HTA Database, Dialnet, EBSCO, LENS, and Google Scholar for studies up to November 1, 2024. We included peerreviewed studies reporting quantitative effect size estimates for the association between maternal tobacco smoking and ADHD. Study quality was assessed using the Newcastle-Ottawa Scale( NOS).
Results: We identified 2,981 articles and included 55 studies( 4,016,522 participants) in the analysis. The metaanalysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring( pooled Odds Ratio( OR) = 1.71, 95 % CI: 1.55-1.88; P < 0.001). Egger ' s test indicated no publication bias( p = 0.204), but Begg ' s test did( p = 0.042). By employing the trim and fill method, the revised OR was estimated to be 1.54( 95 % CI: 1.40-1.70; P < 0.001). The OR were 2.37( 95 % CI: 1.72-3.28; P < 0.001) in cross-sectional studies, 1.72( 95 % CI: 1.49-2.00; P < 0.001) in case-control studies, and 1.53( 95 % CI: 1.34-1.74; P < 0.001) in cohort studies. Meta-regression showed study design and study region significantly influenced heterogeneity( P < 0.10). Sensitivity and subgroup analyses confirmed the robustness of these findings.
Conclusion: This systematic review and meta-analysis demonstrate a significant association between maternal tobacco smoking during pregnancy and increased odds of ADHD in offspring. These findings highlight the need for prenatal care guidelines and tobacco smoking cessation programs for pregnant women to reduce ADHD risk and promote optimal neurodevelopmental outcomes. Future research should explore underlying mechanisms and potential confounders further.
Chen CY, Shih PY, Su CT, Cheng CF, Lee MC, Lane HY. Association between infant feeding and ADHD development in childhood: a birth cohort study in Taiwan. J Child Psychol Psychiatry. 2025 Jun; 66( 6): 881-891. doi: 10.1111 / jcpp. 14100. Epub 2024 Dec 21. PMID: 39707757; PMCID: PMC12062847.
Background: Infant feeding plays a vital role in neurodevelopment, and a lack of breastfeeding and complementary feeding may increase the risk of developing attention-deficit / hyperactivity disorder( ADHD). However, empirical evidence on this relationship remains uncertain, as most studies are based on cross-sectional designs. Therefore, this study aimed to examine this temporal relationship using longitudinal data from a birth cohort.
Methods: A retrospective cohort study was conducted using data from Wave I( starting at 6 months old, 2005-2006) to Wave IV( up to 5 years old, 2010-2011) of the Taiwan Birth Cohort Study. A total of 19,721 pairs completed the four-wave interviews and provided information on infant feeding, medical history, ADHD occurrence, and sociodemographic characteristics. An extended Cox model with timedependent covariates was used to examine this association.
Results: In total, 207 infants developed ADHD during the 54-month observational period, with an estimated cumulative incidence of 5.56 per 1,000 person-years. The average breastfeeding duration was approximately 2 months. With complementary feeding, rice solid food( HR = 0.73) was found to be a protective factor against developing ADHD. Significantly associated factors for increasing ADHD risk included males, lower family income, low birth weight, maternal weight, advanced maternal age, child gastrointestinal disease, child seizures, maternal heart disease, and paternal diabetes mellitus.
Conclusions: Complementary feeding within 6 months is important to protect infants from developing ADHD. The beneficial effect of breastfeeding within 6 months was not observed while controlling for other risk factors. However, owing to the limitation of a smaller number of ADHD cases, further studies should rely on larger observational periods.
248 | vol31 | no4 | AJNM