Association between Small for Gestational Age and Attentiondeficit/ Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Introduction: This study aimed to conduct a meta-analysis to assess whether neonates born small for gestational age (SGA) have an increased risk of developing Attention-deficit/hyperactivity disorder (ADHD). Methods: In order to identify relevant studies examining the association between neonates born SGA and ADHD in children, we conducted comprehensive searches across major databases, including PubMed, Scopus, and Web of Science. The meta-analysis employed a random-effects model, and the Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Results: A total of 13 records, comprising a sample population of 12,610,162, were included. The pooled estimates of Relative Risk (RR) and Odds Ratio (OR) showed a significant association between SGA neonates and ADHD in children, with RR = 1.35 (95% CI: 1.20, 1.50) and OR = 1.29 (95% CI: 1.03, 1.55). While no significant association was found between SGA and the risk of ADHD in case-control studies (OR = 1.25, 95% CI: 0.77, 1.73, p=0.000, I2=97.0%), a significant association was observed in cohort studies (OR = 1.25, 95% CI: 1.19, 1.31, p=0.665, I2=0.0%). Cohort study results demonstrated homogeneity (I2=0.0%). Conclusion: The present meta-analysis showed that being born small for gestational age (SGA) is a risk factor for developing attentiondeficit/ hyperactivity disorder (ADHD).