The association between congenital heart disease and the risk of Autism spectrum disorders or attention-deficit/hyperactivity disorder among children: a meta-analysis

ABSTRACT

Background and objective. To our knowledge, this is the first meta-analysis conducted about the association between congenital heart disease (CHD) and the risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorders (ASD) based on observational studies.Methods PubMed, Web of Science, and Scopus were systematically searched from the earliest possible year to December 2020. Heterogeneity was conducted using the chi-square test and its quantity was measured using the I2 statistic. The publication bias was assessed using Egger's and Begg's line regression tests. The results were reported using the odds ratio (OR) estimated with its 95% confidence interval (CI) using a random-effects model. Results. In total, 812 citations were included in the search initial until December 2020 with 467,164 children. Based on the random effect model, the estimated OR of the risk of ASD associated with CHD was OR=1.35 (95% CI 1.17, 1.52; 6 studies; I2=0.0%) and the risk of ADHD associated with CHD was OR=3.04 (95% CI 1.58, 4.49; 15 studies; I2=88.1%). Conclusions. Our findings suggested that CHD is a risk factor for ASD and ADHD. Therefore, Screening for ASD and ADHD should be considered among young children with CHD.