Risk of ADHD in children born through assisted reproductive techniques: a systematic review and meta-analysis
Bibliographic record
Abstract
To evaluate the association between assisted reproductive techniques (ART) and the risk of attention-deficit hyperactivity disorder (ADHD) in children. A systematic search was done in PubMed, Embase, Web of Science, and Scopus. Cohort and case-control studies were included. Effect sizes were pooled using hazard ratios (HRs) with 95% confidence intervals (CIs), and subgroup analyses were performed by sex, multiplicity of pregnancy, and gestational age. Heterogeneity and publication bias were assessed, and the certainty of evidence was evaluated using GRADE criteria. Children conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection had a slightly increased risk of ADHD compared to those conceived spontaneously (HR 1.07, 95% CI: 1.04, 1.10), with a moderate certainty of evidence. Three studies on ovulation induction /intrauterine insemination led to a pooled effect size of HR 1.13 (95% CI: 1.04, 1.23) with a moderate certainty of evidence. Subgroup analyses indicated an increased risk in both boys and girls. Singleton pregnancies exhibited a higher risk, while no significant association was observed in multiple pregnancies. Term births showed an elevated risk, with a higher but non-significant effect size in preterm births. Moderate certainty of evidence suggests that the magnitude of observed risk of ADHD is small in ART-conceived children, which is reassuring for parents and clinicians. Long-term monitoring, developmental screening, and tailored counselling for parents of ART-conceived children might be useful.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.030 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".