scholarly journals Prevalence of bone fractures among children and adolescents with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoda Seens ◽  
Shirin Modarresi ◽  
Joy C MacDermid ◽  
David M Walton ◽  
Ruby Grewal
Keyword(s):  
Systematic Review ◽  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Children With Adhd ◽  
Hyperactivity Disorder

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a significant neurodevelopment disorder among children and adolescents, with 5 % prevalence. Bone fractures account for 25 % of accidents and injuries among all children and adolescents. Considering the characteristics of inattention, hyperactivity, and impulsivity in children with ADHD, it is critical to examine bone fractures among these children. The objective of our meta-analysis was to determine the prevalence of bone fractures among children and adolescents with ADHD. Methods We completed a systematic review and meta-analysis using an electronic search of the following databases: CINAHL, EMBASE, PsycINFO, PubMed, and Scopus. The search terms used were: “attention deficit hyperactivity disorder OR attention deficit disorder” and “bone fracture*.” We included studies examining patients 18 years or younger who were diagnosed with ADHD and tracked (prospectively or retrospectively) for five or more years. Effect size (es), using a random effects model, was calculated. We registered the review protocol with PROSPERO (CRD42019119527). Results From 445 records retrieved, 31 full text articles were reviewed and 5 articles met inclusion criteria for meta-analysis. The summary es revealed the prevalence of bone fractures among children and adolescents with ADHD to be 4.83 % (95 % CI: 3.07–6.58 %). The location of bone fractures, using a subset of data, showed a distribution of 69.62 %, 22.85 %, and 7.53 % in the upper limbs, lower limbs, and other anatomical regions, respectively. Another subset of studies revealed a 2.55-fold increase in the prevalence of fractures among the children with ADHD compared to their counterparts. Conclusions Awareness of these findings is critical to physicians, parents, and policy makers to create safe environments and provide supports in order to optimize the health and safety of children and adolescents with ADHD.

Dental caries in children with attention deficit/hyperactivity disorder: a meta-analysis

2021 ◽  
Author(s):  
Victor Zanetti Drumond ◽  
Gabriela Luíza Nunes Souza ◽  
Mateus José de Carvalho Pereira ◽  
Ricardo Alves Mesquita ◽  
Maryam Amin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Attention Deficit Hyperactivity Disorder ◽  
Dental Caries ◽  
Attention Deficit ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Significant Difference ◽  
Dmft Index

Objectives: To evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis. Design: Electronic searches was performed in four databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by two reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CI). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained. Results: Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I²=42%; MD=0.75 [0.38-1.13]). For decayed, missing, and filled surfaces (DMFS) (I²=0; MD=0.39 [-0.02-0.80]) and decayed surfaces (DS/ds) (I²=0%; MD=0.35 [-0.63-1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I² = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I² = 0%) Risk of bias ranged from low to high. Conclusion: The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts. Funding: No funding Registration: CRD42021238923

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