Parental Age and the Risk of ADHD in Offspring: A Systematic Review and Meta-Analysis

Evidence has suggested that parental age at birth is a risk factor of offspring attention deficit/hyperactivity disorder (ADHD). We conducted a meta-analysis of observational studies investigating the association between parental age and offspring ADHD. We conducted a systematic search that followed the recommended guidelines for performing meta-analyses on PUBMED, EMBASE, and Web of Science up to 8 April 2021. We calculated pooled risk estimates from individual age with and without adjusting for possible confounding factors. Dose-response analysis for parental age and ADHD risk was performed. Eleven studies were selected in this meta-analysis, which included 111,101 cases and 4,417,148 participants. Compared with the reference points, the lowest parental age category was associated with an increased risk of ADHD in the offspring, with adjusted odds ratios (ORs) of 1.49 (95% confidence intervals (95%CI) 1.19-1.87) and 1.75 (95%CI 1.31-2.36) for the mother and father, respectively. The highest parental age was statistically insignificant, with adjusted ORs of 1.11 (95%CI 0.79-1.55) and 0.93 (95%CI 0.70-1.23) for mother and father separately. Dose-response analysis indicated a non-linear relationship of parental age with offspring ADHD, with the lowest ADHD risk at 31-35 years old. The results of this meta-analysis support an association between young parental age and the risk of ADHD. More high-quality studies are needed to establish whether the association with parental age is causal.