Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Jun 13;22(1):395.
doi: 10.1186/s12888-022-04037-4.

Migration modulates the prevalence of ASD and ADHD: a systematic review and meta-analysis

Xuping Gao #  1   2 , Yilu Zhao #  1 , Ning Wang  1 , Li Yang  3
Affiliations
Meta-Analysis

Migration modulates the prevalence of ASD and ADHD: a systematic review and meta-analysis

Xuping Gao et al. BMC Psychiatry. .

Abstract

Background: Migration has been implicated as a risk factor for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but evidence is still limited and inconsistent. We aim to investigate the relationship between migration status and risk of ASD and ADHD.

Methods: Electronic databases including PubMed, EMBASE, Web of Science, and PsychINFO were searched to identify observational studies on this topic, from inception to February 2021. Random-effects meta-analysis models were used to pool the summary odds ratio (OR) and 95% confidence interval (95% CI), and subgroup analyses were conducted to detect possible discrepancies in associations. Certainty of evidence was assessed as per the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines.

Results: A total of 13 studies (6,532,546 participants) for ASD, five studies (2,875,070 participants) for ADHD, and six studies (31,158 participants) for hyperactivity were included. Overall, the pooled results indicated that migration was associated with increased risk of ASD (pooled OR: 1.32; 95% CI: 1.07-1.63; P for Z test = 0.010), but no association was found between migration and ADHD (pooled OR: 0.84; 95% CI: 0.53-1.32; P for Z test = 0.452) or hyperactivity (pooled standardized mean difference: -0.073; 95% CIs: - 0.383-0.236; P for Z test = 0.642). Subgroup analyses further demonstrated that maternal migration was ASD risk factor (pooled OR: 1.49; 95% CI: 1.19-1.87), and migrant children were more likely to develop ASD with comorbid intellectual disability (ID) (pooled OR: 1.21, P for interaction = 0.006) than ASD without ID. After standardized the origin of migrants, European migrant children from Americas were at higher risk of ASD and ADHD (pooled OR were 4.13 and 1.26), and increased ASD risk was also observed in African children (pooled OR: 2.72). The GRADE of evidence was very low.

Conclusions: Maternal migration is a risk factor for ASD, and migrant ASD children are more likely comorbid ID. The role of migration on ADHD remains controversial, more studies are needed to assess the association between migration status and ADHD. Health care practitioners should consider screening and providing extra resources for migrant children.

Keywords: Attention-deficit/hyperactivity disorder; Autism spectrum disorder; Meta-analysis; Migration.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study selection in the current systematic review and meta-analysis. Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ASD, autism spectrum disorder
Fig. 2
Fig. 2
Forest plot of the association between migration status and risk of ASD. Error bars indicate 95% confidence intervals. Abbreviations: ASD, autism spectrum disorder; CI, confidence interval; OR, odds ratio
Fig. 3
Fig. 3
Forest plot of the association between migration status and risk of ADHD. Error bars indicate 95% confidence intervals. Abbreviations: ADHD, attention-deficit/hyperactivity disorder; CI, confidence interval; OR, odds ratio
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. United Nations Department of Economic and Social Affairs . International Migration. 2020.
    1. Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, et al. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet. 2018;392(10164):2567–2582. doi: 10.1016/S0140-6736(18)32558-3. - DOI - PMC - PubMed
    1. Dealberto MJ. Prevalence of autism according to maternal immigrant status and ethnic origin. Acta Psychiatr Scand. 2011;123(5):339–348. doi: 10.1111/j.1600-0447.2010.01662.x. - DOI - PubMed
    1. Hilario CT, Oliffe JL, Wong JP, Browne AJ, Johnson JL. Migration and young people's mental health in Canada: a scoping review. J Ment Health. 2015;24(6):414–422. doi: 10.3109/09638237.2015.1078881. - DOI - PubMed
    1. Claassen D, Ascoli M, Berhe T, Priebe S. Research on mental disorders and their care in immigrant populations: a review of publications from Germany, Italy and the UK. Eur Psychiatry. 2005;20(8):540–549. doi: 10.1016/j.eurpsy.2005.02.010. - DOI - PubMed

Publication types

MeSH terms