Adjusted Variables in Included Studies.

IntroductionMaternal tobacco smoking during pregnancy is a significant public health concern with potential long-lasting effects on child development. ADHD, a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, may be influenced by prenatal nicotine exposure. This systematic review and meta-analysis examine the association between maternal tobacco smoking during pregnancy and the risk of ADHD in offspring.MethodsFollowing PRISMA guidelines, we searched databases including PubMed, Web of Science, Cochrane Central, Embase, Scopus, CINAHL, LILACS, SciELO, Allied and Complementary Medicine Database (AMED), ERIC, CNKI, HTA Database, Dialnet, EBSCO, LENS, and Google Scholar for studies up to November 1, 2024. We included peer-reviewed studies reporting quantitative effect size estimates for the association between maternal tobacco smoking and ADHD. Study quality was assessed using the Newcastle-Ottawa Scale (NOS).ResultsWe identified 2,981 articles and included 55 studies (4,016,522 participants) in the analysis. The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring (pooled Odds Ratio (OR) = 1.71, 95% CI: 1.55-1.88; P ConclusionThis systematic review and meta-analysis demonstrate a significant association between maternal tobacco smoking during pregnancy and increased odds of ADHD in offspring. These findings highlight the need for prenatal care guidelines and tobacco smoking cessation programs for pregnant women to reduce ADHD risk and promote optimal neurodevelopmental outcomes. Future research should explore underlying mechanisms and potential confounders further.引言：孕期母亲吸烟是一项重大公共卫生议题，其对儿童发育可产生持久影响。注意缺陷多动障碍（ADHD，Attention Deficit Hyperactivity Disorder）是一种以注意力不集中、多动及冲动为核心特征的神经发育障碍，可能受到产前尼古丁暴露的影响。本系统综述与荟萃分析旨在探讨孕期母亲吸烟与后代患注意缺陷多动障碍风险之间的关联。 方法：本研究遵循系统综述与荟萃分析首选报告条目（PRISMA，Preferred Reporting Items for Systematic Reviews and Meta-Analyses）指南，检索了截至2024年11月1日的多个数据库，包括PubMed、Web of Science、Cochrane对照试验中心注册库（Cochrane Central）、Embase、Scopus、CINAHL、LILACS、SciELO、辅助与替代医学数据库（AMED，Allied and Complementary Medicine Database）、ERIC、中国知网（CNKI）、卫生技术评估数据库（HTA Database）、Dialnet、EBSCO、LENS及谷歌学术（Google Scholar）。纳入经同行评议的、报道了孕期母亲吸烟与注意缺陷多动障碍关联的量化效应量估计值的研究。采用纽卡斯尔-渥太华量表（NOS，Newcastle-Ottawa Scale）对纳入研究的质量进行评估。 结果：本研究共检索到2981篇文献，最终纳入55项研究（总计4016522名参与者）开展荟萃分析。结果显示，孕期母亲吸烟与后代注意缺陷多动障碍风险升高存在显著关联（合并比值比（OR）=1.71，95%置信区间（CI）：1.55-1.88；P<0.001）。 结论：本系统综述与荟萃分析证实，孕期母亲吸烟与后代患注意缺陷多动障碍的风险升高存在显著关联。上述研究结果提示，亟需完善产前保健指南并推广孕期戒烟干预项目，以降低后代注意缺陷多动障碍的发病风险，促进子代最优神经发育结局。未来研究应进一步探讨其潜在作用机制与潜在混杂因素。