Risk Factors For Attention-Deficit/Hyperactivity Disorder: Literature Review
DOI:
https://doi.org/10.23917/fisiomu.v7i2.17426Keywords:
ADHD, risk factors, children, prenatal, postnatalAbstract
Introduction: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity that affect children’s social and academic functioning. ADHD has a multifactorial etiology involving interactions among biological, genetic, environmental, psychosocial, and economic factors during the prenatal and postnatal periods. This study aimed to identify the prevalence and dominant risk factors contributing to the incidence of ADHD in children based on previous research findings. Methods: This study employed a systematic literature review following the PRISMA guidelines and the PECO framework. Articles were searched through the PubMed and ScienceDirect databases between October and November 2025, with inclusion criteria consisting of children aged 0–18 years, observational study designs, discussion of ADHD risk factors, English language, and publications from 2015 to 2025. Results: A total of 28 articles met the inclusion criteria, comprising 13 prenatal phase studies (46.4%) and 15 postnatal phase studies (53.6%). Biological factors were the most dominant component (49.0%), followed by environmental (22.2%), psychosocial (13.3%), genetic (11.1%), and economic factors (4.4%). Conclusion: ADHD in children results from multifactorial interactions, highlighting the need for multidisciplinary approaches and multifactorial interventions beginning in the prenatal period to support prevention and early detection.
Downloads
References
Santrock JW. Life-span development. 2019.
Aprilia Santana S, Intana Putri Kusumah T, Pendidikan Indonesia U. Interaksi Resiprokal Otak Dan Perilaku Pada Perkembangan Anak. Cendekia : Jurnal Ilmu Pengetahuan [Internet]. 2025;5(2). Available from: https://jurnalp4i.com/index.php/cendekia
Desmita. Psikologi Perkembangan Peserta Didik. Bandung: Remaja Rosdakarya; 2014.
Azizah N, Susilo TE, Rahman F, Naufal AF, Pristianto A, Fatmarizka T. Efektivitas Sosialisasi Berbasis Komunitas dalam Mencegah Stunting pada Ibu Hamil Dan Remaja Putri di Desa Bakalan. Mestaka: Jurnal Pengabdian Kepada Masyarakat. 2025 Apr 24;4(2):130–4. doi:10.58184/mestaka.v4i2.620
Almadani Z, Ningsih AF, Purwaningsih I, Wibowo AP, Pristianto A, Herlinawati I. The Impact of Puzzle Games on Attention and Fine Motor Abilities Upon Cases of Autism Spectrum Disorder: A Case Report. Physical Therapy Journal of Indonesia. 2022 Jul 1;3(2):58–62. doi:10.51559/ptji.v3i2.56
Song J, Park SJ, Jeong S, Chun AY, Park SM. Increasing incidence of ADHD among children, adolescents and young adults: COVID-19 pandemic-driven trend in Korea (2012–2023). BMJ Mental Health. 2025 Jun;28(1):e301662. doi:10.1136/bmjment-2025-301662
World Health Organization. World Health Organization. 2019. ICD-10: Hyperkinetic Disorders (F90).
Junaidin J. Peran Orang Tua Dalam Perkembangan Sosial Motorik Anak-Anak Attention Deficit Hyperactivity Disorder. Al-Qalam: Jurnal Kajian Islam dan Pendidikan. 2024 Jun 22;16(1):90–8. doi:10.47435/al-qalam.v16i1.2946
Ayano G, Demelash S, Gizachew Y, Tsegay L, Alati R. The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of Affective Disorders. Elsevier B.V.; 2023. p. 860–6. doi:10.1016/j.jad.2023.07.071 PubMed PMID: 37495084.
Naufal AF, Safitri EF, Nurulinsani A, Susilo TE, Darojati HPI, Pristianto A, et al. Hubungan Durasi Penggunaan Gadget Terhadap Gejala Attention Deficit Hyperactivity Disorder (ADHD). FISIO MU: Physiotherapy Evidences. 2023 Jun 7;4(2):152–60. doi:10.23917/fisiomu.v4i2.22133
Thapar A, Cooper M, Jefferies R, Stergiakouli E. What causes attention deficit hyperactivity disorder? Archives of Disease in Childhood. 2012. p. 260–5. doi:10.1136/archdischild-2011-300482 PubMed PMID: 21903599.
Bitsko RH, Holbrook JR, O’masta B, Maher B, Cerles A, Saadeh K, et al. A Systematic Review and Meta-analysis of Prenatal, Birth, and Postnatal Factors Associated with Attention-Deficit/Hyperactivity Disorder in Children HHS Public Access. Prev Sci. 2024;25(2):203–24. doi:10.1007/sll121-022-01359-3
Ragadran J, Kamal Nor N, Ismail J, Ong JJ, Sundaraj C. Estimating the Risk of Attention Deficit Hyperactivity Disorder (ADHD) in Parents of Children with ADHD and the Association with Their Children’s Disease Severity and Adherence to Medication. Children. 2023 Sep 1;10(9). doi:10.3390/children10091440
Rahman MS, Takahashi N, Iwabuchi T, Nishimura T, Harada T, Okumura A, et al. Elevated risk of attention deficit hyperactivity disorder (ADHD) in Japanese children with higher genetic susceptibility to ADHD with a birth weight under 2000 g. BMC Med. 2021 Dec 1;19(1). doi:10.1186/s12916-021-02093-3 PubMed PMID: 34556092.
Cortese S. pharmacologic Treatment of Attention Deficit-Hyperactivity Disorder. N Engl J Med. 2020.
Ginting RL, Sagala AK, Nst MA, Simamora MS, Pulungan RA, Silalahi RU, et al. Hubungan Antara Faktor Genetik dan Lingkungan Perkembangan Autisme dan Attention Deficit Hyperactivity Disorder (ADHD). DIKSI: Jurnal Kajian Pendidikan dan Sosial. 2023 Dec 28;4(2):77–85. doi:10.53299/diksi.v4i2.361
Tiara Fatmarizka, Nabila Rizka Lathifani, Faradila Risky Adha, Fadhilla Mutiara Zahra, Sakhina Lancha Faliha, Revina Nanda Alya, et al. Edukasi Aktivitas Fisik Pada Ibu Hamil Di Posyandu Dewi Ratih 1 Dengan Media Leaflet. jurnal ABDIMAS Indonesia. 2023 Sep 22;1(3):88–95. doi:10.59841/jurai.v1i3.336
Russell G, Ford T, Rosenberg R, Kelly S. The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: Alternative explanations and evidence. J Child Psychol Psychiatry. 2014;55(5):436–45. doi:10.1111/jcpp.12170 PubMed PMID: 24274762.
Amallia HT, Feliyanti F, Lukmawati L, Rahmi A, Permitasari I. Efek Toksik Logam Berat terhadap Kejadian Stunting. JURNAL BIOSHELL. 2025 Oct 19;14(2):245–53. doi:10.56013/bio.v14i2.4577
Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev Med Rep. 2018 Dec 1;12:271–83. doi:10.1016/j.pmedr.2018.10.003
Claussen AH, Holbrook JR, Hutchins HJ, Robinson LR, Bloomfield J, Meng L, et al. All in the Family? A Systematic Review and Meta-analysis of Parenting and Family Environment as Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD) in Children. Prevention Science. 2024 May 1;25(Suppl 2):249–71. doi:10.1007/s11121-022-01358-4 PubMed PMID: 35438451.
Naufal AF, Sulistiowati NT, Hasanah U, Prasojo WPJ, Utami AR, Marasabessy MRI, et al. Pengaplikasian Permainan Busy Board untuk Melatih Fokus Anak ADHD Di PAUD Inklusi Harapan Bunda Wita. Jurnal Pustaka Mitra (Pusat Akses Kajian Mengabdi Terhadap Masyarakat). 2023 Dec 1;3(6):238–42. doi:10.55382/jurnalpustakamitra.v3i6.620
Racine N; PT; PS; MSW; PSB; TS; MS. Perinatal risk and protective factors associated with diagnosis of mental health disorders in children by age 9 years. Canadian Journal of Psychiatry. 2025.
Snyder H. Literature review as a research methodology: An overview and guidelines. J Bus Res. 2019 Nov 1;104:333–9. doi:10.1016/j.jbusres.2019.07.039
Takahashi N, Nishimura T, Harada T, Okumura A, Iwabuchi T, Rahman MS, et al. Interaction of genetic liability for attention deficit hyperactivity disorder (ADHD) and perinatal inflammation contributes to ADHD symptoms in children. Brain Behav Immun Health. 2023 Jul 1;30. doi:10.1016/j.bbih.2023.100630
Dypås LB, Olsen AK, Gützkow KB, Andreassen O, Brunborg G, Magnus P, et al. Circulating microRNAs in cord blood to predict attention-deficit/hyperactivity disorder diagnosis. Biol Psychiatry. 2025 Oct. doi:10.1016/j.biopsych.2025.10.010
Tusa BS, Alati R, Betts K, Ayano G, Dachew B. Maternal perinatal depressive disorders and the risk of attention deficit and hyperactivity disorder in offspring: A linked data study. J Psychiatr Res. 2025 Aug 1;188:169–75. doi:10.1016/j.jpsychires.2025.05.058 PubMed PMID: 40449224.
Borbye-Lorenzen N, Holmgaard S, Ottosson F, Nudel R, Appadurai V, Laursen TM, et al. High level of immunoglobulin G targeting mycoplasma or cytomegalovirus in the newborn increases risk of ADHD. Brain Behav Immun. 2025 Jan 1;123:99–107. doi:10.1016/j.bbi.2024.09.009 PubMed PMID: 39260764.
Holmgaard S, Kiilerich P, Borbye-Lorenzen N, Skogstrand K. Maternal pre-pregnancy and prenatal penicillin, neonatal inflammation and growth factors are associated to ADHD in the offspring. Brain Behav Immun Health. 2024 Mar 1;36. doi:10.1016/j.bbih.2024.100739
Baker BH, Wu H, Laue HE, Boivin A, Gillet V, Langlois MF, et al. Methylparaben in meconium and risk of maternal thyroid dysfunction, adverse birth outcomes, and Attention-Deficit Hyperactivity Disorder (ADHD). Environ Int. 2020 Jun 1;139. doi:10.1016/j.envint.2020.105716 PubMed PMID: 32283359.
Abel MH, Ystrom E, Caspersen IH, Meltzer HM, Aase H, Torheim LE, et al. Maternal iodine intake and offspring attention-deficit/hyperactivity disorder: Results from a large prospective cohort study. Nutrients. 2017 Nov 13;9(11). doi:10.3390/nu9111239 PubMed PMID: 29137191.
Chen S, Ahlqvist VH, Sjöqvist H, Stephansson O, Magnusson C, Dalman C, et al. Maternal intrahepatic cholestasis of pregnancy and neurodevelopmental conditions in offspring: A population-based cohort study of 2 million Swedish children. PLoS Med. 2024 Jan 1;21(1). doi:10.1371/journal.pmed.1004331 PubMed PMID: 38227577.
Leviton A, Hooper SR, Hunter SJ, Scott MN, Allred EN, Joseph RM, et al. Antecedents of Screening Positive for Attention Deficit Hyperactivity Disorder in Ten-Year-Old Children Born Extremely Preterm. Pediatr Neurol. 2018 Apr 1;81:25–30. doi:10.1016/j.pediatrneurol.2017.12.010 PubMed PMID: 29523493.
Koller D, Mitjans M, Kouakou M, Friligkou E, Cabrera-Mendoza B, Deak JD, et al. Genetic contribution to the comorbidity between attention-deficit/hyperactivity disorder and substance use disorders. Psychiatry Res. 2024 Mar 1;333. doi:10.1016/j.psychres.2024.115758 PubMed PMID: 38335780.
Piazza GG, Allegrini AG, Eley TC, Epskamp S, Fried E, Isvoranu AM, et al. Polygenic Scores and Networks of Psychopathology Symptoms. JAMA Psychiatry. 2024 Sep 4;81(9):902–10. doi:10.1001/jamapsychiatry.2024.1403 PubMed PMID: 38865107.
Baker BH, Lugo-Candelas C, Wu H, Laue HE, Boivin A, Gillet V, et al. Association of Prenatal Acetaminophen Exposure Measured in Meconium with Risk of Attention-Deficit/Hyperactivity Disorder Mediated by Frontoparietal Network Brain Connectivity. JAMA Pediatr. 2020 Nov 1;174(11):1073–81. doi:10.1001/jamapediatrics.2020.3080 PubMed PMID: 32986124.
Joseph M, Lajili M, Dudoignon B, Delclaux C, Bokov P. Loudness of snoring, not apnea-hypopnea index, is associated with hyperactivity behavior in snoring children and adolescents. Sleep Med. 2025 Mar 1;127:43–8. doi:10.1016/j.sleep.2025.01.006 PubMed PMID: 39787820.
Hernández-Lorca M, Sevelsted A, Jepsen JRM, Pedersen CET, Rosenberg JB, Mohammadzadeh P, et al. COVID-19 lockdown, genetic ADHD susceptibility, and mental health in 10- year-old children. Psychiatry Res. 2023 Nov 1;329. doi:10.1016/j.psychres.2023.115481 PubMed PMID: 37776756.
Ahrens AP, Hyötyläinen T, Petrone JR, Igelström K, George CD, Garrett TJ, et al. Infant microbes and metabolites point to childhood neurodevelopmental disorders. Cell. 2024 Apr 11;187(8):1853-1873.e15. doi:10.1016/j.cell.2024.02.035 PubMed PMID: 38574728.
Haile SR, Peralta GP, Adams M, Bharadwaj AN, Bassler D, Moeller A, et al. Health-related quality of life in children and adolescents born very preterm and its correlates: a cross-sectional study. BMJ Paediatr Open. 2024 Oct 10;8(1). doi:10.1136/bmjpo-2024-002885 PubMed PMID: 39389623.
Ing C, Sun M, Olfson M, DiMaggio CJ, Sun LS, Wall MM, et al. Age at exposure to surgery and anesthesia in children and association with mental disorder diagnosis. Anesth Analg. 2017;125(6):1988–98. doi:10.1213/ANE.0000000000002423 PubMed PMID: 28857799.
Ing C, Ma X, Sun M, Lu Y, Wall MM, Olfson M, et al. Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications. Anesth Analg. 2020 Sep 1;131(3):723–33. doi:10.1213/ANE.0000000000004619 PubMed PMID: 31923004.
Hadzic E, Sinanovic O, Memisevic H. 64-2017-Is Bacterial Meningitis a Risk Factor for Developing Attention Deficit Hyperactivity Disorder. 2017.
Nunes-Moreno M, Buchanan C, Cole FS, Davis S, Dempsey A, Dowshen N, et al. Behavioral Health Diagnoses in Youth with Gender Dysphoria Compared with Controls: A PEDSnet Study. Journal of Pediatrics. 2022 Feb 1;241:147-153.e1. doi:10.1016/j.jpeds.2021.09.032 PubMed PMID: 34571022.
Wu J, Gu M, Chen S, Chen W, Ni K, Xu H, et al. Factors related to pediatric obstructive sleep apnea-hypopnea syndrome in children with attention deficit hyperactivity disorder in different age groups. Medicine (United States). 2017 Oct 1;96(42). doi:10.1097/MD.0000000000008281 PubMed PMID: 29049225.
Wilkinson AA, Dennis M, Simic N, Taylor MJ, Morgan BR, Frndova H, et al. Brain biomarkers and pre-injury cognition are associated with long-term cognitive outcome in children with traumatic brain injury. BMC Pediatr. 2017 Jul 24;17(1). doi:10.1186/s12887-017-0925-6 PubMed PMID: 28738850.
Allred EN, Dammann O, Fichorova RN, Hooper SR, Hunter SJ, Joseph RM, et al. Systemic Inflammation during the First Postnatal Month and the Risk of Attention Deficit Hyperactivity Disorder Characteristics among 10 year-old Children Born Extremely Preterm. Journal of Neuroimmune Pharmacology. 2017 Sep 1;12(3):531–43. doi:10.1007/s11481-017-9742-9 PubMed PMID: 28405874.
Lee CY, Chen MH, Jeng MJ, Hsu JW, Tsai SJ, Bai YM, et al. Longitudinal association between early atopic dermatitis and subsequent attention-deficit or autistic disorder A population-based case-control study. Medicine (United States). 2016;95(39). doi:10.1097/MD.0000000000005005 PubMed PMID: 27684861.
Liu S, Kuja-Halkola R, Larsson H, Lichtenstein P, Ludvigsson JF, Svensson AM, et al. Poor glycaemic control is associated with increased risk of neurodevelopmental disorders in childhood-onset type 1 diabetes: a population-based cohort study [Internet]. 2021. doi:10.1007/s00125-020-05372-5/Published
Ünver H, Perdahlı Fiş N. An Analysis of Admissions to a Refugee Child Mental Health Unit in the Context of the COVID-19 Pandemic. Clin Child Psychol Psychiatry. 2022 Jan 1;27(1):136–44. doi:10.1177/13591045211058337 PubMed PMID: 34823386.
Liu ZY, Wang QQ, Pang XY, Huang XB, Yang GM, Zhao S. Association of congenital heart disease and neurodevelopmental disorders: an observational and Mendelian randomization study. Ital J Pediatr. 2024 Dec 1;50(1). doi:10.1186/s13052-024-01610-3 PubMed PMID: 38589916.
Downloads
Submitted
Accepted
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 FISIO MU: Physiotherapy Evidences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with FISIO MU: Phsiotherapy Evidences agree to the following terms:
- Author(s) retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International License that allow others to share the work within an acknowledgement of the work’s authorship and initial publication of this journal.
- Author(s) are able to enter into separate, additional contractual arrangement for the non-exclusive distribution of the the journal’s published version of the work (e.g. acknowledgement of its initial publication in this journal).
- Author(s) are permitted and encouraged to post their work online (e.g. in institutional repositories or on their websites) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published works.











