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

BMC Psychiatry

Table 2 Associations between migration status and risk of ASD

Groups	No. studies	No. participants	Pooled ORs (95% CIs)	P for Z test	Heterogeneity		P for interaction
Groups	No. studies	No. participants	Pooled ORs (95% CIs)	P for Z test	I² (%)	P	P for interaction
Overall migration	13	6,532,546	1.32 (1.07, 1.63)	0.010	87.6	< 0.001
Diagnostic subgroup
Autism	7	6,220,489	1.26 (1.06, 1.50)	0.010	57.0	0.030	0.583
Autism spectrum disorder	6	312,057	1.46 (0.89, 2.40)	0.133	91.4	< 0.001
Comorbid intellectual disability							0.006
Yes	4	2,435,381	1.21 (1.09, 1.35)	0.001	4.6	0.370
No	3	809,027	0.68 (0.46, 1.01)	0.057	84.0	0.002
Parental country of birth							0.514
Foreign-born mother	11	6,334,601	1.49 (1.19, 1.87)	0.001	81.9	< 0.001
Foreign-born father	2	10,850	1.19 (0.86, 1.65)	0.302	0.0	0.617
Both parents foreign-born	2	49,610	1.24 (0.63, 2.43)	0.541	90.9	0.001
Migration type ^a							0.016
Africa to Europe	4	50,005	2.72 (1.25, 5.89)	0.011	93.6	< 0.001
Americas to Europe	4	50,005	4.13 (1.26, 13.50)	0.019	96.6	< 0.001
Eastern Mediterranean to Europe	2	49,610	0.88 (0.61, 1.26)	0.489	0.0	0.867
Europe to Europe	5	993,669	1.20 (0.97, 1.50)	0.097	41.7	0.143
South-East Asia to Europe	3	44,358	1.80 (0.71, 4.56)	0.213	92.7	< 0.001
Western Pacific to Europe	1	43,963	0.90 (0.60, 1.30)	–	–	–
NOS score							0.739
< 7	1		1.40 (1.00, 1.90)	–	–	–
≥ 7	12		1.31 (1.05, 1.64)	0.017	88.0	< 0.001
Influence analyses ^b
Minimal	–	6,463,332	1.24 (1.01, 1.51)	0.036	84.4	< 0.001
Maximal	–	6,425,593	1.39 (1.11, 1.73)	0.004	88.3	< 0.001

^aThe number of participants was calculated based on the total population of included studies in each group
^bInfluence analysis was conducted by eliminating one study at a time; excluded study by Haglund et al. [47] for minimal pooled ORs, and excluded study by van der Ven et al. [22] for maximal pooled ORs
Abbreviations: CI Confidence interval, NOS Newcastle-Ottawa scale, OR Odds ratio

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