儿童屏幕时间与注意缺陷/多动障碍：一项系统综述与荟萃分析。
完整摘要 · 中文译文
背景：儿童接触电子屏幕的时间急剧增加。本研究通过系统综述和荟萃分析定量评估了过度屏幕时间与儿童注意缺陷多动障碍（ADHD）风险之间的关联，并探讨了年龄和媒体类型的调节作用。 方法：遵循PRISMA指南，我们系统检索了评估儿童屏幕时间与ADHD的观察性研究，最终纳入10项观察性研究，总体偏倚风险为低至中等。使用ROBINS-I工具评估偏倚风险。连续数据采用Chinn转换规则统一。采用DerSimonian-Laird随机效应模型计算合并比值比（OR）和95%置信区间（CI）。还进行了亚组分析、留一法敏感性分析以及Begg法和Egger法检验。 结果：过度屏幕时间与儿童ADHD风险升高显著相关（合并OR = 1.56，95% CI：1.31-1.87，P < 0.001）。观察到显著的研究间异质性（Q = 344.51，I2 = 97.4%，P < 0.001）。亚组分析揭示了显著的年龄相关异质性：学龄前儿童（0-6岁）显示出更大程度的关联（OR = 2.40，95% CI：1.44-3.98），而学龄儿童和青少年（>6岁）的关联程度较小（OR = 1.16，95% CI：1.05-1.29）。被动电视/视频观看的ADHD风险点估计值（OR = 2.20）高于互动式数字媒体（OR = 1.10），但组间差异未达到统计学显著性。S 敏感性分析证实了这些发现的稳健性。 结论：过度的屏幕暴露与儿童ADHD风险升高显著相关，并呈现明显的年龄特异性和媒体类型特异性模式。学龄前期似乎是屏幕相关神经发育效应的高风险窗口，且被动屏幕暴露的关联呈更强趋势。公共卫生和临床干预应优先限制早期屏幕暴露，尤其是缺乏实质性互动的被动、快节奏视频。
完整摘要 · 英文原文
BACKGROUND: Children's exposure to electronic screens has risen sharply. This study quantitatively evaluated the association between excessive screen time and childhood attention-deficit/hyperactivity disorder (ADHD) risk through a systematic review and meta-analysis, exploring the moderating roles of age and media type. METHODS: Following PRISMA guidelines, we systematically searched observational studies assessing children's screen time and ADHD, and finally included 10 observational studies with overall low-to-moderate risk of bias. Risk of bias was evaluated using the ROBINS-I tool. Continuous data were unified using the Chinn conversion rule. A DerSimonian-Laird random-effects model calculated pooled odds ratios (OR) and 95% confidence intervals (CI). Subgroup analyses, leave-one-out sensitivity analyses, and Begg's and Egger's tests were also conducted. RESULTS: Excessive screen time was significantly associated with elevated childhood ADHD risk (pooled OR = 1.56, 95% CI: 1.31-1.87, P < 0.001). Substantial between-study heterogeneity was observed (Q = 344.51, I2 = 97.4%, P < 0.001). Subgroup analyses revealed significant age-related heterogeneity: preschoolers (0-6 years) showed a larger magnitude of association (OR = 2.40, 95% CI: 1.44-3.98), whereas the association in school-age children and adolescents (>6 years) was of smaller magnitude (OR = 1.16, 95% CI: 1.05-1.29). Passive TV/video viewing showed a higher point estimate of ADHD risk (OR = 2.20) than interactive digital media (OR = 1.10), but the between-group difference did not reach statistical significance. Sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS: Excessive screen exposure is significantly associated with elevated ADHD risk in children, with distinct age-specific and media type-specific patterns. The preschool period appears to be a high-risk window for screen-related neurodevelopmental effects, with a trend toward stronger association for passive screen exposure. Public health and clinical interventions should prioritize restricting early screen exposure, particularly passive, fast-paced videos without substantial interaction.