Authors
Eren Halaç, Nazan Gündoğan Küçükşahin, Emre Bora
Published in
Nordic journal of psychiatry. Pages 1-10. Aug 20, 2026. Epub Aug 20, 2026.
Abstract
Minor physical anomalies (MPAs) are subtle morphological variants that may reflect atypical prenatal development. Elevated MPAs have been reported in autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but findings have been inconsistent.
We systematically searched PubMed, Web of Science, and grey-literature sources for case-control studies published through December 2025 that reported total MPA scores in ASD or ADHD versus typically developing controls. Pooled effect sizes were calculated as Hedges' g using random-effects models with restricted maximum likelihood estimation. Shared control groups were handled by sample splitting. Heterogeneity, subgroup and moderator effects, and small-study effects were examined.
Twelve ASD studies and eight ADHD studies met inclusion criteria. Across disorders, MPAs were significantly elevated relative to controls (pooled g = 0.72, 95% CI 0.56-0.89). Disorder-specific pooled estimates were significant for both ASD (g = 0.69) and ADHD (g = 0.77), with no significant difference between disorders (Qbet = 0.22, p = 0.64). In ASD, effects were stronger for craniofacial anomalies than for peripheral anomalies, and item-level syntheses highlighted several ear- and palate-related features. In ADHD, evidence of small-study effects suggested possible overestimation, although conclusions remained robust in sensitivity analyses.
MPAs are reliably elevated in both ASD and ADHD. Current case-control evidence supports MPAs as a transdiagnostic marker of early developmental perturbation rather than a feature that strongly differentiates between these disorders.
PMID:
42619500
Bibliographic data and abstract were imported from PubMed on 20 Aug 2026.
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