Maternal smoking and autism spectrum disorder: meta-analysis with population smoking metrics as moderators
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While exposure to nicotine during developmental periods can significantly affect brain development, studies examining the association between maternal smoking and autism spectrum disorder (ASD) in offspring have produced conflicting findings, and prior meta-analyses have found no significant association. Our meta-analysis used a novel approach of investigating population-level smoking metrics as moderators. The main meta-analysis, with 22 observational studies comprising 795,632 cases and 1,829,256 control participants, used a random-effects model to find no significant association between maternal smoking during pregnancy and ASD in offspring (pooled odds ratio (OR) = 1.16, 95% CI: 0.97–1.40). However, meta-regression analyses with moderators were significant when we matched pooled ORs with adult male smoking prevalence (z = 2.55, p = 0.01) in each country, using World Health Organization data. Our study shows that using population-level smoking metrics uncovers significant relationships between maternal smoking and ASD risk. Correlational analyses show that male smoking prevalence approximates secondhand smoke exposure. While we cannot exclude the possibility that our findings reflect the role of paternal or postnatal nicotine exposure, as opposed to maternal or in utero nicotine exposure, this study underlines the importance of investigating paternal and secondhand smoking in addition to maternal smoking in ASD.
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In subgroup analysis, smoking prevalence in males in the country of each study had a significant influence on ASD risk after maternal smoking (z = 2.33, p < 0.05).
“However, when they performed sub-group analysis, they found that smoking prevalence in males in the country of each study had a significant influence on ASD risk after maternal smoking (z = 2.33, p < 0.05).”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [119]
In a Nature meta-analysis by Jung et al. analyzing 22 observational studies, the random-effects model found no significant association between maternal smoking during pregnancy and ASD in offspring (pooled OR = 1.16, 95% CI 0.97-1.40).
“Analyzing 22 observational studies that comprised 795,632 cases and 1,829,256 control participants, their random-effects model found no significant association between maternal smoking during pregnancy and ASD in offspring (pooled OR = 1.16, 95% CI: 0.97–1.40).”
From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [119]
A more recent meta-analysis employing population-based smoking metrics as moderators pointed to the importance of investigating paternal and secondhand smoking exposure, in addition to maternal smoking, in understanding ASD risk from smoking.
“A more recent meta-analysis employing population-based smoking metrics as moderators pointed to the importance of investigating paternal and secondhand smoking exposure, in addition to maternal smoking, in understanding the risk smoking bears in ASD [148].”
From The contribution of environmental exposure to the etiology of autism spectrum disorder (2019) · cites this paper as [148]
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- Authors
- Jung, Y., Lee, A. M., McKee, S. A., & Picciotto, M. R.
- Affiliations
- Yale University (US)
- Corresponding author
- Picciotto, Marina R.
- Venue
- Scientific Reports
- Published
- 2017-06-28
- Volume
- 7
- Issue
- 1
- Pages
- 4315-4315
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5489536
- OpenAlex
- W2638748052
- Cited by
- 77
- References
- 66
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 10 · 2023: 12 · 2022: 13 · 2021: 12 · 2020: 8 · 2019: 9 · 2018: 4
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (DA033945, DA014241, UL1TR001863)
- National Institute of Mental Health (R01MH077681)
- National Institute on Drug Abuse (R01DA014241, P50DA033945, R37DA014241)
- National Institute of General Medical Sciences (T32GM007205)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- maternal smoking, autism spectrum disorder, prenatal nicotine exposure, passive smoking, paternal smoking, ASD risk
- MeSH terms
- Autism Spectrum Disorder, Female, Humans, Population Surveillance, Pregnancy, Prenatal Exposure Delayed Effects, Smoking, Tobacco Smoke Pollution, Odds Ratio, Publication Bias, Maternal Exposure
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