Prenatal, perinatal, and postnatal factors associated with autism: A meta-analysis
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BACKGROUND: The aim of this meta-analysis was to investigate the prenatal, perinatal, and postnatal risk factors for children autism. METHODS: PubMed, Embase, Web of Science were used to search for studies that examined the prenatal, perinatal, and postnatal risk factors for children autism. A fixed-effects model or random-effects model was used to pool the overall effect estimates. RESULTS: Data from 37,634 autistic children and 12,081,416 nonautistic children enrolled in 17 studies were collated. During the prenatal period, the factors associated with autism risk were maternal and paternal age≥35 years, mother's and father's race: White and Asian, gestational hypertension, gestational diabetes, maternal and paternal education college graduate+, threatened abortion, and antepartum hemorrhage. During perinatal period, the factors associated with autism risk were caesarian delivery, gestational age≤36 weeks, parity≥4, spontaneous labor, induced labor, no labor, breech presentation, preeclampsia, and fetal distress. During the postnatal period, the factors associated with autism risk were low birth weight, postpartum hemorrhage, male gender, and brain anomaly. Parity≥4 and female were associated with a decreased risk of autism. In addition, exposure to cigarette smoking, urinary infection, mother's and father's race: Black and Hispanic, mother's country of birth outside Europe and North America, umbilical cord around neck, premature membrane rupture, 5-minutes Apgar score<7, and respiratory infection were not associated with increased risk of autism. CONCLUSION: The present meta-analysis confirmed the relation between some prenatal, perinatal, and postnatal factors with autism. All these factors were examined individually, thus it was still unclear that whether these factors are causal or play a secondary role in the development of autism. Further studies are needed to verify our findings, and investigate the effects of multiple factors on autism, rather than the single factor.
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Increased risk for autism is associated with cesarean delivery, gestational age ≤ 36 weeks at birth, induced labor, no labor, breech presentation, and fetal distress, although most odds and relative risk ratios were modest.
“A more current review found an increased risk for autism associated with cesarean delivery, gestational age ≤ 36 weeks at birth, induced labor, no labor, breech presentation, and fetal distress, although most odds and relative risk ratios were modest”
From The contribution of environmental exposure to the etiology of autism spectrum disorder (2019) · cites this paper as [124]
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- Authors
- Wang, C., Geng, H., Liu, W., & Zhang, G.
- Corresponding author
- Liu, Weidong
- Zhang, Guiqin
- Venue
- Medicine
- Published
- 2017-05
- Volume
- 96
- Issue
- 18
- Pages
- e6696
- ISSN
- 0025-7974 (ISSN-L)
- PMC
- PMC5419910
- OpenAlex
- W2611128431
- Cited by
- 348
- References
- 50
- Citations by year
- 2026: 20 · 2025: 42 · 2024: 49 · 2023: 39 · 2022: 52 · 2021: 62 · 2020: 35 · 2019: 22 · 2018: 20 · 2017: 5
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nd
- Locations
- Medicine (publishedVersion, cc-by-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nd)
- PubMed Central (publishedVersion, cc-by-nd)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- autism spectrum disorder, autism risk factors, prenatal risk factors, perinatal risk factors, postnatal risk factors, maternal age, gestational diabetes mellitus, gestational hypertension, parity, low birth weight, preeclampsia, fetal distress, maternal race, paternal age
- MeSH terms
- Autistic Disorder, Female, Humans, Pregnancy, Pregnancy Complications, Risk Factors
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