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Prenatal, perinatal, and postnatal factors associated with autism: A meta-analysis
Open accessAbstract
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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“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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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
(2014) · Medical Entomology and Zoology · Cited by 17,633
Operating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955
Statistical Aspects of the Analysis of Data From Retrospective Studies of Disease
(1959) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/22.4.719 · Cited by 14,689 · cited 1×
“The DerSimonian–Laird method with random-effects model([22]) was used to calculate the pooled RRs with 95% CIs when the heterogeneity was identified; otherwise, a fixed-effects model (Mantel–Haenszel method) was used to pool the estimates.([23]) We also conducted subgroup analysis according to case definition, study d…”
MethodGlobal Prevalence of Autism and Other Pervasive Developmental Disorders
Elsabbagh, M., Divan, G., Koh, Y., Kim, Y. S., Kauchali, S., Marcín, C., Montiel‐Nava, C., Patel, V., Paula, C. S., Wang, C., et al. (2012) · Autism Research · doi:10.1002/aur.239 · Cited by 2,636
Self-citationGenetic Heritability and Shared Environmental Factors Among Twin Pairs With Autism
Hallmayer, J. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.76 · Cited by 1,970
(2005) · PubMed · Cited by 775
Advancing Paternal Age and Autism
Reichenberg, A., Gross, R., Weiser, M., Bresnahan, M. A., Silverman, J. M., Harlap, S., Rabinowitz, J., Shulman, C., Malaspina, D., Lubin, G., et al. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.9.1026 · Cited by 686
Perinatal and Neonatal Risk Factors for Autism: A Comprehensive Meta-analysis
Gardener, H., Spiegelman, D., & Buka, S. L. (2011) · Pediatrics · doi:10.1542/peds.2010-1036 · Cited by 665
Prevalence of Autism in a United States Population: The Brick Township, New Jersey, Investigation
Bertrand, J., Mars, A. E., Boyle, C. A., Bove, F., Yeargin‐Allsopp, M., & Decouflé, P. (2001) · PEDIATRICS · doi:10.1542/peds.108.5.1155 · Cited by 577
Perinatal risk factors for infantile autism
Hultman, C. M., Sparén, P., & Cnattingius, S. (2002) · Epidemiology · doi:10.1097/00001648-200207000-00009 · Cited by 561
Perinatal Factors and the Development of Autism
Glasson, E. J., Bower, C. I., Petterson, B., de Klerk, N. H., Chaney, G., & Hallmayer, J. F. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.6.618 · Cited by 542
Prenatal and Perinatal Risk Factors for Autism
Kolevzon, A. L., Gross, R., & Reichenberg, A. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.4.326 · Cited by 541
Advanced Parental Age and the Risk of Autism Spectrum Disorder
Durkin, M. S., Maenner, M. J., Newschaffer, C. J., Lee, L.-C., Cunniff, C. M., Daniels, J. L., Kirby, R. S., Leavitt, L. A., Miller, L. A., Zahorodny, W. M., et al. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn250 · Cited by 417
Maternal and paternal age and risk of Autism Spectrum Disorders
Croen, L. A., Najjar, D. V., Fireman, B., & Grether, J. K. (2007) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.161.4.334 · Cited by 410
Advancing Maternal Age Is Associated With Increasing Risk for Autism: A Review and Meta-Analysis
Sandin, S., Hultman, C. M., Kolevzon, A. L., Gross, R., MacCabe, J. H., & Reichenberg, A. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.02.018 · Cited by 367
Pre‐, peri‐ and neonatal risk factors for autism
GUINCHAT, V., THORSEN, P., LAURENT, C., CANS, C., BODEAU, N., & COHEN, D. (2012) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2011.01325.x · Cited by 294
The Role of Prenatal, Obstetric and Neonatal Factors in the Development of Autism
Dodds, L. A., Fell, D. B., Shea, S. E., Armson, B. A., Allen, A. C., & Bryson, S. E. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-1114-8 · Cited by 280
Gillberg, C., & Gillberg, I. C. (1983) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01531816 · Cited by 246
Prenatal, perinatal, and neonatal factors associated with autism spectrum disorders
Bilder, D., Pinborough-Zimmerman, J., Miller, J., & McMahon, W. (2009) · Pediatrics · doi:10.1542/peds.2008-0927 · Cited by 222
Independent and Dependent Contributions of Advanced Maternal and Paternal Ages to Autism Risk
Shelton, J., Tancredi, D. J., & Hertz-Picciotto, I. (2010) · Autism Research · doi:10.1002/aur.116 · Cited by 208
Parental Age and Autism Spectrum Disorders
Parner, E. T., Baron‐Cohen, S., Lauritsen, M. B., Jørgensen, M., Schieve, L. A., Yeargin‐Allsopp, M., & Obel, C. (2012) · Annals of Epidemiology · doi:10.1016/j.annepidem.2011.12.006 · Cited by 196
Risk of Autism and Increasing Maternal and Paternal Age in a Large North American Population
Grether, J. K., Anderson, M. C., Croen, L., Smıth, D. J., & Windham, G. C. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp247 · Cited by 191
Prenatal and Perinatal Risk Factors for Autism in China
Zhang, X., Lv, C.-C., Tian, J., Miao, R.-J., Wei, X., Hertz‐Picciotto, I., & Qi, L. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-0992-0 · Cited by 191
Larsson, M., Weiss, B., Janson, S., Sundell, J., & Bornehag, C.-G. (2009) · NeuroToxicology · doi:10.1016/j.neuro.2009.01.011 · Cited by 184
Prenatal and perinatal risk factors for autism
Burd, L., Severud, R., Kerbeshian, J., & Klug, M. G. (1999) · Journal of Perinatal Medicine · doi:10.1515/jpm.1999.059 · Cited by 167
Ornoy, A., Ratzon, N. Z., Greenbaum, C. W., Wolf, A. L., & Dulitzky, M. (2001) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2001.14.s1.681 · Cited by 167
Burstyn, I., Sithole, F., & Zwaigenbaum, L. (2010) · Chronic Diseases and Injuries in Canada · doi:10.24095/hpcdp.30.4.04 · Cited by 159
PRE‐. PERI‐, AND NEONATAL FACTORS AND INFANTILE AUTISM
Finegan, J. K., & Quarrington, B. J. (1979) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1979.tb00492.x · Cited by 148
Pre-Eclampsia, Birth Weight, and Autism Spectrum Disorders
Mann, J. R., McDermott, S. W., Bao, H., Hardin, J. W., & Gregg, A. R. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0903-4 · Cited by 145
Risk factors for autism and Asperger syndrome: Perinatal factors and migration
Haglund, N. G. S., & Källén, K. B. M. (2011) · Autism · doi:10.1177/1362361309353614 · Cited by 129
Prenatal and perinatal risk factors in a twin study of autism spectrum disorders
Froehlich, W. M., Tobón, A. L., Cleveland, S. C., Torres, A., Phillips, J. M., Cohen, B., Torigoe, T., Miller, J., Fedele, A., Collins, J., et al. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.03.019 · Cited by 121
Tchaconas, A., & ADESMAN, A. R. (2012) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e32835c2b70 · Cited by 116
Pre- and perinatal factors in high-functioning females and males with autism
Lord, C., Mulloy, C., Wendelboe, M., & Schopler, E. (1991) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02284760 · Cited by 111
Perinatal and maternal risk factors for Autism Spectrum Disorders in new South Wales, Australia
Williams, K., Helmer, M., Duncan, G. W., Peat, J. K., & Mellis, C. M. (2008) · Child: Care, Health and Development · doi:10.1111/j.1365-2214.2007.00796.x · Cited by 98
Obstetric Risk Factors and Autism Spectrum Disorders in Finland
Polo‐Kantola, P., Lampi, K. M., Hinkka‐Yli‐Salomäki, S., Gissler, M., Brown, A. S., & Sourander, A. (2013) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2013.09.044 · Cited by 91
Independent and dependent contributions of advanced maternal and paternal ages to autism risk
Shelton, J. F., Tancredi, D. J., & Hertz‐Picciotto, I. (2010) · Autism Research · doi:10.1002/aur.135 · Cited by 85
Maternal stress and perinatal features in autism and attention deficit/hyperactivity disorder
Say, G. N., Karabekiroğlu, K., Babadağı, Z., & Yüce, M. (2015) · Pediatrics International · doi:10.1111/ped.12822 · Cited by 84
Paternal age increases the risk for autism in an Iranian population sample
Sasanfar, R., Haddad, S. A., Tolouei, A., Ghadami, M., Yu, D., & Santangelo, S. L. (2010) · Molecular Autism · doi:10.1186/2040-2392-1-2 · Cited by 80
Prenatal, perinatal and postnatal factors associated with autism spectrum disorder
Hadjkacem, I., Ayadi, H., Turki, M., Yaïch, S., Khemekhem, K., Walha, A., Chérif, L., Moalla, Y., & Ghribi, F. (2016) · Jornal de Pediatria · doi:10.1016/j.jped.2016.01.012 · Cited by 76
Obstetrical Suboptimality in Autistic Children
Bryson, S. E., Smith, I. M., & EASTWOOD, D. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198807000-00006 · Cited by 75
Brief report: A case-control study of obstetric complications and later autistic disorder
Cryan, E., Byrne, M., O'Donovan, A., & O'Callaghan, E. (1996) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172829 · Cited by 65
Brief report: maternal smoking during pregnancy and autism spectrum disorders
Lee, B. K., Gardner, R. M., Dal, H., Svensson, A., Galanti, M. R., Rai, D., Dalman, C., & Magnusson, C. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1425-4 · Cited by 61
Dawson, S., Glasson, E. J., Dixon, G., & Bower, C. I. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp059 · Cited by 53
Smoking in pregnancy: a risk factor for adverse neurodevelopmental outcome in preterm infants?
Kiechl‐Kohlendorfer, U., Ralser, E., Peglow, U. P., Reiter, G., Griesmaier, E., & Trawöger, R. (2010) · Acta Paediatrica · doi:10.1111/j.1651-2227.2010.01749.x · Cited by 41
A Qualitative and Quantitative Review of Obstetric Complications and Autistic Disorder
Brašić, J. R., & Holland, J. A. (2007) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-007-9054-8 · Cited by 13
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Bölte, S., Girdler, S., & Marschik, P. B. (2019) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-018-2988-4 · Cited by 509
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Metadata
- 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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