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Cited by 10Effects and risks of endocrine disrupting chemicalsAutism Spectrum Disorder ResearchHealth, Environment, Cognitive Aging

Systematic review of prenatal exposure to endocrine disrupting chemicals and autism spectrum disorder in offspring

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Marí-Bauset, Salvador, Peraita-Costa, Isabel, Donat-Vargas, Carolina, Llopis-González, Agustín, Marí-Sanchis, Amelia, Llopis-Morales, Juan, Morales Suárez-Varela, María·2022·Autism
DOI 10.1177/13623613211039950
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Abstract

Epidemiological studies, which can have inherent methodological limitations, are used to study the relation between endocrine disrupting chemicals and autism spectrum disorder. The objective is to systematically review the treatment of methodological limitations and assess the quality and strength of the findings in the available literature. The quality and strength of the evidence were evaluated using the Navigation Guide Systematic Review Methodology. The overall quality and strength of the available studies were “moderate” and “limited,” respectively. Risk of bias due to the methodological limitations regarding the exclusion of potential confounding factors and the lack of accuracy of exposure assessment methods were the most prevalent and were also considered to arrive at these results. The omnipresence of endocrine disrupting chemicals, their persistence and bioaccumulation, and the biological plausibility of the association between prenatal exposure to these and later development of autism spectrum disorder highlight the need to carry out well-designed epidemiological studies that overcome the methodological limitations observed in the currently available literature in order to be able to inform public policy to prevent exposure to these potentially harmful chemicals. Lay abstract: Autism spectrum disorders comprise a complex group with many subtypes of behaviorally defined neurodevelopmental abnormalities in two core areas: deficits in social communication and fixated, restricted, repetitive, or stereotyped behaviors and interests each with potential unique risk factors and characteristics. The underlying mechanisms and the possible causes of autism spectrum disorder remain elusive and while increased prevalence is undoubtable, it is unclear if it is a reflection of diagnostic improvement or emerging risk factors such as endocrine disrupting chemicals. Epidemiological studies, which are used to study the relation between endocrine disrupting chemicals and autism spectrum disorder, can have inherent methodological challenges that limit the quality and strength of their findings. The objective of this work is to systematically review the treatment of these challenges and assess the quality and strength of the findings in the currently available literature. The overall quality and strength were “moderate” and “limited,” respectively. Risk of bias due to the exclusion of potential confounding factors and the lack of accuracy of exposure assessment methods were the most prevalent. The omnipresence of endocrine disrupting chemicals and the biological plausibility of the association between prenatal exposure and later development of autism spectrum disorder highlight the need to carry out well-designed epidemiological studies that overcome the methodological challenges observed in the currently available literature in order to be able to inform public policy to prevent exposure to these potentially harmful chemicals and aid in the establishment of predictor variables to facilitate early diagnosis of autism spectrum disorder and improve long-term outcomes.

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  • Evidence from animal and human studies suggests that endocrine-disrupting compounds such as bisphenol A affect neurodevelopmental outcomes via immune cell functioning, although most human studies are limited by imprecise measures of exposure.

    “Evidence from animal and human studies also suggests that endocrine-disrupting compounds such as bisphenol A affect neurodevelopmental outcomes via immune cell functioning274, although most human studies are limited by imprecise measures of exposure and more rigorous epidemiological studies are warranted275.”

    From Sex and gender in neurodevelopmental conditions (2023) · cites this paper as [275]

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Research works printed but not linked: 12

  1. Centers for Disease Control and Prevention). (2007). Prevalence of autism spectrum disorders-Autism and developmental disabilities monitoring network, 6 sites, United States, 2000. Morbidity and Mortality Weekly Report Surveillance Summaries , 56 (1), 1-11.
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  3. The Cochrane Collaboration. (2011). Cochrane handbook for systematic reviews of interventions. Cochrane book series (J. Higgins & S. Green, Eds.) (Version 5.1). The Cochrane Collaboration and John Wiley & Sons.
  4. European Food Safety Authority Scientific Committee. (2013). Scientific opinion on the hazard assessment of endocrine disruptors: Scientific criteria for identification of endocrine disruptors and appropriateness of existing test methods for assessing effects mediated by these substances on human health and the environment. EFSA Journal , 11 (3), 31323215.
  5. Geier, D. A., Mumper, E., Gladfelter, B., Coleman, L., & Geier, M. R. (2008). Neurodevelopmental disorders, maternal Rh-negativity, and Rho (D) immune globulins: A multi- center assessment. Neuroendocrinology Letters , 29 (2), Article 272.
  6. Greene, C., Goeden, H., Rice, N., & Shubat, P. (2012). Apportionment of exposure and risk from contaminants of emerging concern (2012 Annual Meeting: Advancing Analysis ed.). Society for Risk Analysis (SRA).
  7. Heindel, J. J., Balbus, J., Birnbaum, L., Brune-Drisse, M. N., Grandjean, P., Gray, K., . . . Slechta, D. C. (2016). Developmental origins of health and disease: Integrating environmental influences. Endocrinology , 2016 (1), 17-22.
  8. Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. Lancet , 383 (9920), 896-910. https://doi.org/10.1016/ S0140-6736(13)61539-1
  9. Newbold, R. R., Padilla-Banks, E., & Jefferson, W. N. (2006). Adverse effects of the model environmental estrogen diethylstilbestrol are transmitted to subsequent generations. Endocrinology , 147 (6), s11-s17.
  10. United Nations Environment Programme & World Health Organization. (2013). State of the science of endocrine disrupting chemicals-2012. An assessment of the state of the science of endocrine disruptors prepared by a group of experts for the United Nations Environment Programme (UNEP) and World Health Organization (WHO) (Å. Bergman, J. J. Heindel, S. Jobling, K. Kidd, & T. R. Zoeller, Eds.). WHO Press.
  11. United States Environmental Protection Agency. (2002). A review of the reference dose and reference concentration processes (No. EPA/630/P-02/002F). Risk Assessment Forum of the United States Environmental Protection Agency.
  12. Vandenberg, L. N. (2012). State of the science in non-monotonic dose responses. In Workshop on Low Dose Effects and Nonmonotonic Dose Responses for Endocrine Active Chemicals . European Commission's Joint Research Centre's Institute for Health and Consumer Protection (IHCP).

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Authors
Marí-Bauset, S., Peraita-Costa, I., Donat-Vargas, C., Llopis-González, A., Marí-Sanchis, A., Llopis-Morales, J., & Morales Suárez-Varela, M.
Affiliations
  • Universitat de València (ES)
  • Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
  • Karolinska Institutet, Sweden
  • Complejo Hospitalario de Navarra (ES)
ORCID
Venue
Autism
Publisher
SAGE Publications
Published
2021-08-19
Volume
26
Issue
1
Pages
6-32
ISSN
  • 1362-3613 (ISSN-L)
  • 1461-7005
DOI
10.1177/13623613211039950
OpenAlex
W3195157286
Cited by
10
References
186
Citations by year
2026: 3 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 1
FWCI
0.09
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Autism (publishedVersion)
  • PubMed (publishedVersion)
  • Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
Keywords
endocrine disruptors, autism spectrum disorder, prenatal exposure, neurodevelopmental disorders, confounding, risk of bias, biological plausibility, environmental chemicals, early diagnosis
MeSH terms
Autism Spectrum Disorder, Female, Humans, Pregnancy, Prenatal Exposure Delayed Effects, Risk Factors, Stereotyped Behavior, Endocrine Disruptors

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