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Review
. 2009 Jul;195(1):7-14.
doi: 10.1192/bjp.bp.108.051672.

Prenatal risk factors for autism: comprehensive meta-analysis

Hannah Gardener  1 , Donna Spiegelman, Stephen L Buka
Affiliations
Review

Prenatal risk factors for autism: comprehensive meta-analysis

Hannah Gardener et al. Br J Psychiatry. 2009 Jul.

Abstract

Background: The aetiology of autism is unknown, although prenatal exposures have been the focus of epidemiological research for over 40 years.

Aims: To provide the first quantitative review and meta-analysis of the association between maternal pregnancy complications and pregnancy-related factors and risk of autism.

Method: PubMed, Embase and PsycINFO databases were searched for epidemiological studies that examined the association between pregnancy-related factors and autism. Forty studies were eligible for inclusion in the meta-analysis. Summary effect estimates were calculated for factors examined in multiple studies.

Results: Over 50 prenatal factors have been examined. The factors associated with autism risk in the meta-analysis were advanced parental age at birth, maternal prenatal medication use, bleeding, gestational diabetes, being first born v. third or later, and having a mother born abroad. The factors with the strongest evidence against a role in autism risk included previous fetal loss and maternal hypertension, proteinuria, pre-eclampsia and swelling.

Conclusions: There is insufficient evidence to implicate any one prenatal factor in autism aetiology, although there is some evidence to suggest that exposure to pregnancy complications may increase the risk.

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Comment in

  • Fetal androgens and autism.
    Voracek M. Voracek M. Br J Psychiatry. 2010 May;196(5):416; author reply 416-7. doi: 10.1192/bjp.196.5.416. Br J Psychiatry. 2010. PMID: 20435973 No abstract available.

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