Clin Exp Pediatr.
2024 Sep;67(9):459-464. 10.3345/cep.2024.00136.
Neonatal risk factors associated with autism spectrum disorders: an umbrella review
- Affiliations
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- 1Student Research Committee, Hamadan University of Medical Sciences School of Medicine, Hamadan, Iran
- 2Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- 3Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
- 4Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- KMID: 2558849
- DOI: http://doi.org/10.3345/cep.2024.00136
Abstract
- Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors. Purpose: This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews.
Methods
We conducted a systematic search of interna- tional databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist.
Results
A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta- analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17–1.52), macrosomia (OR, 1.11; 95% CI, 1.05–1.18), low birth weight (OR, 1.63; 95% CI, 1.48–1.81), very low birth weight (OR, 2.25; 95% CI, 1.79–2.83), small for gestational age (OR, 1.17; 95% CI, 1.09–1.24), jaundice (OR, 1.74; 95% CI, 1.42– 2.12), male sex (OR, 1.47; 95% CI, 1.39–1.55) and 1-minute Apgar score <7 (OR, 1.40; 95% CI, 1.26–1.55) were graded as suggestive evidence (class III). Only 3 studies reported heterogeneity (I2<50%). Based on the AMSTAR2 analysis, the methodological quality was critically low in 3 meta- analyses, low in 2, and moderate in 1.
Conclusion
Based on these results, clinicians should consider the risk factors for ASD and screen children in clinics.
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