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  • Kim, Jong YeobYonsei Univ, South Korea (author)

Environmental risk factors and biomarkers for autism spectrum disorder: an umbrella review of the evidence

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • ELSEVIER SCI LTD,2019
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-158834
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-158834URI
  • https://doi.org/10.1016/S2215-0366(19)30181-6DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:141214289URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:for swepub-publicationtype

Notes

  • Funding Agencies|Health Education England [ICA-CL-2017-03-001]; National Institute for Health Research (NIHR) [ICA-CL-2017-03-001]; NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust; Maudsley Charity; Kings College London; NIHR South London Collaboration for Leadership in Applied Health Research and Care
  • Background Numerous studies have identified potential risk factors and biomarkers for autism spectrum disorder. We aimed to study the strength and validity of the suggested environmental risk factors or biomarkers of autism spectrum disorder. Methods We did an umbrella review and systematically appraised the relevant meta-analyses of observational studies. We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for papers published between database inception and Oct 17, 2018, and screened the reference list of relevant articles. We obtained the summary effect, 95% CI, heterogeneity, and 95% prediction intervals. We examined small study effects and excess significance. We did analyses under credibility ceilings. This review is registered with PROSPERO, number CRD42018091704. Findings 46 eligible articles yielded data on 67 environmental risk factors (544 212 cases, 81 708 787 individuals) and 52 biomarkers (15 614 cases, 15 433 controls). Evidence of association was convincing for maternal age of 35 years or over (relative risk [RR] 1.31, 95% CI 1.18-1.45), maternal chronic hypertension (odds ratio [OR] 1.48, 1.29-1.70), maternal gestational hypertension (OR 1.37, 1.21-1.54), maternal overweight before or during pregnancy (RR 1.28, 1.19-1.36), pre-eclampsia (RR 1.32, 1.20-1.45), prepregnancy maternal antidepressant use (RR 1.48, 1.29-1.71), and maternal selective serotonin reuptake inhibitor (SSRI) use during pregnancy (OR 1.84, 1.60-2.11). Only two associations, maternal overweight before or during pregnancy and SSRI use during pregnancy, retained their high level of evidence under subset sensitivity analyses. Evidence from biomarkers was scarce, being supported by p values close to the significance threshold and too few cases. Interpretation Convincing evidence suggests that maternal factors, such as age and features of metabolic syndrome, are associated with risk of autism spectrum disorder. Although SSRI use during pregnancy was also associated with such risk when exposed and non-exposed groups were compared, this association could be affected by other confounding factors, considering that prepregnancy maternal antidepressant use was also convincingly associated with higher risk of autism spectrum disorder. Findings from previous studies suggest that one possible confounding factor is underlying maternal psychiatric disorders. Copyright (C) 2019 Elsevier Ltd. All rights reserved.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Son, Min JiYonsei Univ, South Korea (author)
  • Son, Chei YunWashington Univ, MO 63110 USA (author)
  • Radua, JoaquimKarolinska Institutet (author)
  • Eisenhut, MichaelLuton and Dunstable Univ Hosp NHS Fdn Trust, England (author)
  • Gressier, FlorenceBicetre Univ Hosp, France (author)
  • Koyanagi, AiUniv Barcelona, Spain; CIBERSAM, Spain (author)
  • Carvalho, Andre F.Ctr Addict and Mental Hlth, Canada; Univ Toronto, Canada (author)
  • Stubbs, BrendonSouth London and Maudsley NHS Fdn Trust, England; Kings Coll London, England (author)
  • Solmi, MarcoKings Coll London, England; Univ Padua, Italy; Univ Padua, Italy (author)
  • Rais, Theodor B.Univ Toledo, OH 43606 USA (author)
  • Lee, Keum HwaYonsei Univ, South Korea; Severance Childrens Hosp, South Korea (author)
  • Kronbichler, AndreasMed Univ Innsbruck, Austria (author)
  • Dragioti, ElenaLinköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum(Swepub:liu)eledr71 (author)
  • Il Shin, JaeYonsei Univ, South Korea; Severance Childrens Hosp, South Korea (author)
  • Fusar-Poli, PaoloKings Coll London, England; South London and Maudsley NHS Fdn Trust, England (author)
  • Yonsei Univ, South KoreaWashington Univ, MO 63110 USA (creator_code:org_t)

Related titles

  • In:Lancet psychiatry: ELSEVIER SCI LTD6:7, s. 590-6002215-03742215-0366

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