Pre-eclampsia and the risk of autism-spectrum disorder in offspring: meta-analysis

Br J Psychiatry. 2018 Mar;212(3):142-147. doi: 10.1192/bjp.2017.27. Epub 2018 Jan 24.

Abstract

Background: Evidence about the effect of intrauterine exposure to pre-eclampsia on offspring autism-spectrum disorder (ASD) is not well established. Aims To examine the association between pre-eclampsia and ASD.

Method: PubMed, Embase and PsycINFO databases were searched. Pooled relative risks (RR) with 95% confidence intervals were calculated. Subgroup and sensitivity analyses were performed. Heterogeneity was assessed using Cochran's Q- and the I 2-test. The presence of publication bias was evaluated by Egger's test and visual inspection of the symmetry in funnel plots.

Results: Ten studies meet the inclusion criteria. The risk of ASD was 32% higher in offspring who had intrauterine exposure to pre-eclampsia compared with those not exposed (RR = 1.32, 95% CI 1.20-1.45). Sensitivity analysis revealed consistent pooled estimates ranging from RR = 1.30 (95% CI 1.17-1.44) to RR = 1.37 (95% CI 1.26-1.48). We found no significant heterogeneity and evidence of publication bias.

Conclusion: Pre-eclampsia increased the risk of ASD in offspring. The finding suggests a need for early screening for ASD in offspring of women with pre-eclampsia. Declaration of interest None.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Autism Spectrum Disorder / epidemiology*
  • Autism Spectrum Disorder / etiology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Pre-Eclampsia / epidemiology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Young Adult