09 mai 2017

Facteurs prénataux, périnatals et postnatals associés à l'autisme: une méta-analyse

Aperçu: G.M.
L'objectif de cette méta-analyse était d'étudier les facteurs de risque prénatal, périnatal et postnatal pour les enfants autistes.
Au cours de la période prénatale, les facteurs associés au risque d'autisme étaient mères et pères âgés de plus de 35 ans, l'ethnie des parents : blanc et asiatique, l'hypertension gestationnelle, le diabète gestationnel, l'éducation maternelle et paternelle, le diplôme d'études supérieures, la menace d'avortement et l'hémorragie antepartite.
Au cours de la période périnatale, les facteurs associés au risque d'autisme étaient l'accouchement par césarienne, l'âge gestationnel âgé de 36 semaines, la parité ≥ 4, le travail spontané, le travail induit, le non-travail, la présentation par siège, la prééclampsie et la détresse fœtale. 
Au cours de la période postnatale, les facteurs associés au risque d'autisme étaient le faible poids à la naissance, l'hémorragie post-partum, le sexe masculin et l'anomalie du cerveau. 
La parité ≥4 et le sexe féminin ont été associées à une diminution du risque d'autisme.  
En outre, l'exposition à la cigarette, l'infection urinaire, l'éthnie des parents : africain et l'hispanique, le pays de naissance de la mère hors Europe et l'Amérique du Nord, le cordon ombilical autour du cou, la rupture prématurée de la membrane, le score Apgar de 5 minutes <7 et l'infection respiratoire n'étaient pas associés à un risque accru d'autisme. 


Medicine (Baltimore). 2017 May;96(18):e6696. doi: 10.1097/MD.0000000000006696.

Prenatal, perinatal, and postnatal factors associated with autism: A meta-analysis

Author information

1
Department of Pediatrics, Maternal and Child Health Hospital of Yancheng, Yancheng City, Jiangsu Province, P.R. China.

Abstract

BACKGROUND:

The aim of this meta-analysis was to investigate the prenatal, perinatal, and postnatal risk factors for children autism.

METHODS:

PubMed, Embase, Web of Science were used to search for studies that examined the prenatal, perinatal, and postnatal risk factors for children autism. A fixed-effects model or random-effects model was used to pool the overall effect estimates.

RESULTS:

Data from 37,634 autistic children and 12,081,416 nonautistic children enrolled in 17 studies were collated. During the prenatal period, the factors associated with autism risk were maternal and paternal age≥35 years, mother's and father's race: White and Asian, gestational hypertension, gestational diabetes, maternal and paternal education college graduate+, threatened abortion, and antepartum hemorrhage. During perinatal period, the factors associated with autism risk were caesarian delivery, gestational age≤36 weeks, parity≥4, spontaneous labor, induced labor, no labor, breech presentation, preeclampsia, and fetal distress. During the postnatal period, the factors associated with autism risk were low birth weight, postpartum hemorrhage, male gender, and brain anomaly. Parity≥4 and female were associated with a decreased risk of autism. In addition, exposure to cigarette smoking, urinary infection, mother's and father's race: Black and Hispanic, mother's country of birth outside Europe and North America, umbilical cord around neck, premature membrane rupture, 5-minutes Apgar score<7, and respiratory infection were not associated with increased risk of autism.

CONCLUSION:

The present meta-analysis confirmed the relation between some prenatal, perinatal, and postnatal factors with autism. All these factors were examined individually, thus it was still unclear that whether these factors are causal or play a secondary role in the development of autism. Further studies are needed to verify our findings, and investigate the effects of multiple factors on autism, rather than the single factor.
PMID: 28471964
DOI: 10.1097/MD.0000000000006696

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