Autism Spectrum Disorder and prenatal factors

a control case study Autism Spectrum Disorder and Prenatal Factors

Authors

DOI:

https://doi.org/10.35699/2316-9389.2025.52882

Keywords:

Autism Spectrum Disorder, Prenatal Care, Pregnancy, Risk Factors

Abstract

Objective: to investigate the association between Autism Spectrum Disorder (ASD) and prenatal factors. Methods: a control case study was conducted with the responsible adults of 248 children/teenagers diagnosed with ASD (case group) and 886 neurotypical participants (control group). A semi structured questionnaire was used to collect data and logistic regression model was adopted to estimate the crude and adjusted odds ratio (OR). Results:  It was identified significant ASD association with the following prenatal factors: prenatal done in private care (OR=1,59); pre-eclampsia or eclampsia (OR=1,61); bleeding in pregnancy (OR=1,54); Absence of ferrous sulphate/iron supplement in pregnancy (OR=1,52); In the adjusted model, the variables of confounding factors also presented a positive association with ASD: very low weight when born, gender of the child, age of mother when giving birth, mother’s color of skin and ASD family history.  Conclusions: This study suggests that prenatal done in private care, occurrence of pre-eclampsia or eclampsia, bleeding in pregnancy e absence of ferrous sulphate/iron supplement in pregnancy presents an association with a high chance of ASD. The results found can be useful for prenatal advice over modifiable risk factors and early diagnosis.

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References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5 [Internet]. 5th ed. Washington, D.C: American Psychiatric Association; 2013. 947p. [citado em2025 abr. 04]. Disponível em: https://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf.

2. Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and characteristics of Autism Disorder among children aged 8 years – Autism and Developmental Disabilities monitoring Network,11 Sites, United States. MMWR Surveill Summ [Internet]. 2023[citado em 2025 abr. 04];72(2):1-14. Disponível em: https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm

3. Grosvenor LP, Croen LA, Lynch FL, Marafino BJ, Maye M, Penfold RB, et al. Autism diagnosis among US children and adults, 2011-2022. JAMA Netw Open [Internet]. 2024[citado em 2025 abr. 04];7(10):e2442218. Disponível em: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825472

4. Love C, Sominsky L, O'Hely M, Berk M, Vuillermin P, Dawson SL. Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms. BMC Med[Internet]. 2024[citado em 2025 abr. 04];22:393. Disponível em: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03617-3

5. Courchesne E, Gazestani VH, Lewis NE. Prenatal Origins of ASD: the when, what, and how of ASD development. Trends Neurosci[Internet]. 2020 May [citado em 2025 abr. 04];43(5):326-342. Disponível em: https://www.sciencedirect.com/science/article/abs/pii/S0166223620300515

6. Maia FA, Oliveira LMM, Almeida MTC, Alves MR, Saeger VSA, Silva VBD, et al. Autism spectrum disorder and postnatal factors: a case-control study in Brazil. Rev Paul Pediatr[Internet]. 2019[citado em 2025 abr. 04];37(4):398-405. Disponível em: https://doi.org/10.1590/1984-0462/;2019;37;4;00006

7. Maia FA, Almeida MTC, Alves MR, Bandeira LVS, Silva VB, Nunes NF, et al. Transtorno do espectro do autismo e idade dos genitores: estudo de caso-controle no Brasil. Cad Saúde Pública[Internet]. 2018[citado em 2025 abr. 04];34:e00109917. Disponível em: https://www.scielo.br/j/csp/a/jnW54sST6BQWyvyH8HVbcrj/abstract/?lang=pt.

8. Lwanga SK, Lemeshow S, WHO. Determinación del tamaño de las muestras en los estudios sanitarios : manual práctico. Geneve: Organización Mundial de la Salud; 1991. [citado em 2025 abr. 04]. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/ens-23797

9. Kazantzidou P, Antonopoulou K, Costarelli V, Papanikolaou G. Environmental factors associated with autism spectrum disorder in Southern Europe: a systematic review. Int J Dev Disabil[Internet]. 2023 May 23[citado em 2025 abr. 04];71(1):30-40. Disponível em: https://www.tandfonline.com/doi/full/10.1080/20473869.2023.2215012

10. Yenkoyan K, Mkhitaryan M, Bjørklund G. Environmental risk factors in autism spectrum disorder: a narrative review. Curr Med Chem[Internet]. 2024[citado em 2025 abr. 04];31(17):2345-60. Disponível em: https://modernonco.orscience.ru/0929-8673/article/view/644475

11. Santos Bandeira LV, Dias Alves F, Mendes Cezar IA, Nunes Oliveira SL, Soares Oliveira AJ, da Silva VB, et al. Autism spectrum disorder association with socioeconomic and demographic factors: a case-control study. Port J Public Health[Internet]. 2024[citado em 2025 abr. 04];42(1):15-22. Disponível em: https://europepmc.org/article/pmc/pmc11498917

12. Carter S, Lin JC, Chow T, Martinez MP, Qiu C, Feldman RK, et al. Preeclampsia onset, days to delivery, and autism spectrum disorders in offspring: clinical birth cohort study. JMIR Public Health Surveillance [Internet]. 2024[citado em 2025 abr. 04];10:e47396. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC11063875/

13. Gumusoglu SB, Chilukuri ASS, Santillan DA, Santillan MK, Stevens HE. Neurodevelopmental outcomes of prenatal preeclampsia exposure. Trends Neurosci[Internet]. 2020 Apr[citado em 2025 abr. 04];43(4):253-68. Disponível em: https://www.sciencedirect.com/science/article/abs/pii/S016622362030028X

14. Wang C, Geng H, Liu W, Zhang G. Prenatal, perinatal, andpostnatal factors associated with autism: a meta-analysis. Medicine(Baltimore) [Internet]. 2017[citado em 2025 abr.04];96(18):e6696. Disponível em: https://journals.lww.com/mdjournal/FullText/2017/05050/Prenatal,_perinatal,_and_postnatal_factors.14.aspx

15. Brynge, M., Gardner, R., Sjöqvist, H. et al. Maternal levels of acute phase proteins in early pregnancy and risk of autism spectrum disorders in offspring. Transl Psychiatry [Internet]. 2022[citado em 2025 abr. 04];12:148. Disponível em: https://doi.org/10.1038/s41398-022-01907-z.

16. Worsham W, Dalton S, Bilder DA. The Prenatal Hormone Milieu in Autism Spectrum Disorder. Front Psychiatry[Internet]. 2021[citado em 2025 abr. 04];12:655438. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC8280339/

17. Li M, Usui N, Shimada S. Prenatal sex hormone exposure is associated with the development of autism spectrum disorder. Int J Mol Sci[Internet]. 2023[citado em 2025 abr. 04];24(3):2203. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC9916422/

18. Linsell L, Malouf R, Johnson S, Morris J, Kurinczuk JJ, Marlow N. Prognostic factors for behavioral problems and psychiatric disorders in children born very preterm or very low birth weight: a systematic review. J Dev Behav Pediatr[Internet]. 2016[citado em 2025 abr. 04];37(1):88-102. Disponível em: https://journals.lww.com/jrnldbp/abstract/2016/01000/prognostic_factors_for_behavioral_problems_and.12.aspx

19. Edlund S, Haglund N, Bornehag C, Gennings C, Kiviranta H, Kolevzon A, et al. Perinatal and maternal factors associated with Autism Spectrum Disorder. Medrxiv [Internet]2024[citado em 2025 abr. 04]. DOI: 12.22.24319503. Disponível em: https://www.medrxiv.org/content/10.1101/2024.12.22.24319503v1.full

20. Hadjkacem I, Ayadi H, Turki M, Yaich S, Khemekhem K, Walha A, et al. Prenatal, perinatal and postnatal factors associated with autism spectrum disorder. J Pediatr (Rio J) [Internet]. 2016[citado em 2025 abr. 04];92(6):595-601. Disponível em: https://www.scielo.br/j/jped/a/sHsmdbXgczf7P4qvtQmTkwt/

21. Wroten M, Yoon S, Andrews P, Yamrom B, Ronemus M, Buja A, et al. Sharing parental genomes by siblings concordant or discordant for autism. Cell Genomics[Internet]. 2023[citado em 2025 abr. 04];3(6):100319. Disponível em: https://www.cell.com/cellgenomics/pdf/S2666-979X(23)00087-3.pdf

Published

2025-05-27

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Research

How to Cite

1.
Autism Spectrum Disorder and prenatal factors: a control case study Autism Spectrum Disorder and Prenatal Factors. REME Rev Min Enferm. [Internet]. 2025 May 27 [cited 2026 Apr. 15];29. Available from: https://periodicos.ufmg.br/index.php/reme/article/view/52882