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The aetiology of autism is unknown, although prenatal exposures have been
the focus of epidemiological research for over 40 years.
To provide the first quantitative review and meta-analysis of the
association between maternal pregnancy complications and
pregnancy-related factors and risk of autism.
PubMed, Embase and PsycINFO databases were searched for epidemiological
studies that examined the association between pregnancy-related factors
and autism. Forty studies were eligible for inclusion in the
meta-analysis. Summary effect estimates were calculated for factors
examined in multiple studies.
Over 50 prenatal factors have been examined. The factors associated with
autism risk in the meta-analysis were advanced parental age at birth,
maternal prenatal medication use, bleeding, gestational diabetes, being
first born v. third or later, and having a mother born abroad. The
factors with the strongest evidence against a role in autism risk
included previous fetal loss and maternal hypertension, proteinuria,
pre-eclampsia and swelling.
There is insufficient evidence to implicate any one prenatal factor in
autism aetiology, although there is some evidence to suggest that
exposure to pregnancy complications may increase the risk.
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