| Neonatal risk factors associated with autism spectrum disorders: An umbrella review |
Amir Mohammad Salehi1 
, Erfan Ayubi2
, Salman Khazaei3
, Ensiyeh Jenabi4
, Saeid Bashirian5
, Zohreh Salimi4
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1Student Research Committee, Hamadan University of Medical Sciences School of Medicine, Hamadan, Iran
2Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
3Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
4Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
5Professor of Health Education, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran |
Correspondence:
Ensiyeh Jenabi, Email: En.jenabi@yahoo.com
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Received: 22 January 2024 • Revised: 27 April 2024 • Accepted: 9 May 2024 |
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| Abstract |
Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors.
Purpose
This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews.
Methods
We conducted a systematic search of interna-tional databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist.
Results
A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta-analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17–1.52), macrosomia (OR, 1.11; 95% CI, 1.05–1.18), low birth weight (OR, 1.63; 95% CI, 1.48–1.81), very low birth weight (OR, 2.25; 95% CI, 1.79–2.83), small for gestational age (OR, 1.17; 95% CI, 1.09–1.24), jaundice (OR, 1.74; 95% CI, 1.42–2.12), male sex (OR, 1.47; 95% CI, 1.39–1.55) and 1-minute Apgar score <7 (OR, 1.40; 95% CI, 1.26–1.55) were graded as suggestive evidence (class III). Only 3 studies reported heterogeneity (I2<50%). Based on the AMSTAR2 analysis, the methodological quality was critically low in 3 meta-analyses, low in 2, and moderate in 1.
Conclusion
Based on these results, clinicians should consider the risk factors for ASD and screen children in clinics. |
| Key Words:
Autism spectrum disorder, Risk factors, Neonatal, Umbrella review |
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