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Impaired Gas Exchange at Birth and Risk of Intellectual Disability and Autism: A Meta-analysis

Amirhossein Modabbernia1,2,3, Josephine Mollon4,5, Paolo Boffetta6,7

  • 1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, USA. amirhossein.modabbernia@mssm.edu.

Journal of Autism and Developmental Disorders
|January 29, 2016
PubMed

Insights

Neonatal hypoxia, indicated by acidosis or low Apgar scores, significantly increases the risk of intellectual disability (ID) and autism spectrum disorder (ASD) in children. These findings highlight critical links between infant gas exchange and neurodevelopmental outcomes.

Area of Science:

  • Perinatal Medicine
  • Neurodevelopmental Disorders
  • Pediatric Neurology

Background:

  • Impaired gas exchange during the neonatal period is a potential risk factor for adverse neurodevelopmental outcomes.
  • Intellectual disability (ID) and autism spectrum disorders (ASD) are complex neurodevelopmental conditions with multifactorial etiologies.
  • Understanding the impact of neonatal factors on long-term neurodevelopment is crucial for early intervention and prevention strategies.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the association between neonatal proxies of impaired gas exchange and the risk of intellectual disability (ID) or autism spectrum disorders (ASD).
  • To quantify the risk of ID and ASD associated with specific indicators of neonatal hypoxia, such as acidosis, low Apgar scores, and oxygen treatment.

Main Methods:

  • Meta-analysis of 67 studies examining the relationship between neonatal gas exchange indicators and neurodevelopmental outcomes.
  • Calculation of odds ratios (OR) with 95% confidence intervals (CI) to assess the strength of association.

Main Results:

  • Neonatal acidosis was linked to a significantly higher odds ratio for ID (OR 3.55) and a non-significant trend for ASD (OR 1.10).
  • A 5-minute Apgar score below 7 showed a strong association with increased odds of ID (OR 5.39) and ASD (OR 1.67).
  • Oxygen treatment in neonates was associated with elevated odds for both ID (OR 4.32) and ASD (OR 2.02).

Conclusions:

  • Neonatal hypoxia, evidenced by acidosis, low Apgar scores, and oxygen therapy, is associated with an increased risk of intellectual disability and, to a lesser extent, autism spectrum disorders.
  • The findings suggest that impaired neonatal gas exchange is a significant risk factor for neurodevelopmental disorders.
  • The study posits that intellectual disability may mediate the observed association between neonatal gas exchange proxies and autism spectrum disorders.

Keywords:
AsphyxiaAutismHypoxiaIntellectual disabilityNeonatalPerinatal

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