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Prenatal, perinatal, and postnatal factors associated with autism: A meta-analysis
Chengzhong Wang1, Hua Geng, Weidong Liu
1Department of Pediatrics, Maternal and Child Health Hospital of Yancheng, Yancheng City, Jiangsu Province, P.R. China.
Insights
This meta-analysis identified prenatal, perinatal, and postnatal risk factors for autism in children. Advanced maternal/paternal age and certain pregnancy complications were associated with increased autism risk.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Public Health
Background:
- Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition.
- Identifying risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To conduct a meta-analysis investigating prenatal, perinatal, and postnatal risk factors associated with autism in children.
- To synthesize evidence from multiple studies to identify key risk indicators.
Main Methods:
- Systematic literature search of PubMed, Embase, and Web of Science databases.
- Inclusion of 17 studies encompassing 37,634 autistic children and 12,081,416 non-autistic children.
- Application of fixed-effects or random-effects models for pooled effect estimation.
Main Results:
- Prenatal factors linked to increased autism risk: advanced maternal/paternal age (≥35 years), White/Asian parental race, gestational hypertension/diabetes, higher parental education, threatened abortion, antepartum hemorrhage.
- Perinatal factors: Cesarean delivery, preterm birth (≤36 weeks), high parity (≥4), spontaneous/induced/no labor, breech presentation, preeclampsia, fetal distress.
- Postnatal factors: low birth weight, postpartum hemorrhage, male gender, brain anomaly. High parity (≥4) and female gender were associated with decreased risk.
Conclusions:
- The meta-analysis confirms associations between specific prenatal, perinatal, and postnatal factors and autism risk.
- Individual factors' causality or secondary role in autism development remains unclear.
- Further research is needed to validate findings and explore the impact of multiple interacting factors on autism.
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.
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