Rethinking autism: the impact of maternal risk factors on autism development

Autism spectrum disorders (ASD) are a group of lifelong neurodevelopmental disorders characterized by cognitive deficits and impaired social and communicative development that have been rising in prevalence in recent decades. These disorders may be accompanied by disabling health issues and often lead to a substantial economic burden. The causes and mechanisms of ASD have not yet been fully elucidated, although it has been reported that genetic background, epigenetic modification, and environmental risk factors all contribute to the development of ASD. Environmental factors, which include prenatal circumstances or events, all play a very important role in the early development of autism, yet the exact mechanism remains largely undetermined. In this review, we promote a 'rethinking' of autism as a neurodevelopmental disease that originates from early life development. We focus on the impact of the prenatal and maternal risk factors such as maternal diabetes, prenatal chemical exposure, and hormone imbalances during pregnancy on the risk for ASD development in children and offspring, identifying important pathological bases and prevention measures for future decades. Further research focused on understanding the role of the environmental factors in the etiology of ASD will drive forward innovation strategies towards intervention and the prevention of the maternal risk factors for autism.