Association between maternal asthma and ASD/ADHD in offspring: A meta-analysis based on observational studies

This meta-analysis aims to examine the association between maternal asthma and autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) in offspring. A literature search was performed in PubMed, Web of Science, Embase, and the Cochrane Library from electronic database inception to October 2024 for studies on the relationship between asthma and ASD/ADHD. The definition of maternal asthma was "asthma existing prior to childbirth". The primary outcome was the incidence of ASD/ADHD in the offspring. This meta-analysis incorporated 5 cohort studies and 7 case-control studies. The statistical results suggested that there is a higher incidence of ASD (odds ratio (OR) = 1.36, 95% confidence interval (95%CI) = 1.28-1.44, P < 0.001) and ADHD (OR = 1.43, 95% CI = 1.37-1.51, P < 0.001) in offspring with maternal asthma compared to the control group. The subgroup analysis revealed that there was no difference in ASD incidence between maternal asthma group and control group in subgroup of female (OR = 1.81, 95%CI = 0.72-4.25, P = 0.205). However, in subgroup of male, the incidence of ASD was higher in the maternal asthma group than the control group (OR = 1.28, 95%CI = 1.01-1.61, P = 0.04). Furthermore, an elevated incidence of ADHD was observed in the maternal asthma group compared to the control group, both in male offspring (OR = 1.36, 95%CI = 1.30-1.42, P < 0.001) and female offspring (OR = 1.45, 95%CI = 1.38-1.53, P < 0.001) subgroups. This study indicates that maternal asthma may have a potential association with ASD and ADHD in the offspring.