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Fetal Growth Restriction, Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder-Connecting the Dots:
Alexios Kozonis1, Maria Papadoliopoulou2, Ioannis Margaris2
13rd Department of Obstetrics and Gynaecology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 12462 Athens, Greece.
Insights
Fetal growth restriction (FGR) may be linked to autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but current research offers limited evidence. More studies are needed to confirm this association in FGR children.
Area of Science:
- Perinatal medicine
- Neurodevelopmental disorders
- Pediatric neurology
Background:
- Fetal growth restriction (FGR), previously known as intrauterine growth retardation (IUGR), signifies a fetus' inability to achieve its genetic growth potential.
- Emerging evidence suggests a potential link between FGR and the development of autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD).
- However, robust scientific literature supporting this association is currently limited.
Purpose of the Study:
- To review existing literature on the associations between FGR and ASD or ADHD.
- To explore potential underlying mechanisms explaining these associations.
- To evaluate the strength of evidence linking FGR to neurodevelopmental disorders.
Main Methods:
- A systematic electronic literature search was conducted using PubMed/MEDLINE and Scopus databases.
- Keywords included 'Autism spectrum disorder,' 'Attention deficit hyperactivity disorder,' 'neurodevelopmental disorders,' 'intrauterine growth retardation (IUGR),' and 'fetal growth restriction (FGR).'
Main Results:
- Few studies have investigated the risk of ASD or ADHD in children with IUGR/FGR.
- While IUGR/FGR is associated with cognitive impairment and behavioral issues, the specific link to ASD or ADHD remains unclear due to inconsistent findings.
- Some studies suggest a potential increased risk for ASD, but most lack statistical significance.
Conclusions:
- The current body of literature provides limited evidence to substantiate a general association between FGR and ASD or ADHD.
- Further research is required to clarify the relationship and potential etiological mechanisms.
Background/Objectives:
Fetal growth restriction (FGR), formerly known as intrauterine growth retardation (IUGR), is defined as a fetus' failure to reach its genetically predetermined growth potential. FGR has also been implicated in the development of autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD), though strong supporting literature has yet to be published. This study aims to review the existing associations between FGR and autism spectrum disorder or attention-deficit hyperactivity disorder as studied in relevant literature, as well as the mechanisms that provide explanation of that association.
Methods:
We used a combination of the terms 'Autism spectrum disorder' OR 'Attention deficit hyperactivity disorder' OR 'neurodevelopmental disorders' AND 'intrauterine growth retardation (IUGR)' OR 'fetal growth restriction (FGR)' in an electronic search of PubMed/MEDLINE and Scopus databases.
Results:
After evaluating the existing literature, we found only a few studies assessed the risk of developing ASD or ADHD in IUGR/FGR children. Neurodevelopmental disorders have generally been linked to very low birth weight, small for gestational age neonates (SGA), prematurity, somatic mutations, and intrauterine caffeine and alcohol exposure. While available evidence supports the notion that IUGR/FGR is related to cognitive impairment and behavioural disorders, the association with ASD or ADHD remains elusive due to the marked variability in the reported outcomes. Few studies have reported a respective higher risk for autism spectrum disorders, yet most of them have failed to identify a statistically significant correlation.
Conclusions:
While autism spectrum disorders and attention deficiency disorder have been generally associated with FGR children, the existing body of literature offers limited evidence to support this theory.
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