Pre-, peri-, and neonatal risk factors for autism.

Acta Obstet Gynecol Scand. 2011 Nov 15. doi: 10.1111/j.1600-0412.2011.01325.x. [Epub ahead of print]
Pre-, peri-, and neonatal risk factors for autism.
Guinchat V, Thorsen P, Laurent C, Cans C, Bodeau N, Cohen D.
SourceDepartment of child and adolescent psychiatry. Pitié-Salpêtrière Universitary Hospital, Paris, France Department of Obstetrics and Gynecology, Lillebaelt Hospital, Kolding, Denmark, Biotechnology and Biotherapy Unit, Research Centre-Brain and spinal cord Institute, Pierre and Marie Curie University /INSERM UMR_S 975/C.N.R.S. UMR 7225, Pitié-Salpêtrière Hospital, Paris, France, and Register for Disabled Children and the Isère county Perinatal Survey, Grenoble, France.

Abstract
Objective. To identify pre-, peri-, and neonatal risk factors for Pervasive Developmental disorders (PDD). Methods. We searched the Medline database through March 2011 for relevant case control and population based studies on pre-, peri-, and neonatal hazards related to Pervasive Developmental Disorders (PDD) including autism. We identified 85 studies for this review. Data were extracted systematically and organised according to risk factors related to family history, pregnancy, gestational age, delivery, birth milestones and the neonate's condition at birth. Results. During the prenatal period, risk factors for PDD were advanced maternal or paternal ages, being firstborn vs. third or later, maternal prenatal medication use, and mother's status as foreign born. During the perinatal and neonatal periods, the risk factors for PDD were preterm birth, breech presentation, planned cesarean section, low Apgar scores, hyperbilirubinemia, birth defect, and a birthweight small-for-gestational age. The influence of maternal preeclampsia, diabetes, vomiting, infections, and stress during pregnancy need to be studied more are insufficiently studied, to state. Discussion. Despite evidence for the association of some pre-, peri-, and neonatal risk factors associated with PDD, it remains unclear whether these risks are causal or play a secondary role in shaping clinical expression in individuals with genetic vulnerability. A plausible hypothsesis is that improvements in obstetrical and neonatal management have led to an increased rate of survivors with pre-existing brain damage. Given the variety of risk factors, we propose that future studies should investigate combinations of multiple factors, rather than focusing on a single factor.

© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.