Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Is meconium exposure associated with autism spectrum disorders in children?

  • Jenabi, Ensiyeh (Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences) ;
  • Ayubi, Erfan (Health Promotion Research Center, Zahedan University of Medical Sciences) ;
  • Khazaei, Salman (Research Center for Health Sciences, Hamadan University of Medical Sciences) ;
  • Bashirian, Saeid (Social Determinants of Health Research Center, Hamadan University of Medical Sciences) ;
  • Khazaei, Mojtaba (Department of Neurology, School of Medicine, Hamadan University of Medical Sciences)
  • Received : 2020.06.15
  • Accepted : 2020.08.12
  • Published : 2021.07.15
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Abstract

Background: The results differ among published studies regarding exposure to meconium and the risk of developing autism spectrum disorders (ASDs). Purpose: The present study pooled all of the epidemiologic studies retrieved from broader databases on the association between meconium exposure and risk of developing ASD in children. Methods: The Web of Science, PubMed, Scopus, and Google Scholar databases were searched without language restrictions for articles published between their inception to February 20, 2020, using relevant keywords. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as random-effect estimates of the associations among studies. A subgroup analysis was conducted to explore any potential sources of heterogeneity among studies. Results: The pooled estimate of OR reported a weakly significant association between meconium exposure and ASD development in children (OR, 1.13; 95% CI, 1.03-1.24). There was low heterogeneity among the articles reporting risk for ASD among children (I2=19.3%; P=0.259). The results of subgroup analysis based on meconium exposure showed a significant association between a meconium-stained neonate and ASD development (OR, 1.18; 95% CI, 1.11-1.24). Couclusion: Meconium exposure was weakly associated with an increased risk of ASD. However, more evidence based on large prospective cohort studies is required to provide conclusive evidence about whether meconium exposure is associated with an increased risk of ASD development.

Keywords

Acknowledgement

Hamadan University of Medical Sciences financially supported this study but had no role in the data analysis and interpretation process, writing of the manuscript, or decision to submit the manuscript for publication. The protocol of this study was confirmed by Hamadan University of Medical Sciences with Code 99010537.

References

  1. Miller KM, Xing G, Walker CK. Meconium exposure and autism risk. J Perinatol 2017;37:203-7. https://doi.org/10.1038/jp.2016.200
  2. Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ 2013;346:f2059. https://doi.org/10.1136/bmj.f2059
  3. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res 2009;65:591-8. https://doi.org/10.1203/PDR.0b013e31819e7203
  4. Nath S, Roy R, Mukherjee S. Perinatal complications associated with autism--a case control study in a neurodevelopment and early intervention clinic. J Indian Med Assoc 2012;110:526-9.
  5. Chaste P, Leboyer M. Autism risk factors: genes, environment, and gene-environment interactions. Dialogues Clin Neurosci 2012;14:281-92. https://doi.org/10.31887/DCNS.2012.14.3/pchaste
  6. Moore GS, Kneitel AW, Walker CK, Gilbert WM, Xing G. Autism risk in small- and large-for-gestational-age infants. Am J Obstet Gynecol 2012;206:314.e1-9. https://doi.org/10.1016/j.ajog.2012.01.044
  7. Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics 2014;133:e1241-8. https://doi.org/10.1542/peds.2013-3406
  8. Walker CK, Krakowiak P, Baker A, Hansen RL, Ozonoff S, Hertz-Picciotto I. Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatr 2015;169:154-62. https://doi.org/10.1001/jamapediatrics.2014.2645
  9. Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics 2012;129:e1121-8. https://doi.org/10.1542/peds.2011-2583
  10. Fanaroff AA. Meconium aspiration syndrome: historical aspects. J Perinatol 2008;28 Suppl 3:S3-7. https://doi.org/10.1038/jp.2008.162
  11. Monen L, Hasaart TH, Kuppens SM. The aetiology of meconium-stained amniotic fluid: pathologic hypoxia or physiologic foetal ripening? (Review). Early Hum Dev 2014;90:325-8. https://doi.org/10.1016/j.earlhumdev.2014.04.003
  12. Hutton EK, Thorpe J. Consequences of meconium stained amniotic fluid: what does the evidence tell us? Early Hum Dev 2014;90:333-9. https://doi.org/10.1016/j.earlhumdev.2014.04.005
  13. Beligere N, Rao R. Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review. J Perinatol 2008;28 Suppl 3:S93-101. https://doi.org/10.1038/jp.2008.154
  14. Maimburg RD, Vaeth M. Perinatal risk factors and infantile autism. Acta Psychiatr Scand 2006;114:257-64. https://doi.org/10.1111/j.1600-0447.2006.00805.x
  15. Matsuishi T, Yamashita Y, Ohtani Y, Ornitz E, Kuriya N, Murakami Y, et al. Brief report: incidence of and risk factors for autistic disorder in neonatal intensive care unit survivors. J Autism Dev Disord 1999;29:161-6. https://doi.org/10.1023/A:1023048812202
  16. Piven J, Simon J, Chase GA, Wzorek M, Landa R, Gayle J, et al. The etiology of autism: pre-, peri- and neonatal factors. J Am Acad Child Adolesc Psychiatry 1993;32:1256-63. https://doi.org/10.1097/00004583-199311000-00021
  17. Mrozek-Budzyn D, Majewska R, Kieltyka A. Prenatal, perinatal and neonatal risk factors for autism-study in Poland. Cent Eur J Med 2013;8:424-30.
  18. Bilder D, Pinborough-Zimmerman J, Miller J, McMahon W. Prenatal, perinatal, and neonatal factors associated with autism spectrum disorders. Pediatrics 2009;123:1293-300. https://doi.org/10.1542/peds.2008-0927
  19. Gregory SG, Anthopolos R, Osgood CE, Grotegut CA, Miranda ML. Association of autism with induced or augmented childbirth in North Carolina Birth Record (1990-1998) and Education Research (1997-2007) databases. JAMA Pediatr 2013;167:959-66. https://doi.org/10.1001/jamapediatrics.2013.2904
  20. Wu DM, Wen X, Han XR, Wang S, Wang YJ, Shen M, et al. Relationship between neonatal vitamin D at birth and risk of autism spectrum disorders: the NBSIB study. J Bone Miner Res 2018;33:458-66. https://doi.org/10.1002/jbmr.3326
  21. Winkler-Schwartz A, Garfinkle J, Shevell MI. Autism spectrum disorder in a term birth neonatal intensive care unit population. Pediatr Neurol 2014;51:776-80. https://doi.org/10.1016/j.pediatrneurol.2014.07.009
  22. Gardener H, Spiegelman D, Buka SL. Perinatal and neonatal risk factors for autism: a comprehensive meta-analysis. Pediatrics 2011;128:344-55. https://doi.org/10.1542/peds.2010-1036
  23. Dargaville PA. Respiratory support in meconium aspiration syndrome: a practical guide. Int J Pediatr 2012;2012:965159. https://doi.org/10.1155/2012/965159
  24. Beligere N, Rao R. Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review. J Perinatol 2008;28 Suppl 3:S93-101. https://doi.org/10.1038/jp.2008.154
  25. Rossi AC, Prefumo F. Antepartum and intrapartum risk factors for neonatal hypoxic-ischemic encephalopathy: a systematic review with meta-analysis. Curr Opin Obstet Gynecol 2019;31:410-7. https://doi.org/10.1097/gco.0000000000000581
  26. Li C, Miao JK, Xu Y, Hua YY, Ma Q, Zhou LL, et al. Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis. Eur J Neurol 2017;24:1006-15. https://doi.org/10.1111/ene.13337
  27. Salmaso N, Silbereis J, Komitova M, Mitchell P, Chapman K, Ment LR, et al. Environmental enrichment increases the GFAP+ stem cell pool and reverses hypoxia-induced cognitive deficits in juvenile mice. J Neurosci 2012;32:8930-9. https://doi.org/10.1523/JNEUROSCI.1398-12.2012
  28. Rennie JM, Hagmann CF, Robertson NJ. Outcome after intrapartum hypoxic ischaemia at term. Semin Fetal Neonatal Med 2007;12:398-407. https://doi.org/10.1016/j.siny.2007.07.006