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Impaired Gas Exchange at Birth and Risk of Intellectual Disability and Autism: A Meta-analysis

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Abstract

We conducted meta-analyses of 67 studies on the association between neonatal proxies of impaired gas exchange and intellectual disability (ID) or autism spectrum disorders (ASD). Neonatal acidosis was associated with an odds ratio (OR) of 3.55 [95 % confidence interval (95 % CI) 2.23–5.49] for ID and an OR of 1.10 (95 % CI 0.91–1.31) for ASD. Children with a 5-min Apgar score of <7 had an OR of 5.39 (95 % CI 3.84–7.55) for ID and an OR of 1.67 (95 % CI 1.34–2.09) for ASD. O2 treatment was associated with an OR of 4.32 (95 % CI 3.23–5.78) for ID and an OR of 2.02 (95 % CI 1.45 to 2.83) for ASD. Our meta-analysis demonstrates an increased risk of ID and (to a lesser extent) ASD in children with neonatal hypoxia. Moreover, our findings raise the possibility that concomitant ID might account for the observed association between the gas exchange proxies and ASD.

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Acknowledgments

This work was supported by the Seaver Foundation. AM is a Seaver Fellow.

Author Contributions

AM, AR, and PB developed the idea and drafted the protocol. AM and JM searched the literature, screened the studies and extracted the data. AM and AR conducted the analyses. PB provided statistical consultations. AM and JM wrote the first draft. All authors read, critically revised, and approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, USA

    Amirhossein Modabbernia, Josephine Mollon & Abraham Reichenberg

  2. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Amirhossein Modabbernia & Abraham Reichenberg

  3. Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Amirhossein Modabbernia & Abraham Reichenberg

  4. Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK

    Josephine Mollon

  5. Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Paolo Boffetta

  6. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Paolo Boffetta

  7. Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Abraham Reichenberg

Authors
  1. Amirhossein Modabbernia
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  2. Josephine Mollon
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  3. Paolo Boffetta
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  4. Abraham Reichenberg
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Corresponding author

Correspondence to Amirhossein Modabbernia.

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Modabbernia, A., Mollon, J., Boffetta, P. et al. Impaired Gas Exchange at Birth and Risk of Intellectual Disability and Autism: A Meta-analysis. J Autism Dev Disord 46, 1847–1859 (2016). https://doi.org/10.1007/s10803-016-2717-5

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