Journal of Autism and Developmental Disorders

, Volume 44, Issue 4, pp 766–775

Maternal Diabetes and the Risk of Autism Spectrum Disorders in the Offspring: A Systematic Review and Meta-Analysis

Original Paper

DOI: 10.1007/s10803-013-1928-2

Cite this article as:
Xu, G., Jing, J., Bowers, K. et al. J Autism Dev Disord (2014) 44: 766. doi:10.1007/s10803-013-1928-2


We performed a systematic literature search regarding maternal diabetes before and during pregnancy and the risk of autism spectrum disorders (ASD) in the offspring. Of the 178 potentially relevant articles, 12 articles including three cohort studies and nine case–control studies were included in the meta-analysis. Both the meta-analyses of cohort studies and case–control studies showed significant associations. The pooled relative risk and 95 % confidence interval (CI) among cohort studies was 1.48 (1.25–1.75, p < 0.001). For case–control studies, the pooled odds ratio and 95 % CI was 1.72 (1.24–2.41, p = 0.001). No indication of significant heterogeneity across studies or publication bias was observed. In conclusion, maternal diabetes was significantly associated with a greater risk of ASD in the offspring.


Autism spectrum disorders Diabetes Pregnancy 



Autism diagnostic interview-revised


The autism diagnostic observation schedule


Autism spectrum disorders


The childhood autism rating scale


Confidence interval


The diagnostic and statistical manual of mental disorders, fourth edition


International classification of diseases


Odds ratio


Relative risk

Supplementary material

10803_2013_1928_MOESM1_ESM.doc (136 kb)
Supplementary material 1 (DOC 136 kb)

Copyright information

© Springer Science+Business Media New York (outside the USA) 2013

Authors and Affiliations

  1. 1.Department of Maternal and Child Health, School of Public HealthSun Yat-Sen UniversityGuangzhouChina
  2. 2.Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Institutes of HealthRockvilleUSA

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